What is cognitive behavioural therapy?
Cognitive behavioural therapy (CBT) is a form of psychotherapeutic treatment that has been demonstrated to be effective for a range of problems. Many research studies have proven that CBT leads to significant improvement in functioning and quality of life. It has also been demonstrated to be as effective as or even more effective than other forms of psychological therapy or psychiatric medications. In CBT, negative thoughts are identified, challenged, and replaced with more objective, realistic thoughts to help the individual cope.
The core principles of CBT are:
Challenging unhealthy ways of thinking
Learning to identify patterns or unhelpful behaviour
Learning better ways of coping with psychological problems to help relieve symptoms and become more effective in life
Types of cognitive behavioural therapy
Cognitive therapy focuses on identifying and changing inaccurate or distorted thinking patterns, emotional responses, and behaviours.
Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy addresses negative thoughts and behaviours and uses strategies like emotional regulation or mindfulness to change these thoughts or behaviours.
Multimodal therapy addresses seven different, but interconnected, modalities: behaviour, affect, sensation, imagery, cognition, interpersonal facts and drug or biological situations.
Rational emotive behaviour therapy (REBT)
Rational emotive behaviour therapy identifies irrational beliefs and actively challenges them. This also helps individuals learn to recognise harmful thought patterns and learn to change them.
Cognitive behavioural therapy includes many different techniques to identify and change unhealthy ways of thinking and behaviours. Some exercises to aid in these techniques might include: journaling, role playing, relaxation techniques, mental distractions, and many more
Identifying negative thoughts
Negative thoughts, feelings and situations can contribute to maladaptive behaviours, and the process of identifying them can be difficult. However, identifying them can lead to self discovery and insights about oneself, and is an essential part of the treatment process.
Practising new skills
It is important to practise new skills that can be put into use in real life situations to get comfortable and familiar with them. This could be practising new coping mechanisms and rehearsing ways to avoid or deal with social situations that can trigger someone.
Goal setting is an important step in recovery, and helps an individual make changes to improve their health and life. The process includes identifying goals and distinguishing if they are long term or short term goals. The individual’s therapist will bring up the acronym SMART goals, which refers to specific, measurable, attainable, relevant and time-based goals, and will make sure that they focus on the process as much as the end recovery.
Learning problem solving skills can help identify and solve problems that come from stressful situations in life and reduce their negative impact. This includes five steps:
Identifying the problem
Generating a list of solutions
Evaluating the strengths and weaknesses of each solution
Choosing which solution to use
Implementing the solution
This is also known as diary work and is an important part of CBT. This involves tracking behaviours, symptoms, experiences, and sharing them with their therapist. This can provide essential information to the therapist to choose the best treatment.
Psychological problems that cognitive behavioural therapy can help with
Drug or alcohol addiction
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)
In cognitive behavioural therapy sessions, individuals are encouraged to talk about their thoughts and feelings and to shed light on what is troubling them. If the individual is finding it hard to open up and talk about these things, the therapist would work towards helping them gain confidence.
Cognitive behavioural therapy uses a goal-oriented approach, which means that the individual and the therapist would work together to target specific problems raised by the individual.
Other things that the therapist might do is set “homework” - this might include activities or reading that can be done at home, and practises that build on what is learned in therapy sessions. This can encourage the individuals to apply learned things in daily life, therefore making the therapy sessions more effective.
However, the different techniques used by the therapist would vary from person to person, since the therapist designs a structure that is personalised based on an individual’s situation and preferences. The therapist might also choose to combine cognitive behavioural therapy with another therapeutic approach.
Cognitive behavioral therapy can help you:
Manage symptoms of mental illness
Prevent relapse of symptoms
Treat mental illness when medication is not an option
Learn coping strategies with stressful life situations
Cope with grief and loss
Overcome emotional trauma
And so much more
Cognitive behavioural therapy is one of the most well studied forms of treatment, and is the leading evidence based treatment for eating disorders. It can also be very helpful to those suffering with insomnia, and those affected with pain or mood disorders. CBT has been scientifically proven to be effective in treating symptoms of depression and anxiety in children and adolescents, and has a high level of empirical support for treatment of substance use disorders by improving self control, avoiding triggers, and developing coping mechanisms.
Risks and side effects
There is little risk to cognitive behavioural therapy. The individual undergoing therapy may feel emotionally uncomfortable at times, and may even cry, get upset, or feel angry during a difficult session, as CBT explores painful feelings, emotions and experiences. However, once this is overcome, many coping skills to help manage and conquer negative feelings or fears would be established.
Therapists understand that cognitive behavioural therapy is not for everyone. Therefore, there are a range of alternative treatments that a therapist might talk about during your assessment before any sort of therapy.
Some of these alternatives might include:
Despite these alternatives, some may choose to only take medication, and some may even choose not to seek professional help.