According to the Beck Institute, in clinical terms, Cognitive Behavioral Therapy or CBT is a specific theoretical therapy that is used as a psychological treatment. Since its creation in the 1960s by Dr. Aaron Beck and Dr. Judith Beck, CBT has been proven to help reduce the symptoms associated with a range of mental health concerns including diagnoses like Anxiety, Depression, Substance Abuse, PTSD, Marriage and Relationship issues as well as many other chronic mental health concerns.
CBT has been clinically proven to be as effective as medication in many instances. At other times, CBT is a helpful adjunct to medication therapy. Specifically, CBT helps the patient or client to identify the ways in which their thoughts and behaviors contribute to their mental health concerns.
The basis for cognitive behavioral therapy is embedded in the idea that psychological problems are at least partially influenced by maladaptive thought patterns. Furthermore, CBT recognizes that mental health issues are further solidified within unhealthy patterns of behavior that make our mental state feel worse. Finally, CBT provides a way to manage this and develop more helpful and constructive ways of dealing with patients’ lives and the issues that come up in them.
Changing the way that we think has a profound effect on our well-being. Remembering that thoughts become feelings and our emotional state affects even our heart rate and breathing patterns. CBT typically includes these steps according to the Mayo Clinic:
- Identify troubling situations or conditions in your life. These may include such issues as a medical condition, divorce, grief, anger or symptoms of a mental health disorder. You and your therapist may spend some time deciding what problems and goals you want to focus on.
- Become aware of your thoughts, emotions and beliefs about these problems. Once you’ve identified the problems to work on, your therapist will encourage you to share your thoughts about them. This may include observing what you tell yourself about an experience (self-talk), your interpretation of the meaning of a situation, and your beliefs about yourself, other people and events. Your therapist may suggest that you keep a journal of your thoughts.
- Identify negative or inaccurate thinking. To help you recognize patterns of thinking and behavior that may be contributing to your problem, your therapist may ask you to pay attention to your physical, emotional and behavioral responses in different situations.
- Reshape negative or inaccurate thinking. Your therapist will likely encourage you to ask yourself whether your view of a situation is based on fact or on an inaccurate perception of what’s going on. This step can be difficult. You may have long-standing ways of thinking about your life and yourself. With practice, helpful thinking and behavior patterns will become a habit and won’t take as much effort.
An example could be: ‘I always mess up relationships.’
The next step becomes to challenge the maladaptive thought with a more healthy or realistic thought. In the example above it would be helpful to examine the use of ‘always.’ Instead, a healthy way to frame the above thought might be to make the statement, ‘My last relationship didn’t work out but I learned a lot from it.’
By managing our thinking instead of being overcome by it, we empower ourselves and set up a more positive feedback loop to our thoughts, feelings, mind/body connection and even into our relationships. Another benefit to CBT is that problem solving skills are enhanced. Cognitive behavioral therapy is very much focused on the present, in contrast to psychoanalytic counseling which will spend a lot of time fostering informed connections between early childhood experiences and present day defense mechanisms and mental health concerns. In CBT, your therapist is most concerned about what is happening in the here and now, and it is within the present moment that we have the opportunity to change.
The therapist and client collaborate in a mutual fashion by challenging unhealthy thinking, enhancing the development of positive emotional feedback loops and by planning for enhanced wellness. Just as with all forms of counseling, it is not just about the therapy that happens in the 53 minute hour, but CBT especially uses homework exercises to help the clients solidify the changes that they are working on. CBT is one of the most effective tools and some therapists will use it along with other forms of therapy to further benefit the clients’ needs.
In summary, because of its clear research support, CBT is a first-line treatment for many disorders, as noted by the National Institute for Health and Care Excellence’s guidelines and American Psychological Association.
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David D, Cristea I, Hofmann SG. Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Front Psychiatry. 2018 Jan 29;9:4. doi: 10.3389/fpsyt.2018.00004. PMID: 29434552; PMCID: PMC5797481.