An Introduction to Cognitive Behavioral Therapy (CBT)
Are you searching for a way to cope with a mental health challenge or even with everyday life? Cognitive behavioral therapy (CBT) is an effective approach for many people. CBT can help us learn to relax our minds and bodies while facing— rather than avoiding— challenging situations, relationships, and people.
What is cognitive behavioral therapy?
CBT takes a behaviorist approach to treatment. This means that proponents of CBT believe that behavior is influenced by factors both inside and outside of us and that it can be observed, measured, and changed.
The work of psychologists such as B. F. Skinner and Ivan Pavlov proved behaviorist theories early in the twentieth century. Behavioral psychology then became popular in the United States after World War II, when soldiers returning from battle needed fast, effective treatment for depression, anxiety, and post-traumatic stress disorder. Understanding the link between cognition (thoughts), emotion, and behavior, Americans Albert Ellis and Aaron Beck revolutionized psychology in the 1950s and 1960s, leading to the rise of cognitive behavioral therapy as we now know it.
CBT is a form of short-term talk therapy rooted in the ideas that:
- Unrealistic thoughts drive unhealthy emotions.
- Unhealthy emotions lead to unproductive and self-harming behaviors.
- Symptoms of psychological problems can be relieved, coping skills improved, and negative behaviors changed by learning to notice and examine the core beliefs that are at the heart of difficult emotions, then replacing those thoughts with more rational and affirming ones. In turn, those positive thoughts create desirable behaviors.
In his 1980 book, Feeling Good: The New Mood Therapy, Dr. David Burns identified some of the negative thoughts that drive counterproductive behavior. They include, but are not limited to:
- taking things personally
- confusing emotion with reality
- black and white (rigid) thinking
- overgeneralization
- catastrophizing
- blaming
CBT offers tangible techniques to identify these thoughts, see them for the wrong thinking that they are, recognize the ways in which they harm us, and take concrete steps toward real change. With this newfound clarity, it can become easier to respond to challenges more effectively.
What conditions can be treated with cognitive behavioral therapy?
Among other issues, CBT can be effective for adults, adolescents, children, and couples coping with:
- depression
- anxiety
- addiction
- eating disorders
- insomnia
- post-traumatic stress disorder
- obsessive-compulsive disorder
- phobias
- anger management
- distress associated with chronic pain
- marital discord
CBT has also been demonstrated to help anyone seeking more tools to help them deal successfully with the stresses of daily life.
Does cognitive behavioral therapy work?
As word of mouth spread about the convenience of CBT’s limited-time approach and broad effectiveness has spread, it’s become an increasingly popular and requested modality. It is currently the most widely practiced form of psychotherapy in the United States, with nearly three-fourths of all licensed therapists offering it to at least some patients.
There is an abundance of data to support the idea that CBT is effective for many people. The American Psychological Association says that “Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.” In a 2012 review of CBT studies published by the National Institutes of Health, the authors concluded that “the evidence base [in favor] of CBT is enormous.” By 2018, another NIH study called CBT “the gold standard of psychotherapy.”
What does a cognitive behavioral therapist do?
A cognitive behavioral therapist helps us examine our thoughts to better understand how negative self-perceptions can lead to painful emotions and harmful behaviors. Using the acronym SMART, a CBT provider helps clients define goals for their time together—goals are specific, measurable, achievable, realistic, and time-limited. Working with a cognitive behavioral therapist can change and improve self-esteem, relationships, careers, and lives for the better.
What are some cognitive behavioral interventions?
Different therapists employ different modalities in their CBT practices. The most common include:
- journaling
- talk therapy
- role playing
- cognitive restructuring
- behavior experimentation and deliberate exposure to triggers
- mindfulness and purposeful relaxation
- music therapy
- breathwork
What is cognitive restructuring?
Cognitive distortions are dysfunctional coping skills that we have developed over a long period of time and reframing them takes work. Cognitive restructuring is a technique used by CBT therapists that is unfamiliar to many lay people. While the words used to describe the steps may vary from practitioner to practitioner, the process remains essentially the same.
- Become aware of our reflexive negative thoughts.
- Examine our thoughts for cognitive distortions (errors in our thinking caused by stress).
- Challenge those cognitive distortions. Are they based in reality?
- Replace errors in thinking with realistic alternatives.
What is self-directed cognitive behavioral therapy?
One option for people who don’t have access to a cognitive behavioral therapist is self-directed CBT. For people who are able to function well despite mild to moderate symptoms and issues, the National Alliance on Mental Illness recommends starting with a book that resonates with you, preferably written by an expert and offering concrete steps for you to take (remember to keep a journal). FindCenter offers many options for you to try.
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The mirror reflects perfectly; it makes no mistakes because it doesn’t think. To think is to make mistakes.
