Cognitive behavioural therapy (CBT) is a type of psychotherapeutic treatment (talk therapy). It combines cognitive therapy with behaviour therapy to help people learn how to identify and change destructive or disturbing thought patterns, emotional responses, or behaviours and replace them with more desirable or helpful patterns. Mental health professionals, including psychologists, therapists and counsellors, use CBT to treat or manage mental health conditions and emotional concerns. It’s one of the best and most common forms of psychotherapy.
CBT focuses on changing the negative thoughts that can contribute to and worsen emotional difficulties, anxiety, and depression. These spontaneous negative thoughts also have a detrimental influence on your mood. Through CBT, faulty thoughts are identified, challenged, and replaced with more objective, realistic thoughts. During CBT, a mental health professional closely examines your thoughts and emotions. They help you understand how your thoughts affect your actions.
You can learn to replace negative thoughts and behaviours through CBT and adopt healthier thinking patterns and habits. CBT usually takes place over a limited number of sessions. Your therapist uses a question-and-answer format that helps you gain a different perspective. You learn how to respond better to stress, pain and difficult situations. CBT can be used alone or along with medication or other therapies. Your therapist will help you find the best treatment based on your issue.
Types of Cognitive Behavioral Therapy(CBT)
CBT involves various techniques and approaches that help your emotions, thoughts, and behaviours. From structured psychotherapies to self-help practices, it involves specific types of therapeutic approaches, such as:
Cognitive therapy: You will learn to identify and change manipulated or distorted thought patterns, emotional responses, and behaviours.
Dialectical behaviour therapy (DBT): It helps treat destructive or disturbing thoughts and behaviours by incorporating treatment strategies such as mindfulness and emotional regulation.
Multimodal therapy: It includes seven different but interconnected modalities: affect, imagery, behaviour, sensation, cognition, interpersonal factors, and drug/biological considerations to treat psychological issues.
Rational emotive behaviour therapy (REBT): In REBT, you learn to identify irrational beliefs and actively challenge these beliefs. Also, learn to recognise and change these thought patterns.
All types of cognitive behavioural therapy work to treat the underlying thought patterns that contribute to psychological distress and take different approaches.
Cognitive Behavioral Therapy Techniques
CBT uses a wide range of strategies to help people to identify and overcome thought patterns. Here are a few examples of techniques used in cognitive behavioural therapy(CBT).
Identifying Negative Thoughts
Learning what thoughts, feelings, and situations contribute to maladaptive or harmful behaviours is important. This process can be difficult, especially for people who struggle with self-analysis. However, taking the time to identify these thoughts can help you learn about yourself and provide insights essential to the treatment process.
Practicing New Skills
In cognitive behavioural therapy, a new skill can be taught that can be used in real-world situations. If someone has a substance use disorder, they might practice new coping skills and rehearse them. So they can avoid or deal with social situations that could potentially trigger a relapse.
Goal-Setting
It is one of the most important steps and helps in recovery from mental illness. Goal setting can help you to make changes to improve your health and life. During cognitive behavioural therapy, your therapist can help you build and strengthen your goal-setting skills. This might involve teaching you how to identify your goal or distinguish between short- and long-term goals. Your therapist can also help you set SMART goals (measurable, specific, attainable, relevant, and time-based), focusing on the process as much as the end outcome.
Problem-Solving
Learning problem-solving skills during cognitive behavioural therapy can help you learn how to identify and solve problems that may arise from big and small life stressors. It can also help reduce the negative impact of psychological and physical illness. Problem-solving in CBT often involves five steps:
- Identify the problem.
- Make a list of potential solutions.
- Evaluate the strengths and weaknesses of each potential solution.
- Choose the best solution.
- Implement the solution.
Self-Monitoring
Also known as diary work, self-monitoring is an important cognitive behavioural therapy technique. Your therapist advises you to write a diary every day. It helps to track behaviours, symptoms, or experiences over time and share them with your therapist. Self-monitoring can provide your therapist with the information they need to give you the best treatment. People with eating disorders can track their eating habits and any thoughts or feelings that arise when eating a meal or snack.
Conditions Cognitive Behavioural Therapy (CBT) Can Treat
Cognitive behavioural therapy (CBT) is a valuable and helpful tool for treating and managing a wide range of mental health conditions and emotional concerns. It is effective for people of all ages (including children). Psychologists and therapists can use CBT to treat many mental health conditions, such as:
- Anxiety.
- Depression.
- Personality disorders.
- Eating disorders, including binge eating disorder, bulimia, or anorexia.
- Attention-deficit/hyperactivity disorder (ADHD).
- Obsessive-compulsive disorder (OCD).
- Post-traumatic stress disorder (PTSD).
- Phobias.
- Substance use disorder and alcohol use disorder.
CBT is useful when combined with medication to treat schizophrenia and bipolar disorder. It is also effective in helping manage nonpsychological medical conditions, such as:
- Insomnia.
- Migraines.
- Chronic fatigue syndrome.
- Irritable bowel syndrome (IBS).
- Fibromyalgia and other causes of chronic pain.
CBT is also helpful for people to cope with life changes and everyday challenges. Many might seek help for issues such as:
- Problems at work.
- Relationship issues.
- Divorce.
- Stress and coping difficulties.
- Grief.
- Adjusting to a medical condition or new life situation.
Benefits of Cognitive Behavioral Therapy (CBT)
The concept behind CBT is that thoughts and feelings play a fundamental role in behaviour. For example, a person who spends much time thinking about runway accidents, plane crashes, and other air disasters may avoid air travel. CBT aims to teach people that they cannot control every aspect of the world around them; they can control how they interpret and deal with things around them. CBT is known for providing benefits such as:
- It helps develop healthier thought patterns by identifying the negative and often unrealistic thoughts that influence feelings and moods.
- It is effective to treat a wide variety of maladaptive behaviours.
- It can be used for those who don’t require psychotropic medication.
- It is an effective short-term treatment option as improvements can often be seen in five to 20 sessions.
- It is effective whether therapy occurs online or face-to-face.
- It is often more affordable than some other types of therapy.
Effectiveness of Cognitive Behavioral Therapy (CBT)
Cognitive behavioural therapy emerged during the 1960s and originated by psychiatrist Aaron Beck. He noted that certain types of thinking contributed to emotional problems. Beck labelled these “automatic negative thoughts” and developed the process of cognitive therapy. Earlier behaviour therapies had focused almost exclusively on associations, reinforcements, and punishments to modify behaviour. The cognitive approach addresses how feelings and thoughts affect behaviours.
Today, cognitive behavioural therapy is one of the best and most well-studied forms of treatment. Research indicates that cognitive behavioural therapy is the leading evidence-based treatment for eating disorders. A meta-analysis of 41 studies in 2018 found that CBT helped improve symptoms in people with anxiety and anxiety-related disorders, such as obsessive-compulsive disorder (OCD) and post-traumatic stress disorder(PTSD).
Cognitive behavioural therapy has also been scientifically proven to be effective in treating symptoms of depression and anxiety in children and adolescents. Other researchers show that CBT has been proven helpful for people with insomnia and those who have a medical condition that interferes with sleep (pain or mood disorders such as depression).
Cognitive behavioural therapy has a high level of empirical support for the treatment of substance use disorders. It has been proven to help people with these disorders improve self-control, avoid triggers, and develop coping mechanisms for daily stressors. CBT is one of the most researched therapy types because treatment focuses on specific goals, and results can be measured relatively easily.
Things to Consider With Cognitive Behavioral Therapy
People may face many challenges when engaging in cognitive behavioural therapy. Here are a few things you must consider.
Change can be Difficult.
Some people do not accept changes easily. Identifying that certain thoughts are not rational or healthy is difficult for them. So, becoming aware of these thoughts does not make it easy to alter them.
CBT is very Structured.
Cognitive behavioural therapy does not only focus on underlying, unconscious resistance to change but also other things, such as psychoanalytic psychotherapy. CBT may not be suitable for people who want to more freely explore their past and their emotions or who may find structure difficult.
You must be Willing to Change.
For cognitive behavioural therapy to be effective, you must be ready and willing to analyse your thoughts and feelings. This self-analysis can be difficult for many, but it is a great way to learn more about how your feelings and thoughts impact your behaviour.
Progress is often Gradual.
CBT is a gradual process that helps you take incremental steps toward behavioural change. For example, someone with social anxiety might start imagining anxiety-provoking social situations like friends getting to a party. The next step is to practice conversations with friends, family, and acquaintances. Gradually working toward a larger goal makes the process less hectic and makes it easier to achieve goals. Remember, CBT therapy is no magic; all it takes is time and effort.
How to Get Started With Cognitive Behavioral Therapy (CBT)?
Cognitive behavioural therapy is one of the best and most effective treatment choices for a range of psychological issues. If you or your loved one might benefit from CBT therapy, consider these steps:
Consult with your physician: Talk to your doctor or check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a licensed professional in your area. You can also do a search for “cognitive behavioural therapy near me” to find local therapists who specialise in this type of therapy.
Consider your preferences: Choose what will work best for you, face-to-face or online CBT therapy.
Contact your health insurance: See if your health insurance covers cognitive behavioural therapy and how many sessions are covered per year.
Make an appointment: After choosing your therapist, book your appointment. Mark it on your calendar so you don’t forget it or accidentally schedule something else during that time.
Show up for your first session: Prepare yourself with an open mind and positive attitude. Be ready to identify the thoughts and behaviours holding you back. Commit to learning how to replace those thoughts and move forward to make things better.
How does Cognitive Behavioural Therapy (CBT) Work?
If you are new to cognitive behavioural therapy, you may have concerns or fears about what to expect. In many ways, the first session begins like your first appointment with any new healthcare provider. Cognitive behavioural therapy is an evidence-based treatment grounded in theory and skill-based dialogue (conversations). It provides a supportive, non-judgmental, safe environment that allows you to talk openly with psychologists and therapists. They are trained to help you with your issues.
Cognitive behavioural therapy requires limited sessions (5 to 20) depending on your issues. It is a gradual process and takes time, so you should not expect results immediately. Think of your therapist as a partner working with you through a process. You can mark your progress over time if you keep working together toward your goals. Here’s how it works. Your therapist will:
Gain an understanding of the issue: At the start of therapy, discuss the challenges you are dealing with, symptoms you’ve noticed and any concerns you have. Don’t be shy and trust your therapist; it is the only one who can help you. Tell your therapist if you have been diagnosed with a mental health condition. It is the first and most important step to help you set therapy goals.
Ask a series of questions: Depending on your issue, your therapist may ask you questions. Be prepared to answer questionsabout what brought you to therapy, your symptoms, and your history, including your childhood, relationships (family, romantic, friends), education, career, and current living situation. Discuss an incident in your past, fears or phobias, troubling behaviours or your thoughts and feelings. So they get the idea of what challenges you are facing. Together, you will explore your answers to get insight into how you respond to challenges in your life.
Help you recognise problematic thoughts and behaviours: Your therapist will encourage you through interactive question-and-answer sessions. They help you learn how to respond to tough situations. Together, you will work to identify unhealthy emotions, beliefs or behaviours contributing to your troubles. Your therapist may ask you to write a journal daily about these situations and how you respond to them.
Work with you to adjust your thoughts and behaviours: Your therapist will help you find ways to change negative emotions, thoughts and habits. They help you learn the strategies that change your perspective and
implement them to adopt positive thought patterns and behaviours. Then, you can apply those skills to future situations that help you develop healthier thoughts and behaviour patterns.
