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Cognitive Behavioural Therapy


CBT aims to help people change their thinking so they feel and act differently.

With this treatment approach, it is believed that situations alone do not determine how people will feel and act. It suggests that psychological problems arise as a result of the way in which we interpret or evaluate situations, thoughts and feelings, as well as our behaviours.

By changing how you think about things you will change the way you feel and act.

The goal of CBT

The goal of CBT, then, is to help people learn healthier ways of coping with distressing thoughts, as well as reducing avoidance or other problematic behaviours (like substance use).

If someone can change how they evaluate their environment or thoughts and feelings, anxiety and avoidance may be reduced, improving a person's mood and overall quality of life.

How is this done in CBT?

A number of techniques may be used by a cognitive-behavioural therapist. Some common techniques are:

  • Self-Monitoring
  • Cognitive Restructuring
  • Behavioural Experiments

These techniques are all briefly reviewed below.

Self-Monitoring

You may be asked to track (or monitor) their thoughts, feelings and behaviours. By writing down this information, you may become more aware of how you evaluate your experience and the consequences of these evaluations.

Cognitive Challenging

Once these evaluations are identified, you may be assisted to gather evidence against these evaluations. This is then used to get an alternative view of the situation, thought or feeling. This process is called cognitive restructuring.

Through cognitive restructuring, people often conclude that their evaluations or interpretations of situations are not entirely accurate. They may also realize that, although thoughts often feel true, they are rarely based in fact.

For example, the person who fears spiders may realize that it is actually quite rare for spiders to bite you and, in fact, many spiders are not dangerous. This realization will lead to lower levels of anxiety. In addition, by realizing that spiders are not really as dangerous as once thought, the person may be less likely to avoid situations, such as the picnic.

Behavioural Experiments

Finally, the therapist will often ask the patient to take part in behavioural experiments. This involves having the patient "test out" these new ways of looking at the world by going into situations where he or she may contact something that was once feared.

By encountering something that was once feared (such as a spider) and not experiencing any negative outcomes (such as being bitten), the person will have even more evidence that their previous thoughts were not so accurate.

Who can CBT help?

CBT has been found to be successful in treating a range of problems, such as anxiety disorders, depression, eating disorders, and alcohol and drug use problems (Barlow, 2001). However, CBT may not be for everyone.

The sessions in CBT are generally quite structured. There are usually specific goals for each session, and the therapist will structure the session so as to meet those goals. Some people may like this structure. Other people who are looking to do more self-exploration in therapy may not like the structured sessions of CBT.

Many cognitive-behavioural treatments are also time-limited. The treatment may only last a certain number of weeks, after which the patient is expected to have gained enough skills to continue the work on their own. This works well for people who have one specific issue they would like to address. However, the short-term focus of some cognitive-behavioural treatments may not meet the needs of people looking for longer-term support.

It is important to consider what you would like the focus of your treatment to be. In doing so, you can find the one that best suits your needs.

Source:

Barlow, D.H. (2001). Clinical handbook of psychological disorders. New York, NY: Guilford Press.

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