Type of Therapy – Cognitive Behavioral Therapy

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Cognitive behavioral therapy (CBT) is one of the leading methods of psychotherapy currently practiced by Western counselors. The cognitive behavioral approach evolved from earlier traditional Western psychotherapy methods and utilizes many of the same principles as other modes of traditional, individualized therapy.

To fully understand CBT, it is important to recognize its history as well as the goals, common techniques, risks, and limitations of this method of mental health counseling.

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy focuses on individual perception. The underlying assumption of this form of therapy is that the personal experience is more closely tied to an individual’s perception than it is tied to any given situation itself. This means that focusing on perception and addressing the way someone thinks about a situation can help the individual overcome particularly stressful or even traumatic experiences.

CBT is a highly goal-oriented type of psychotherapy. Sessions are designed to help individuals reconceptualize experiences and process events in a way that helps them better understand their own perceptions and therefore their own level of control over their personal perceptions.

Thanks to the highly focused and pragmatic design of the therapeutic session, cognitive behavioral therapy is a short-term method of counseling. The goal of CBT is to help the individual enact change in thinking patterns and behaviors, thereby improving quality of life not by changing the circumstances in which the person lives, but by helping the person take control of his or her own perception of those circumstances. This is generally achieved through a series of strategies, including worksheets, thought experiments, and challenges to existing patterns of thought and behavior.

Cognitive behavioral therapy is utilized for support in a wide variety of situations and for many types of concerns, including interpersonal relationships, addiction and drug abuse, sleeping problems, depression, and anxiety. The idea is that by encouraging changes in thought processes and making fundamental changes to an individual’s underlying attitude, it becomes possible to help the person through whatever circumstances are resulting in pain. In many ways, CBT is a combination of psychotherapy and behavioral training, equally emphasizing the importance of personal meaning and the relationship of problems to thoughts and behaviors.

The cognitive behavioral therapy experience is typically customized to the needs of each individual. Most people who seek CBT for mental health support receive counseling for a period ranging from five to 10 months. A standard therapeutic session is approximately 50 minutes long. During this time, the therapist and the client work together to understand the existing thought patterns that are associated with the client’s current problems, and they develop strategies to overcome those concerns. Group counseling is very rarely utilized in cognitive behavioral therapy.

The History of Cognitive Behavioral Therapy

Cognitive behavioral therapy has been around for over 50 years. Originated by psychiatrist Aaron Beck in the 1960s, CBT was created as an answer to what was growingly perceived as a drawback to psychoanalysis — that it was not sufficiently goal-oriented. Beck perceived that many of his patients, who he was counseling under the psychoanalysis model at the time, had a great deal of internal monologue that was clouding their judgments. However, his clients were sharing only a fraction of their thinking with him. The rest they were keeping to themselves, and it was these underlying and ultimately private thoughts that were shaping so much of their perceptions regarding the situations that troubled them.

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Beck found that there was a strong connection between thoughts and feelings, and he began helping clients connect their own thought patterns to changes in their emotional status. He developed the term “automatic thoughts” to support this concept. Automatic thoughts are emotion-filled thoughts that happen quickly, simply popping into the mind without any overly complex development. These thoughts have the potential to quickly change the way that someone feels. If not addressed or even recognized, the individual is left with an uncomfortable feeling and an uneasiness about why the feeling exists.

The term “cognitive behavioral therapy” was coined to emphasize the importance of thinking in overcoming emotional distress. This model draws heavily from the philosophical ideas of Socratic thinking, encouraging individuals to dig into their own thought processes to increase awareness about their own biases and perceptions. This collaborative effort by the client and therapist can lead to emotional breakthroughs and the ability to overcome mental health issues such as depression and anxiety.

Learn more about cognitive behavioral therapy careers.

Goals of Cognitive Behavioral Therapy

Cognitive behavioral therapy is regarded as a short-term method of psychotherapy. Ideally, a client will attend weekly sessions over the course of several months and will then be able to use the strategies and tools discussed in these sessions independently.

Because cognitive behavioral therapy is tailored to the needs of the individual, the goals of each therapy session are unique based on the client’s personal circumstances. The ultimate goal of CBT is to help clients rethink their own perspectives and thinking patterns, allowing them to take more control over their behavior by separating the actions of others from their own interpretations of the world.

On a personal level, the goals of any CBT session may include objectives such as being able to socialize enjoyably; to feel more comfortable conversing or interacting with friends, strangers, or co-workers; to become comfortable forming friendships or intimate relationships; to speak in public; to become more assertive; to overcome performance anxiety; or to overcome any level of depression or trauma. Again, the exact goals of CBT are personalized to the needs of each client.

Common Techniques Used in Cognitive Behavioral Therapy

One of the biggest differences between cognitive behavioral therapy and other common types of psychotherapy is the structure of the therapeutic session. Cognitive behavioral therapy is highly structured. A standard session typically follows this protocol:

  1. The client and therapist discuss the specific problems that will be their focus for the week.
  2. The therapist and client begin planning strategies for how to deal with the stated problems.
  3. Together, the client and therapist review the client’s homework from the previous week’s session and discuss the client’s progress.
  4. Based on the client’s progress and newly determined goals, the therapist assigns new homework for the following week.

All of this takes place during a standard 50-minute session. Given the time constraint, sessions are used as a forum for reviewing ideas and checking on progress.

Homework is an essential component to the success of the cognitive behavioral model, and it is up to the client to complete the homework tasks and keep up with the expectations that are agreed upon during each counseling session.

CBT homework often includes thought experiments, worksheets, and other behavioral learning strategies.

Common Mental Health Conditions Addressed by Cognitive Behavioral Therapy

Cognitive behavioral therapy works best when an individual wants to focus on a particular problem. The therapist and client work together in their sessions to set goals that will lead to specific outcomes to address the client’s concern. For this reason, cognitive behavioral therapy may not be ideal for someone who is seeking to address vague or uncertain causes of unhappiness.

For individuals facing specific issues and who have particular outcomes in mind, cognitive behavioral therapy is often a successful mode of treatment. Some of the major mental health concerns that CBT can be used to address include:

  • Anger management
  • Social anxiety
  • Depression
  • Panic or anxiety attacks
  • Obsessive-compulsive disorder
  • Sleep problems
  • Mood swings
  • Eating disorders
  • Drug abuse and alcohol dependency
  • Relationship and sex issues

This list is not comprehensive; rather, it identifies some of the most common mental health concerns for which CBT can be successfully employed. The best way to determine if an issue can be addressed via CBT is for the client and therapist to engage in a consultation regarding the issues at hand and to discuss the potential benefits and outcomes of utilizing the cognitive behavioral therapeutic model for treatment.

Getting the Most Out of Cognitive Behavioral Therapy

To get the most out of cognitive behavioral therapy, it is essential that the client and therapist work together during their sessions to identify points of concern and shape goal-oriented behaviors that will encourage positive outcomes. Cognitive behavioral therapy relies on action-oriented solutions that involve homework. Clients cannot expect progress unless they follow up on their sessions by completing their homework, trying the different strategies that they have discussed, and utilizing the various tools they have been given.

Those who are willing to do the homework, put in the extra effort around the clock, and engage openly and honestly with their therapist while actively seeking solutions to overcome the problems in their lives tend to be most successful with CBT.

Risks and Limitations of Cognitive Behavioral Therapy

Cognitive behavioral therapy is one of the most commonly recommended methods of mental health counseling, but it is not the most effective mode of counseling in every context. While it is a popular method for treating anxiety and other specific issues, CBT is not necessarily ideal for those who are looking for support in overcoming unidentified feelings or causes of discomfort. Individuals who are looking for long-term support with feelings of sadness, grief, or even depression may be better served by an alternative method of psychotherapy, such as group counseling.

Due to its highly focused structure, cognitive behavioral therapy may not be appropriate for those who have more complex mental health concerns. Similarly, the fundamental role of homework and behavioral learning strategies makes CBT problematic for some individuals, including those with certain types of learning disorders.

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Cognitive behavioral therapy is one of the most commonly recommended modes of psychotherapy in Western countries. It takes a highly structured approach to mental health counseling, using a long list of strategies and tools to encourage individuals to overcome particular hardships or obstacles in their life. Aspects of cognitive behavioral therapy are often used in conjunction with other forms of mental health counseling. In some contexts, the use of CBT strategies in an alternative setting is ideal for those who are working to overcome obstacles but who are seeking broader benefits than they can obtain with CBT alone.