Cognitive Behavioral Therapies

Last updated date: 14-Jun-2023

Originally Written in English

Cognitive Behavioral Therapies (CBT)

Cognitive Behavioral Therapies

Overview

Aaron Beck created cognitive behavior therapy (CBT) or cognitive therapy in the 1960s. It has since been widely examined and proved to be beneficial in a significant number of outcome studies for a variety of mental diseases, including depression, anxiety disorders, eating disorders, drug misuse, and personality disorders. It has also been shown to be beneficial as a supplement to medicine for major mental diseases such as bipolar disorder and schizophrenia.

CBT has been modified and researched for use with children, adolescents, adults, couples, and families. Its effectiveness in the treatment of non-psychiatric disorders such as irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, insomnia, migraines, and other chronic pain syndromes has also been shown.

 

What is Cognitive behavior therapy (CBT)?

CBT

Cognitive behavior therapy is a type of treatment that is organized, didactic, and goal-oriented. The method is hands-on and practical, with the therapist and patient working collaboratively to adjust patterns of thought and behavior in order to bring about a favorable change in the patient's mood and way of life. It is utilized to aid with a wide range of issues, and treatment procedures are tailored to the patient's diagnosis and concerns.

CBT focuses on modifying negative or harmful ideas and behaviors. It combines two therapies: 'cognitive therapy' and 'behavior treatment.' Both of these strategies are based on the idea that good ideas lead to healthy feelings and behaviors.

 

Cognitive therapy

The aim of cognitive therapy is to change the way you think about an issue that’s causing concern.

Self-destructive sentiments and behaviors are caused by negative ideas. Someone who believes they are undeserving of affection or respect, for example, may retreat and behave sheepishly in social circumstances. Cognitive therapy challenges such ideas and offers you better alternatives.

There are several approaches available. One tactic is to urge you to provide proof to 'prove' that you are unlovable. This might involve reminding you of the relatives and friends that love and respect you. This evidence assists you in realizing that your belief is incorrect. This is known as 'cognitive reorganization.' You learn to recognize and combat negative thoughts, as well as to replace them with more realistic and optimistic ones.

 

Behavior therapy

The goal of behavior therapy is to give you tactics or skills that will help you change your behavior. A shy individual at a party, for example, may have negative ideas and sentiments about themselves. They may also be socially inept.

Behavior therapy teaches you new and more beneficial behaviors. Conversational skills, for example, may be taught to you and practiced in therapy and social contexts. Negative thoughts and feelings fade when you learn how much fun you can have in social circumstances.

 

How does behavioral therapy work?

Behavioral Therapy

The beginnings of behavioral therapy may be traced back to American "behaviorism." This idea holds that human conduct is taught and may thus be unlearned or relearned. Behavioral therapy seeks to determine whether certain behavioral patterns make your life more difficult or exacerbate your issues. The second stage is to work on modifying these behavioral patterns.

People who have developed melancholy thoughts, for example, sometimes retreat and abandon their activities. As a result, they are even more dissatisfied and lonely. Cognitive therapy assists in identifying this process and reactivating it.

Behavioral treatment for anxiety disorders frequently includes learning ways to help you calm down. You may learn to lessen anxiety, for example, by purposefully breathing in and out deeply so that your body and breathing can relax. When you do this, you focus on your breathing rather than the source of your fear. These approaches might assist you in calming down rather than becoming overly anxious.

By the way, in Germany, most cognitive-behavioral therapists refer to themselves as behavioral therapists.

 

Strengths and Limitations of CBT

Strength of CBT

 

Strengths of CBT

  1. Because it focuses on human mind, model has a lot of attraction. Human cognitive powers, which have been responsible for many of our achievements, may also be accountable for our troubles.
  2. Cognitive ideas are amenable to testing. When individuals were coerced into accepting unfavorable ideas or thoughts, they felt more worried and sad.
  3. Many patients suffering from psychological problems, including depressive, anxiety, and sexual disorders, have been discovered to have maladaptive beliefs and ideas.
  4. Cognitive therapy has been shown to be extremely successful in the treatment of depression and moderately effective in the treatment of anxiety problems.

 

Limitations of CBT

  1. The specific involvement of cognitive processes is yet unknown. It is unclear if defective cognitions are a cause or a result of psychopathology.
  2. Those who eventually developed depression had no more negative thoughts than those who did not acquire sadness. This shows that hopelessness and pessimistic thinking are symptoms of depression rather than causes of it.
  3. The cognitive paradigm is limited in scope; thinking is only one aspect of human functioning; other difficulties must be addressed.
  4. Ethical concerns: RET is a directed treatment that aims to change cognitions fairly forcibly at times. This method may be deemed unethical by some.

 

How is cognitive behavioral therapy different from other psychotherapies?

Cognitive behavioral therapy

Cognitive behavioral therapy is a problem-solving approach. It focuses on contemporary issues and how to solve them. It does not, for example, deal largely on the past, as does psychoanalysis. Cognitive behavioral therapy focuses on coping with present concerns. The most essential thing is to assist individuals in assisting themselves: they should be able to manage with their life without the use of treatment as soon as feasible. This is not to say that cognitive behavioral therapy fully disregards the impact of prior events. However, it is primarily concerned with recognizing and modifying present stressful thinking and behavioral patterns.

Analytic psychotherapy, which has its roots in classic Freudian psychoanalysis, employs a variety of techniques. The therapist attempts to assist the patient in discovering and comprehending issues and their underlying causes.

 

When is cognitive behavioral therapy an option?

CBT therapy

CBT is a frequent treatment for a wide range of mental health issues and experiences, including:

  • Anger problems
  • Anxiety and panic attacks
  • Bipolar disorder
  • Depression
  • Drug or alcohol problems
  • Eating problems
  • hoarding

Obsessive-compulsive disorder (OCD):

Depression, anxiety, obsessive-compulsive disorder, and addictions are all treated using cognitive behavioral therapy. However, it can also be used to treat bodily ailments such as chronic pain, tinnitus, and rheumatism. It may assist to alleviate symptoms.

Cognitive behavioral treatment necessitates the patient's dedication and initiative. Therapy can only be effective if the patient actively participates in the therapy and works on their problems outside of sessions. This may be a significant burden, especially when dealing with serious illnesses like depression or anxiety disorders. That is why medicine is sometimes used to treat the severe symptoms fast so that psychotherapy may begin.

The goals must also be considered while selecting a type of psychotherapy. If you want in-depth insight into the root reasons of your difficulties, cognitive behavioral therapy is generally not the best option. It is especially effective if you are primarily focused with solving specific problems and are just secondary concerned with the "why".

 

How does cognitive behavioral therapy work?

Cognitive behavioral therapy

It is critical that you and your psychotherapist establish a good working connection. It might take some time to locate the perfect therapist. You will define your expectations and briefly explain your present challenges in the first session. This serves as the foundation for discussing therapeutic goals and treatment plans. If your personal goals alter throughout therapy, the strategy can be changed.

Therapy often includes recording your own thoughts in a journal over a certain period of time. The therapist will then check the following things with you: 

  • Do I have an accurate and realistic perception of events?
  • What happens if I act differently than usual in a certain situation?

You will meet on a regular basis to address any issues that arise as well as your progress. Relaxation exercises, stress and pain reduction approaches, and specific problem-solving skills are also used in cognitive behavioral therapy.

Cognitive behavioral therapy is a short-term treatment as compared to analytical psychotherapy techniques. However, there is no typical duration for cognitive behavioral treatment. Some people feel significantly better after just a few sessions, while others require treatment for several months. This is determined by the kind and severity of the difficulties, among other factors. An individual session lasts around one hour. Sessions are normally held once a week. Cognitive behavioral therapy is available in a variety of settings, including psychotherapist offices, hospitals, and rehabilitation centers. It is also occasionally provided as group therapy.

 

Who provides CBT?

CBT can be delivered by counsellors, psychologists, mental health social workers, and therapists in one-on-one treatment sessions, small groups, or online. You are taught to examine the facts for your negative beliefs logically and to change your perspective on the world around you. Between sessions, the therapist will assign "homework." In general, 6 to 10 sessions are necessary, however this varies from person to person.

Issues to consider before choosing CBT

Risk having CBT

Before choosing CBT, issues you may like to consider include:

  • For persons with any sort of brain disease or damage that inhibits their rational thinking, CBT may not be the optimal method of therapy.
  • CBT necessitates your active participation in therapy. You may be expected to keep extensive diaries about your thoughts, feelings, and behaviors, for example. If you are unwilling to put in the effort, the outcomes of CBT may disappoint you.
  • CBT requires you and your therapist to have a good working relationship. Professional trust and respect are essential. If you don't like the first therapist you meet with, search for another one.
  • While CBT is a short-term kind of psychotherapy, it may take months or more to successfully confront and overcome problematic patterns of thought and behavior. If you are seeking for a "fast fix," CBT may disappoint you.

 

Can cognitive behavioral therapy also have side effects?

Psychotherapy-related side effects cannot be ruled out. Being confronted with your difficulties or fears can be quite unpleasant at first, and your relationships may suffer as a result. If any challenges arise during treatment, it is critical to communicate freely with your psychotherapist.

 

The Cognitive Triad

The Cognitive Triad

The cognitive triad refers to three types of negative (helpless and critical) thinking that are common in those who suffer from depression: negative views about the self, the world, and the future. Depressed people's thoughts tended to be automatic, as they arose spontaneously.

When these three components interact, they disrupt normal cognitive functioning, resulting in difficulties in perception, memory, and problem solving, as well as the individual being fixated with negative ideas.

 

Negative Self-Schemas

Beck felt that those who are prone to depression acquire a negative self-schema. They have a set of negative and gloomy thoughts and expectations about themselves. Beck asserted that negative schemas might be established as a result of a traumatic occurrence as a youngster. The following experiences may have contributed to bad schemas:

  • Death of a parent or sibling.
  • Parental rejection, criticism, overprotection, neglect or abuse.
  • Bullying at school or exclusion from peer group.

People who have negative self-schemas are more likely to make logical mistakes in their reasoning and to focus selectively on some parts of a scenario while neglecting equally significant facts.

 

Cognitive Distortions

Beck describes several incorrect cognitive processes (i.e. distortions of thought processes). These erroneous mental processes are self-defeating and can cause the individual tremendous distress or sadness.

  • Arbitrary interference: Drawing judgments based on insufficient or irrelevant evidence: for example, believing you are useless because an open-air concert you planned to attend was rained off.
  • Selective abstraction: concentrating on one facet of a problem while neglecting others: For example, you may feel guilty for your team's loss in a football game despite the fact that you are only one of the players on the field.
  • Magnification: inflating the significance of unfavorable events For example, if you scrape some paint off your automobile and, as a result, consider yourself a terrible driver.
  • Minimisation: minimizing the significance of an event. For example, your instructors may compliment you on a good term's work, but you consider it insignificant.
  • Overgeneralization: forming large negative inferences from a single small incident. For example, if you get a D on a test when you generally earn consecutive As, you may believe you are stupid.
  • Personalisation: Attributing others' bad sentiments to oneself. For example, if your instructor enters the room looking angry, he must be angry with you.

 

Can CBT help with sleep?

CBT help with sleep

CBT-I is a short-term therapy for persistent insomnia. The treatment attempts to reframe people's sleep-related ideas, attitudes, and actions. Insomniacs frequently get into a pattern of attempting to catch up on sleep, sleeping poorly the next night, and then feeling nervous about sleeping. Going to bed too early, taking naps, or relying on alcohol to fall asleep are examples of these practices. The role of CBT- I is to change those patterns, through techniques such as challenging anxious thoughts and adhering to a set sleep schedule. 

 

Frequently asked questions

  • How will I know if CBT is for me?

Most individuals can tell if they are comfortable with CBT and whether it is satisfying their treatment needs after just a few sessions. When the "fit" isn't quite right, the therapist may change the treatment or recommend another choice.

In general, CBT may be a good therapy option if:

  • You are interested in learning practical skills to manage your day-to-day life
  • You are interested in practicing change strategies ("homework") between sessions to consolidate improvement.

CBT may not be for you if you want to focus exclusively on past issues or if you want supportive counseling.

 

  • How long does CBT last?

CBT is a time-limited, targeted therapy method. CBT typically entails 12 to 20 sessions for issues such as anxiety and depression. However, depending on the degree and complexity of your difficulties, the length of treatment might vary—some individuals recover dramatically in four to six sessions, while others may require more than 20 sessions.

 

  • What can I expect on my first visit with a CBT therapist?

At your first visit, you and the CBT therapist will discuss:

  1. The nature and origins of your problems, as well as the variables that may be contributing to them
  2. How the therapist intends to apply the CBT approach to your specific problems
  3. What you want to gain out of treatment and how the tasks you will undertake in therapy can help to address different parts of the difficulties.

 

Conclusion 

Cognitive behavioral therapy (CBT) is a type of psychological treatment that has been shown to be useful for a variety of issues such as depression, anxiety disorders, alcohol and drug abuse issues, marital problems, eating disorders, and serious mental disease. Numerous research studies indicate that CBT improves functionality and quality of life significantly. CBT has been shown in several trials to be as successful as, if not more effective than, other types of psychological treatment or psychiatric drugs.