Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) can be used to treat people with a wide range of mental health problems.

CBT is based on the idea that:

how we think (cognition)

how we feel (emotion)

how we act (behavior)

all interact together.

Specifically, our thoughts determine our feelings and our behavior.

Therefore, negative and unrealistic thoughts can cause us distress and result in problems. When a person suffers with psychological distress, the way in which they interpret situations becomes skewed, which in turn has a negative impact on the actions they take.

CBT aims to help people become aware of when they make negative interpretations, and of behavioral patterns which reinforce the distorted thinking. Cognitive therapy helps people to develop alternative ways of thinking and behaving which aims to reduce their psychological distress.

A major component of CBT involves the client carrying out tasks between therapy sessions. These tasks are agreed between client and therapist and are based on a shared understanding of the problems.

Together the client and therapist identify how these problems affect thoughts, behaviour, feelings and physical functioning and work together in order to find solutions that are more helpful than the present way of coping.

The aim of therapy is for the client to learn to be their own therapist and use the skills learned during therapy in order to maintain their improvement.

CBT is generally focussed on what is happening in the present, although in some cases it is useful to explore early experiences or past trauma in order to develop an understanding of how thought patterns and beliefs were formed by these experiences. However, in other cases such as phobias, simple desensitising and exposure exercises may be all that is required.

The goals of treatment and the pace of treatment are determined by the client.

Progress is monitored throughout therapy by the use of well established psychological rating scales, by the attainment of specified goals and by client ratings of their subjective experience.

This informs therapy by identifying areas of improvement that can be built upon and problematic areas that have to be addressed further.

In CBT therapy is structured towards identifiable goals and progress can be seen, felt and also measured.

Cognitive Therapy Based Assumptions:

Thoughts determine Feelings and Behaviors
Psychological disorders involve maladaptive thinking
CT helps a patient overcome difficulties by identifying and changing dysfunctional thinking
Changes in thinking are presumed to lead to changes in Feelings

CBT

Therapist Active
Challenge Patient
Homework
Structured
Time-limited
Therapist/Patient Records

Advantages of CBT

Can be as effective as medication in treating some mental health disorders and may be helpful in cases where medication alone has not worked.
Can be completed in a relatively short period of time compared to other talking therapies.
The highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books and computer programs.
Skills you learn in CBT are useful, practical and helpful strategies that can be incorporated into everyday life to help you cope better with future stresses and difficulties even after the treatment has finished.

Disadvantages of CBT

To benefit from CBT, you need to commit yourself to the process. A therapist can help and advise you, but cannot make your problems go away without your cooperation.
Attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time.
Due to the structured nature of CBT, it may not be suitable for people with more complex mental health needs or learning difficulties.
As CBT can involve confronting your emotions and anxieties, you may experience initial periods where you are more anxious or emotionally uncomfortable.
Some critics argue that because CBT only addresses current problems and focuses on specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood.
CBT focuses on the individual’s capacity to change themselves (their thoughts, feelings and behaviours), and does not address wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing.