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What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that takes a goal-oriented, practical approach to changing the thought or behavior patterns behind people’s emotional and behavioral problems.

A combination of psychotherapy and behavioral therapy, CBT emphasizes the role our thoughts play in how we feel and what we do, as opposed to external factors, like people, situations and events. According to the American Psychological Association (APA), CBT focuses on cognitive processes that contribute to problematic behaviors and feelings. The benefit of this premise is that we can use tools to change the way we think to feel and act better even if the situation remains the same.

The History of CBT

Cognitive Behavioral Therapy was founded by Dr. Aaron T. Beck, according to the Beck Institute. In the 1960s, as a psychiatrist at the University of Pennsylvania, Dr. Beck created experiments to test psychoanalytic concepts of depression. He found that patients with depression experienced a stream of negative thoughts about themselves, the world, and/or the future, which he defined as ‘automatic thoughts.’ He worked with the patients to identify and evaluate these automatic thoughts, which helped them change how these thoughts negatively impacted their actions and emotions.

How CBT is Different From Other Therapies

CBT is different from other forms of therapy in a few ways. First, the relationship between the therapist and the client is different. The relationship in CBT is equal, problem-focused and practical; the therapist and patient will collaborate, according to the APA, with the therapist asking for feedback and working together to figure out which ideas can best be applied to the individual’s problems.

Second, Cognitive Behavioral Therapy has an ending point, unlike other types of therapy that can be unending. CBT is time-limited because clients and therapists work together to set specific goals and to create strategies to meet these goals. Typically the patient is provided with homework to practice these tools; CBT is instructive and structured. Throughout this process, the client learns tools they can apply to their future problems.

What CBT Typically Includes

Cognitive Behavioral Therapy typically includes the following steps:

  • Identifying problematic situations: this could be a medical condition, grief, anger, divorce or mental health symptoms.
  • Recognizing the thoughts, emotions and beliefs that arise in these situations: the therapist and the patient will discuss these along with the client’s experience, their interpretation and the beliefs about themselves and other people.
  • Identifying negative or inaccurate thinking: the patient talks to the therapist and they find the thought and behavioral patterns that may be contributing to the patient’s issues.
  • Challenge negative or inaccurate thinking: the therapist will ask the patient to consider whether their view of the situation is based on fact or an inaccurate idea of what is going on. This step is difficult and can take time, because the patient’s long-held beliefs need to be reexamined.
  • Tools and principles: the cognitive behavioral therapist will provide principles to apply to these inaccurate perceptions, which the patient can use after the therapy is over.

The therapist’s specific approach will vary on the situation and preferences of the client; for example, they may incorporate another form of therapy, such as interpersonal therapy, if the patient needs to strengthen their relationships with other people.

How is CBT Used?

According to the Mayo Clinic, Cognitive Behavioral Therapy can be used to:

  • Prevent a relapse
  • Manage symptoms of mental illness
  • Treat a mental illness when using medication is not an option
  • Acquire techniques to manage and cope with grief, stress and other emotions
  • Learn improved ways to communicate
  • Overcome emotional trauma
  • Deal with medical illness
  • Manage chronic pain, fatigue, insomnia or other physical symptoms

CBT can be used for a wide range of issues – from sleeping problems to substance abuse to relationship difficulties. Mental health illnesses that may benefit from CBT include:

  • Anxiety
  • Depression
  • Phobias
  • Sleep disorders
  • Schizophrenia
  • Obsessive-compulsive disorder
  • Personality disorders
  • Psychotic disorders
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Mood disorders

How Effective is CBT?

The effectiveness of Cognitive Behavioral Therapy’s application has been examined in much psychological research. For example, one meta-analysis from 2012 found CBT to be effective for a large variety of issues, including anxiety disorders, anger control problems and general stress. Another study found from 2013 found CBT to be effective for depression patients. This 2017 study found CBT to be effective for patients with health anxiety. While its effectiveness depends on both the practitioner and the patient, Cognitive Behavioral Therapy has become an important therapy model with various applications.

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