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Cognitive behavioral therapy, or CBT, is a widespread psychological treatment administered by therapists and professionals.

The practice of cognitive behavioral therapy is different from other forms of psychological therapy in that the focus is not on the individual’s past but on their current day-to-day life and the coping mechanisms they might need to access to improve their functioning.

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What is Cognitive Behavioral Therapy?

CBT as a treatment aims to change thinking patterns that are causing harm to the patient and may be contributing to problems they are facing in their life. There is a wide range of problems that CBT has proved effective for, both in terms of diagnosed mental health conditions and in terms of difficult personal circumstances. These include anxiety disorders, alcohol, and drug abuse, marital and relationship problems, eating disorders, and many other forms of mental illness.

The therapist will likely expect that some information about the individual’s life is provided to provide in-context treatment and coping mechanisms, but this is just part of the broader techniques used.

Treatment through CBT has two main focuses – the changing of thinking patterns and the changing of behavioral patterns. For thinking patterns, this could appear as below:

  • Improved recognition of the patient of their abilities and the building of confidence
  • Reframing the behaviors of others and what may motivate them to act the way they do
  • Improving and integrating problem-solving when situations arise that the patient struggles to cope with
  • Improved recognition through a more realistic viewpoint of warped perceptions that might be causing difficulties for the patient.

The changing of behavioral patterns can include a few different strategies – these might include:

  • Relaxation techniques to find new ways to calm the body and the mind to better prepare the patient for difficult situations.
  • Roleplay sessions help prepare the patient for situations they may find challenging.
  • Encouragement to face their fears

CBT is an outlier when compared with many other forms of psychological treatment. According to advances made through research and clinical practice, the therapy has been seen to aid in providing accurate, evidenced change for the individual receiving it. Some studies even indicate that CBT can be considered practical or even more effective than psychiatric medication.

According to the American Psychological Association, cognitive behavioral therapy is based on core principles that guide those administering the treatment – these principles include:

  • Those suffering from psychological problems can relieve their symptoms by learning better-coping mechanisms.
  • Psychological problems experienced by the individual are in part due to unhelpful or faulty thinking patterns
  • Psychological patterns experienced by the individual are in part due to unhelpful learned patterns of behavior

Which techniques are used in cognitive behavioral therapy?

Cognitive behavioral therapists will likely use some techniques from a standardized list that has been proven successful for patients who go through the therapy process using them. These techniques include:

SMART goals

SMART stands for Specific, Measurable, Achievable, Realistic, and Time-bound. Setting SMART goals allows the patient to understand the direction they are heading toward and provides a very useful framework for therapy.

Journaling

This is often a crucial part of cognitive behavioral therapy and is very effective. In this context, it is important to note any negative thought patterns and then think meaningfully about how these thoughts can be replaced with more positive ones.

Thought recording

This technique helps the patient to think more mindfully about how certain events trigger specific thoughts and the faulty thinking patterns that could be misinforming and harming them.

Cognitive restructuring

This technique can aid patients in examining their cognitive distortions and then help challenge them in a measured way.

Guided discovery and questioning

As part of cognitive behavioral therapy, it is understood that patient has certain assumptions about themselves. Guided questioning can allow the patient to challenge their assumptions and help them to see themselves or the situation they are in more healthily and realistically.

Self-talk

This strategy allows patients to be encouraged to talk to themselves in a more compassionate way, which for many individuals struggling with problems such as anxiety disorders, will feel very challenging at first. This can help to replace existing patterns of negative or self-critical thinking.

Situation exposure

Similar to another technique known as systematic desensitization, situation exposure is a key part of cognitive behavioral therapy. It encourages patients to gradually expose themselves to situations they imagine they might find stressful, providing them with coping mechanisms as they build up to increasingly challenging situations.

Homework

Not so much a strategy in itself, but it is important to note that for those engaging in cognitive behavioral therapy, committing their own time outside of the sessions to learning and helping themselves will be very important for their progress. Techniques mentioned above, such as journaling and thought recording, will require patients to work on these strategies individually to understand how their thoughts affect them daily.

The above is by no means an exhaustive list, and for each patient, their cognitive behavioral therapy experience will be different. A key part of the CBT journey will be for the patient and therapist to try out a range of strategies to understand better which techniques work well for the patient and which will be worth building on within their treatment. The eventual aim for cognitive behavioral therapy is that those undertaking treatments are eventually able to ‘be their therapist’, in that after being equipped with a roster of potential techniques, they can understand which technique is most appropriate for any difficult or stressful situation they may encounter in life.

When might cognitive behavioral therapy be used?

There is a wide range of situations where cognitive behavioral therapy might be appropriate for an individual or a group. Cognitive behavioral therapy is very useful because it often requires fewer sessions than other forms of therapy, so it can be a successful treatment for those who may not be able to afford open-ended, unstructured therapy programs. Some medical practitioners may also recommend CBT as an additional aid for patients when recommending antidepressants.

For individual CBT, some situations that it may be recommended for might include:

  • Patients suffering from a particular physical medical condition with chronic physical symptoms
  • Patients who have suffered the loss of someone close to them and need aid in dealing with and understanding their grief
  • Treatment or management of symptoms for a mental illness
  • Aiding with a reduction in the chance of relapse for mental illness symptoms
  • Patients who struggle to manage their emotions
  • Patients who suffer from PTSD who are aiming to overcome emotional trauma
  • A variety of disorders relating to sleep, anxiety, eating, or sex
  • Patients with schizophrenia
  • Patients with obsessive-compulsive disorder
  • Patients with bipolar disorder
  • Patients with phobias
  • Those who are suffering from substance abuse issues
  • Those who find they are struggling with conflicts in their relationships related to their trauma or mental illness

Group CBT is often appropriate for families or groups of people suffering from similar issues that include any of the above. For example, for individuals suffering from an eating disorder, sharing experiences with others who understand what they are going through can be helpful. For couples, cognitive behavioral therapy can also be a helpful tool to analyze their relationship and help to resolve problems being experienced that may be due to faulty thinking patterns for one or both parties.

Are there any checks I should carry out to organize cognitive behavioral therapy?

The most important thing with looking for a therapist is to ensure their practice will allow focusing on your needs and align well with the particular form of cognitive behavioral therapy you require. If you are considering cognitive behavioral therapy, either for yourself or are looking to advise a friend/family member to seek help through this technique. It is essential to carry out appropriate checks for the psychotherapist you might contact to administer the treatment. There are some suggestions made for things to look out for when hiring a psychotherapist. These include:

  • Therapist expertise – different therapists will have different expertise areas, and it’s best to ensure this is tailored to the particular symptoms you are experiencing or your situation. For example, some therapists will have experience treating individuals with marital problems, while others might have skills related more directly to treating anxiety disorders.
  • Licensing – It is essential to ensure that whichever practitioner you choose has certification for the state you are in and that their license is appropriate for cognitive behavioral therapy practice.
  • Background – The therapist you seek treatment from can come from different backgrounds. Still, it’s essential to ensure they have a formal qualification of some form that qualifies them to work with patients with your requirements. For example, they might be a medical practitioner who has decided to specialize in mental health or may have a doctoral degree in the required discipline.