Cognitive Behavioural Therapy
I am a seasoned CBT practitioner with advanced, and extensive, post-graduate training in CBT for anxiety and depression, received from the internationally renowned Beck Institute for Cognitive Behavior Therapy, in Philadelphia, U.S.A.
The principles and methods of Cognitive Behavioural Therapy (CBT) are among the primary ways that I help my clients achieve their goals for positive change in their lives. CBT is a very collaborative form of therapy. Therefore, I believe it is helpful for my clients to understand the principles and methods inherent in this approach. Ultimately, I would like for my clients to become skilled in using CBT on their own to meet the challenges in their lives, long after their work with me has ended.
An overview of CBT*
CBT is a form of psychotherapy that has been demonstrated to be effective in helping people overcome a wide variety of problems, including those involving depression and anxiety. It is based upon scientifically-informed principles of human psychology and its effectiveness for many problems has been supported by hundreds of scientific studies. CBT focuses on the patterns of thought and behaviour that maintain both adaptive and maladaptive behaviour. It assumes that these patterns are learned, and that new patterns can be learned when old ones are no longer useful.
CBT tends to be a present-centered, active, collaborative, and short-term form of therapy. Although therapists do not disregard how problems may have developed (e.g., as a result of childhood experiences), their primary focus is on helping the client identify and change what is maintaining the problem in the present. The relationship between the therapist and the client is marked by collaboration, and clients are encouraged to take an active role in applying the techniques both within and between therapy sessions. Therapy tends to be short-term and emphasizes the client learning principles and techniques that will serve them long after their work with the therapist has ended.
Cognitive aspects of CBT
Cognition can be defined as “the mental processes of perceiving, remembering, reasoning, evaluating, and imagining.” CBT holds that most of our emotions and behaviours are the result of our cognitions regarding what we think or believe about ourselves, other people, and the world. These cognitions shape how we interpret and evaluate what happens to us, influence how we feel about it, and provide a guide to how we should respond. Unfortunately, sometimes our interpretations, evaluations, and underlying beliefs thoughts contain distortions, errors, or biases, or are not very useful or helpful. This results in unnecessary suffering and often causes us to react in ways that are maladaptive. CBT provides many methods for becoming more aware of our cognitions and for modifying them when they are distorted or are not useful.
Behavioural aspects of CBT
The behavioural aspects of CBT emphasize the role of what we do (i.e., our behaviour) in shaping how we feel, what we believe, and how we behave in the future. In CBT, the therapist helps the client to identify which behaviours are likely maintaining the problem, and which behaviours are likely to help produce positive changes. Often, problems are the maintained by avoidance, either of actual situations or of internal experiences (such as emotions and memories). This prevents new learning that potentially could disprove distorted negative beliefs about oneself, others, and the world, and keeps people stuck in old maladaptive patterns. It also prevents people from experiencing positive reinforcement that provides satisfaction and motivation. In CBT, the therapist and client collaborate in choosing new behaviours for the client to engage in that help the client to gradually overcome this avoidance.
Techniques of CBT
The following are some of the primary techniques used in CBT.
(1) Promoting more accurate and useful thinking (cognitive restructuring): A key component of CBT is called “cognitive restructuring,” which is a set of procedures that promote more accurate and useful thinking. It is very helpful in treating depression, anxiety, and other problems.
(2) Increasing rewarding activity (behavioural activation): Depression often leads to withdrawal, avoidance, and inactivity. This prevents people from having positive experiences that are satisfying and motivating. CBT helps people to identify and engage in activities that increase the chance they will have rewarding experiences.
(3) Overcoming anxiety by facing fears (exposure therapy): Anxiety disorders are maintained by avoidance. CBT helps people overcome anxiety by facing their fears in a systematic way called “exposure therapy.”
(4) Learning new skills (skills training): Sometimes people avoid certain situations because they perceive they lack the skills to manage them. Accordingly, CBT also often includes learning new behavioural skills, such as assertive communication skills to deal with social situations and relaxation skills to deal with anxiety.
More information about CBT can be found on the websites of the following professional organizations:
Beck Institute for Cognitive Therapy & Research
* Summary of CBT provided by: Nelson Binggeli, PhD (GTCC staff psychologist)