Cognitive Behavioural Therapy
Happiness and grief both are part of our lives. Feeling depressed after losing a loved one, losing a job, or failing an exam is normal. But there is always a chance that these bad feelings can persist.
But with cognitive-behavior therapy, it will be easier for you to cope with these feelings. That’s why it
is important to practice your CBT skills even after completing the treatment.
CBT is a form of talk therapy that can help you manage your problems by altering the way you think. Although it is most commonly used for anxiety and depression, CBT can also help other mental health illnesses.
If you are suffering from any mental ailment, this article on CBT will surely help you. So, keep on reading till the end.
What is cognitive-behavioral therapy?
Cognitive-behavioral therapy or CBT is a form of psychotherapy that focuses on improving your negative and distorted thinking patterns and individual-specific problems. CBT addresses how your feelings and emotions can affect your behavior.
CBT is a goal-oriented and short-term therapy that helps people to reshape their behavior by changing their thoughts. It helps you remain in the present and helps you learn new skills to deal with everyday challenges.
What are mental health illnesses best treated with CBT?
CBT is widely used as psychotherapy for all ages, including – children, teens, adults, and the elderly. CBT has shown effectiveness for diseases such as
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD)
- Attention deficit hyperactivity disorder (ADHD)
- Eating disorders
- Obsessive-compulsive disorder (OCD)
- Bipolar disorder or mania
- Substance abuse disorder
- Antisocial behaviors
- Personality disorder
- Panic attacks
Not only mental health issues but CBT can also help people who are struggling with
- Anger issues
- General stress
- Chronic illnesses or pain
- Low self-esteem
- Sleep problems
- Relationship and work difficulties
Basic components of CBT
The three main components of CBT are
Cognitive therapy puts light on the thinking patterns and behaviors that are the main cause of the problem. Usually, the individuals suffer from feelings of guilt, worthlessness, and hopelessness. They think that everything is their fault.
The main principle of cognitive therapy is cognitive reconstruction and reframing. Cognitive therapy helps them to identify distorted and self-defeating thought patterns. It also helps them to learn new skills to make their response more balanced and reality-based.
Some cognitive techniques are as follow:
- Identifying your thoughts
- Understanding thoughts-behavior relationship, for example, how your thoughts are affecting your behavior
- Replacing biased thoughts with more realistic ones
- Developing problem-solving skills
- Developing self-confidence
Behavioral therapy targets maladaptive behaviors of patients as behaviors are an important component of their problematic psychological patterns.
Your therapist will help you identify and analyze such behaviors and guide you on correcting them. Behavioral therapy works on the “mechanism of change.” This means ineffective and unhealthy behaviors are replaced with effective behaviors by providing learning and facilitating implementation.
This can be done through
- Teaching new behaviors and habits
- Recognizing how your actions are affecting your thoughts and emotions
- Breaking down overwhelming tasks into manageable ones
- Increased rewarding behavior
- Repeated exposure to stimuli instead of avoiding them
- Learning to calm your mind and body
Although cognitive and behavioral therapies can be used as stand-alone, their combination provides better and long-lasting effects.
Mindfulness is a meditation practice to become fully aware and be present in the current moment. It also allows you to acknowledge your feelings, behaviors, and thoughts as they are, without any manipulation.
Mindfulness differs from typical cognitive therapy. It emphasizes on sustain focus on the task at hand. However, traditional cognitive therapy focuses more on assumptions about the past, present, and future.
Goals of CBT
What does CBT aim for? CBT is a goal-oriented therapy that helps you to get rid of maladaptive thoughts and behaviors. The main goals of CBT are:
- To promote self-awareness and emotional intelligence by learning how to read your thoughts and emotions
- To help you to understand how distorted views contribute to painful and unhealthy feelings
- To shape your views into more realistic and healthy ones
- To develop skills to maintain self-control and self-respect
- To reduce symptoms by helping you to take control of your emotions and behaviors
- To prevent further episodes of emotional distress
How will CBT benefit you?
CBT helps you in many ways. With the help of CBT, you can
- Learn new skills to manage powerful emotions like anger, grief, or fear
- Correct maladaptive behavior and improve tolerance
- Manage symptoms of mental health illnesses
- Cope with chronic illness
- Learn assertive skills
- Reduce self-destructive and suicidal behavior
- Prevent relapse
- Improves self-esteem
Length of CBT program:
There are two options to carry out CBT sessions
- A one-to-one session with the therapist
- Group therapy session
Either way, you have to take 30 to 60 minutes sessions every week for 12 to 20 weeks. The sessions can be scheduled as per your facilitation – either once weekly or once every 2 weeks.
But CBT requires some time to work, so the patient should strictly follow their treatment plan.
Intensive cognitive behavior therapy
Have you heard of I-CBT? Intensive cognitive behavior therapy (I-CBT) is becoming more popular day by day. It provides more comprehensive care than traditional CBT. It compromises much longer sessions in months, weeks, or weekends. Sometimes the session’s length can increase up to eight-hour per session.
Cost of CBT:
Is CBT expensive? While CBT is effective for treating mental health disorders, CBT is a bit expensive. CBT programs cost $280 per month for the first three months, but the price will reduce to $140 per month hereafter. Some therapists may charge $100 or more per hour. Different options are available, which includes
- Federally-funded centers for a limited budget, but their waiting list might be very long
- Some clinics operating on a sliding scale
- Some college and university departments offer low-cost treatment. In return, their students can gain experience. But these are not always for the public.
Types of cognitive therapy
CBT is composed of a wide range of structured psychological therapies to self-help approaches. Although the approach may be different, they all address thought patterns that cause emotional disturbance. Some of the types of CBT are
- Cognitive therapy – targets inaccurate emotional responses, behaviors, and thoughts such as black-and-white thinking, jumping to conclusions, or catastrophizing.
- Dialectal behavior therapy (DBT) – work through the technique of “acceptance and change.” It focuses on the acceptance of the patient’s experiences and thoughts and positively changing these thoughts with different skills
- Exposure therapy – helping the patient to build self-confidence by slowly exposing them to situations that might trigger their symptoms.
- Multimodal therapy – centers around the fact that psychological issues are related to seven modalities, including behavior, sensation, cognition, imagery, interpersonal relationships, affect, and biological issues.
- Rational emotive behavior therapy (REBT) addresses irrational thoughts and actively challenges these thoughts to help the patient accept these thoughts and change them.
How to structure a CBT session?
Therapy sessions can either be:
Individual therapy sessions:
A one-to-one therapy session with the therapist provides the opportunity to discuss individual-specific problems. Not all people can express themselves openly in public, especially patients with low self-esteem.
Individual goals are set for the patient for each week. And the patient’s problem-solving behavior of the previous week is discussed. These sessions help patients to build their self-respect and self-image.
Group therapy sessions
Weekly group therapy sessions are run under the supervision of a trained therapist. Group members provide moral support to each other. Also, people become more willing to express themselves among the people suffering from the same.
But now the question is, what should you know about therapy sessions? Learning about how therapy sessions works is important. This knowledge will help you and your therapist and makes things a lot easier. But how can you structure a session? What to expect? What to discuss? These are all the questions; you surely want answers to.
Because attending sessions without any preparation is not much effective. Here are some steps to follow to lead a perfect and profitable therapy session.
- Check patient’s mood. Access how the patient is coping since the last session. Either his mood worsens or becomes more desirable. This should be the first step before starting the session
- Preview of the previous session. Shortly discuss the important issues discussed in the previous session with your therapist. Continue the talk from there to maintain the flow.
- Select a specific to discuss. This is the most important point. Because without a plan, the session will lead nowhere. So, choose a topic that should be prioritized and discussed during that specific therapy session.
- Review of the tasks assigned to the patient. This is a critical step to know the progress of therapy. Make sure to discuss the tasks and the problems you faced while completing them.
- Assigning new tasks. New tasks related to the topic discussed in the session are important. Because it can provide you a perfect opportunity to apply the CBT skills you learn.
- Discuss a summary of the session. Briefly discuss today’s agenda while concluding the session. Discuss with the therapist to tell you any point that you have missed or unable to understand.
Techniques of CBT:
CBT consists of many techniques. But all techniques focus on the single goal – to replace maladaptive and self-defeating thoughts with more encouraging ones.
The targets of all CBT techniques are
- Accepting your condition – the individual becomes aware of the unproductive thoughts and how they can impact their lives and relationships
- Daily-life problems – by understanding the actual problems you are facing and the root causes of these problems, you can change how you feel.
- Learning new behaviors – we face new challenges every day. So, it is essential to learn strategies that can help in shaping our attitude and determine life goals
You cannot treat every patient with the same techniques. You and your therapist will work together to understand the problem and find the best-suited techniques for you.
Now the question arises, “what techniques should you use?” There are some techniques used in CBT
- Identify negative thoughts and behaviors
It is important to learn how these thoughts are affecting your life. Patient acceptance is the basis for establishing the treatment plan. If you aren’t ready, no one can help you. Your therapist will help you to recognize unhealthy behavior from the healthy one.
CBT is goal-specific therapy. If you feel a task is overwhelming and cannot accomplish it, break it into smaller ones and continue making progress. A technique “SMART” is used, which means specific, measurable, achievable, realistic, and time-limited.
Usually, patients with mental health issues often have thoughts of guilt, shame, and worthlessness. Your therapist will help you to identify negative thought patterns through questioning. With cognitive restructuring, you can look at your thoughts more realistically and logically.
Exposure therapy is used to address past traumas and phobias. The therapist will gradually expose you to things or situations that provoke fear or anxiety and thoroughly guide you on coping with your negative feelings and fears. By slowly exposing yourself to such triggers, you can reduce your vulnerability and become more confident.
- Relaxation and stress reduction techniques
Do you overthink situations? Or feel extra pressure on yourself while accomplishing tasks? Well, stress is the cause of many problems. And it can greatly affect your decision-making abilities. CBT teaches you techniques that help you to relax and reduce stress. Exercises such as deep breathing exercises, muscle relaxation, and imagery can help you face situations, fears, or phobias.
- Recording your thoughts by writing or other similar means.
Writing is the best way to reduce your stress. It is the same as talking to someone. Pen down your issues on a piece of paper and list all the possible solutions against them. Then choose the solution you think will produce maximum benefit.
- Engaging in positive activities
By engaging in activities, you once enjoyed, you can shift your attention. It also helps to modify your behaviors positively.
Cognitive-behavioral therapy – is it effective?
CBT is a brief form of psychotherapy that focused on improving mood by changing thoughts and feelings. But is it effective? What does the research say about it?
CBT is the most studied psychotherapy out there. Numerous clinical trials have been conducted over the past years. The result of these studies suggests promising results. Although it cannot cure the disorder, it can identify the root causes of the problem.
There have been almost 350 research studies on CBT, most of which indicate positive results like reducing symptoms of depression and anxiety and relapse prevention. CBT has been shown to help with other mental health diseases too.
Limitations of CBT
Are there any risks associated with CBT? CBT is considered one of the most effective psychotherapy, but there are some limitations to it
- Although it is individual-based, people do not want to voice their fears and thinking before others – even their therapist.
- Sometimes repeated exposure to triggers can increase your stress levels and worsen your condition. Only a wrong move and you will lose all the progress you’ve made.
- CBT requires long-term commitment and willingness to work effectively. Not all peoples can be this patient.
- It’s important to do your homework to increase the effectiveness of therapy, and free-spirited people find it difficult to follow the rules.
Can you apply CBT to yourself?
CBT seems easy to do on your own, but there are several factors involves. But it is possible to do CBT by yourself, especially if you are waiting for further treatment.
There is much material available on the internet that can be of help. However, research suggests that CBT sessions supervised by the trained therapists are more effective than doing it on your own.
Things to keep in mind:
CBT can surely help you to control your thoughts and emotions, but there are few things you should keep in mind
- Although CBT has many benefits, it still cannot treat your conditions. Mental health issues are not curable, but the symptoms can be managed with the right treatment. Along with therapy, medicines are also very important.
- Be patient – CBT cannot produce results overnight. You will see gradual changes in your thinking. But if your condition persists even after few weeks, talk with your therapist and switch to some other therapy.
- CBT does not always work – because every patient is different, and there are many factors involves. So, given these problems, there are chances that CBT will fail.
- CBT is not an easy task – although it seems very easy, changing your beliefs is difficult. You have to put a lot of effort into making it work. You have to face your fears that can be painful and distressing.
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Now that you know how CBT can help you, the next step is to consider other personal challenges and start the therapy plan!