CBT is a talking therapy that has a central place in evidence-based practice and has been backed by therapists around the world. It is recommended by National Institute for Clinical Excellence (NICE) for a range of psychological problems. CBT looks at how we think about a situation (cognitive) and how this, in turn, affects the way we feel and act (behavior). Similarly, our actions could also affect how we think and feel. So, when we think or act in an unhelpful way, it usually creates a perpetual cycle that maintains the problem. Compared to other forms of therapy, this therapy focuses on the ‘here and now’ problems. It could also help you to gain more awareness of how you think about yourself, others and the world.Speaking in practical terms, it is a highly collaborative therapy where the client and therapist work together to identify how to understand unhelpful thought patterns that impede the client’s daily life.
CBT- What Happens?
In CBT, you learn to identify, question and change the thoughts, attitudes, beliefs, and assumptions related to your problematic emotional and behavioral reactions to certain kinds of situations. By monitoring and recording your thoughts during situations that lead to emotional upset, you learn that the way you think can contribute to emotional problems such as depression and anxiety. In CBT, you learn to reduce these emotional problems by:
- Identifying distortions in your thinking
- Seeing thoughts as ideas about what is going on rather than as facts
- “Stand back” from your thinking to consider situations from different viewpoints.
For CBT to be effective, you must be open and willing to discuss your thoughts, beliefs, and behaviors and to participate in exercises during sessions. For best results, you must be willing to do homework between sessions.
What conditions can CBT treat?
CBT is an effective treatment for many psychological conditions. These include:
- Mood disorders, such as depression and bipolar disorder.
- Anxiety disorders, including specific phobias (e.g., fear of animals, heights, enclosed spaces), panic disorder, social phobia (social anxiety disorder), generalized anxiety disorder, obsessive-compulsive disorder and posttraumatic stress disorder.
- Bulimia nervosa and binge eating disorder.
- Body dysmorphic disorder (i.e., body image).
- Substance use disorders (i.e., smoking, alcohol and other drugs).
CBT can also be used to help people with:
- Habits such as hair pulling, skin picking, and tics.
- Sexual and relationship problems.
- Chronic fatigue syndrome.
- Chronic (persistent) pain.
- Long-standing interpersonal problems.
A similar framework is used to treat different emotional problems in CBT; however, the approach and strategies vary and are customized to address each specific problem.
CBT Principles and Elements
There are several different types and/or applications of CBT. They focus on methods like cognitive restructuring, modifying behavior, and/or developing alternative coping skills. Most share some common principles and elements, such as Brief and Time Limited yields positive results for a client in a relatively short period of time.The average number of sessions the clients receive is approximately around 16. The activity is present-centered viz. what is happening with the client in the “here and now?”. Thought focused approach helps the client to recognize and understand personal thoughts that are behind irrational fears and worries. Cognitive distortions are explored by the client and counselor in collaboration. Practice and homework help to develop new skills by teaching different ways to understand situations and their responses. The counselor acts as a teacher and coach simultaneously. Homework (including reading assignments) encourages the client to practice the learned techniques. This Sound Therapeutic Relationship thus establishes a trusting relationship and builds rational self-counseling skills in the client that helps them to learn and think differently.
CBT – Why is it an effective therapy?
CBT is an effective therapeutic approach as it is:
- Problem-focused and goal-oriented
- Proven strategy and skills
- Emphasizes the importance of a good, collaborative therapeutic practice
- A proven relationship between the therapist and client.
In describing how CBT works, the focus of this guide has been on how it applies to treating people experiencing emotional distress.