Cognitive Behavioral Therapy, commonly known as CBT, is a type of psychotherapy practiced by psychologists, LCPCs, LCSWs, and other mental health practitioners. CBT is highly structured and in most cases completed in a shorter number of sessions than other types of psychotherapy. It is goal driven and helps by bringing awareness to inaccurate or negative thinking that impacts emotions and functioning in a negative way. CBT teaches skills that are used to confront those negative thinking habits and replace them with healthy and more effective ones. In other words, CBT approaches problems by changing thoughts and behaviors.
Why is CBT used?
CBT can be used to treat a number of issues and targets a wide variety of symptoms. On a basic level CBT can help manage symptoms of mental illness, prevent a relapse of symptoms or behaviors, teach techniques for coping with stressors, manage emotions, resolve relationship conflicts, cope with grief, cope with trauma, cope with medical problems, and even manage chronic pain. Some of the specific Mental Illnesses that CBT is used with are:
- Panic Disorder
- Obsessive Compulsive Disorder
- Post Traumatic Stress Disorder
- Bipolar Disorder
- Attention-Deficit/Hyperactivity Disorder
- Eating Disorders
- Substance Abuse
- Conduct Disorder
- Relationship Difficulties
What is the process of CBT?
The basic steps of CBT are identifying troubling situations or conditions in daily life, building awareness of thoughts, emotions, and beliefs about those situations, identifying negative or inaccurate thinking patterns (cognitive distortions), and finally challenging cognitive distortions.
- Identifying troubling situations or conditions in daily life
- Possibly including: medical conditions, relationship conflict, grief, anger, depression, anxiety, obsessions, phobias, occupational or academic difficulties, low self-esteem/worth, etc.
- Building awareness of thoughts, emotions, and beliefs about situations
- After identifying distressing conditions, a discussion occurs about thoughts regarding them. This process may include thought logs outside of sessions.
- Identifying negative or inaccurate thinking patterns (cognitive distortions)
- Identifying which thoughts and beliefs are cognitive distortions and determining target thought patterns to address.
- Challenging cognitive distortions
- Using behavioral and cognitive techniques to challenge, reframe, or refocusing cognitive distortions.
What are Cognitive Distortions?
Cognitive Distortions are negative, inaccurate, or irrational thoughts that negatively impact emotions and functioning. Cognitive Distortions are often broken down into categories to help identify and understand them. The most common are:
All or Nothing Thinking: sometimes known as black or white thinking, means placing things in categories without compromise. Terms such as every, always, or never are commonly used in this type of thinking. “I always embarrass myself”
Overgeneralization: coming to a general conclusion based on a single event or piece of information, not getting or using the whole picture. For example, if something bad happens, expecting it to happen over and over again, setting one up for failure before they even try.
Mental Filter: only focusing on the negatives, ignoring the positives. The negatives will hold more weight than positives, creating an overwhelming imbalance between bad and good.
Magnification/Minimization: exaggerating the negatives or minimizing the positives. This includes minimizing compliments or successes and increasing focus on mistakes or failures.
Catastrophizing: expecting the worst to happen in every situation.
Jumping to Conclusions: believing one can tell how someone else is thinking or feeling, without them telling, otherwise known as fortune telling.
Should Statements: self criticizing or criticizing others with “should,” “ought,” “must,” or “have to.” Basically meaning motivating by following strict beliefs or rules in order to be good enough.
Personalization: believing things others say or do is a direct reaction to them self. It involves comparing to others and feeling responsible for things that it is not possible to responsible for.
Why CBT focuses on Behavior?
The behavior part of CBT focuses on helping make changes in behaviors that help people feel the way they want. For example; scheduling positive activities can help increase the possibility for positive experiences that disprove cognitive distortions. Role playing is also an important behavioral component of CBT as it helps practice the skills taught in CBT with the therapist, allowing for practice in a safe environment with coaching to help learn. Behavior modification can be helpful when behavior change is directly rewarded, encouraging continued use of healthy behavior and thinking. Finally, self-monitoring is used to log daily behaviors, noting which are positive and which reinforce the cognitive distortions, leading to negative emotions. All of these behavioral changes target the cognitive distortions that cause negative mood, emotion, and behavior; meaning, changing behavior can change thought patterns.