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Still Waters

Counseling

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Cognitive Behavior Therapy (CBT)

What is Cognitive Behavior Therapy?

Cognitive Behavior Therapy (CBT) is a form of psychotherapy that teaches people to become their own therapists. CBT is based on Dr. Aaron T. Beck’s Cognitive Model, which is the theory that the way individuals perceive a situation is more closely connected to their reaction than the situation itself. CBT is an evidence-based practice, which means that it has been scientifically tested. In fact, more than 2,000 studies have demonstrated that CBT is an effective treatment for many different health and mental health conditions.

In CBT treatment, trained therapists help clients identify distressing thoughts and evaluate how realistic these thoughts are. As clients become aware of their thoughts and are able to evaluate them, they feel better. CBT therapists also work with clients on solving problems, learning new skills, and setting and achieving meaningful goals. Although initially therapists and clients work together in session, therapists also empower clients by teaching them to evaluate their thoughts and practice their new skills on their own, outside of therapy.

When implemented correctly, CBT helps individuals get better and stay better.

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Dr. Judith Beck of the Beck Institute for Cognitive Behavior Therapy explains Cognitive Behavior Therapy (CBT).

How Does CBT Work?

CBT is based on the Cognitive Model which says that a person’s thoughts influence their behavioral, emotional, and physiological reactions to the situations in their lives.

When people are suffering from a mental health condition like depression or anxiety, they may feel negatively about themselves, others, the world, and the future. This can lead to patterns of unrealistic or unhelpful thoughts in their daily lives. These thoughts, in turn, can lead to unhelpful or maladaptive reactions, creating a feedback loop that can continuously reinforce underlying negative beliefs.

One of the goals of Cognitive Behavior Therapy is to interrupt that feedback loop by helping people evaluate their thoughts and think  about the situations in their lives in more helpful ways. CBT therapists start by helping clients do this in session, but eventually teach clients to evaluate their thoughts on their own, outside of session.

How CBT Helps

CBT can help individuals with many health and mental health conditions learn lifelong skills to improve their lives and achieve their goals. But individuals don’t do this work alone. One of the most important aspects of CBT is the relationship between a client and their therapist, often called the therapeutic relationship. This relationship must be strong and collaborative for treatment to work.

 

What are CBT Sessions Like?

CBT treatment is tailored to each individual and is adapted to meet the needs of the client. A good CBT treatment plan carefully considers the client’s goals, values, presenting problems, symptoms, demographics, developmental history and more. However, there are certain elements that are common to CBT treatment across a range of populations and settings. 

Does CBT Work?

CBT is the most extensively studied and widely practiced form of psychotherapy. When Dr. Aaron Beck developed CBT in the 1960s and 1970s, he knew he would need to demonstrate that his revolutionary treatment worked. In 1977, he and colleagues published the results of a landmark randomized clinical trial comparing CBT to anti-depressant medication. CBT became the first talking therapy demonstrated to be more effective than medication for the treatment of depression. In 1981, a UK-based research group published the results of a second study with the same findings.

Since then, more than 2,000 studies have demonstrated the efficacy of CBT for psychiatric disorders, psychological problems and medical problems with a psychiatric component.

Things to Keep in Mind about CBT

It can be challenging: CBT believes that the way people get better is by making small changes in their lives every day.

It takes time: Although CBT is designed to be time-sensitive and clients often see improvement more quickly than with other types of therapy, you shouldn’t expect instantaneous results. Continuing to attend scheduled therapy sessions and completing your Action Plan between sessions will help you feel better faster.

Therapists and clients work together to make treatment effective: In CBT, the relationship between the therapist and the client is paramount. Therapists and clients work together to decide what to talk about in each session, how much time to devote to each issue being discussed, and what interventions would be most helpful.

Honesty is critical: Your CBT therapist should ask you regularly what you are finding helpful or unhelpful about treatment and whether there’s anything they may have gotten wrong. It’s important to be honest with your therapist. This is critical information that can help them improve their treatment plan and benefit you in the long run.

CBT sessions are highly structured: If you have tried other types of therapy, you may be used to a loose session structure, where you are encouraged to relate whatever is on your mind with minimal intervention by the therapist. CBT therapists maximize session time by structuring sessions to make sure that the client’s most pressing problems get solved and most important goals are met. If you are having difficulty adjusting to the structured nature of a CBT session, you should discuss this with your CBT therapist.

Sometimes CBT clients still need medication, and that’s okay: CBT is often used in tandem with medication. CBT can help you manage your medication and can facilitate open and honest conversations about medication preferences with your prescribing physician.

(From, "What is Cognitive Behavior Therapy?" by Beck Institute for Cognitive Behavior Therapy.  Retrieved 7/2022.)