Cognitive-behavior therapy (CBT) is known to be one of the most successful treatments for several psychological problems. It is typically used by many psychologists to treat depressive disorders, anxiety disorders, and behavior problems in children. Learning how CBT works is usually part of the treatment process and can help inform those in the process of seeking psychological treatment.
Basic Principles of CBT
CBT is based on the belief that thoughts, feelings, and behavior are inter-related and impact each other. Since thinking, feelings, and behavior are interconnected, treatment interventions that focus directly on specific thoughts, feelings, or behaviors are expected to impact other thoughts, feelings and behavior. The main goal of CBT is to regulate, modify, augment, or replace problematic thoughts, feelings, and/or actions so that problem behaviors, thoughts, or feelings are interrupted and, ultimately, replaced with more a functional thought-feeling-behavior pattern.
The psychological problems treated with CBT are understood to fall into two classes: Internalizing problems are believed to result when distorted thinking leads to exaggerated emotions or behavior as is the case with depression or anxiety; Externalizing problems are believed to result when the absence of certain thinking patterns produce a lack of self-control as is the case with aggressive or conduct disorders. CBT techniques, therefore, either serve to change existing exaggerated thought-feeling-behavior patterns or help the individual create new, more functional ones.
CBT Techniques
There exist many different types and labels of CBT and many different ways of delivering this treatment. However, there are several basic techniques or tools used by CBT therapists. To some degree, psychologist preferences, style, experience, and the nature of the client problem will influence the specific techniques selected.
- Teaching how thoughts, feelings, and behaviors operate;
- Challenging, disputing or re-interpreting existing thoughts, feelings, or behavior;
- Teaching new ways of understanding and thinking about self and others;
- Teaching self-observation and self-control of thoughts, feelings, or behavior;
- Coping skills training;
- Problem-solving skills training;
- Social skills training;
- Observational learning or modeling desired behavior (often with children);
- Behavior management training (often with children);
- Relaxation or stress-management training;
- Visualization, imagery, or mental rehearsal of desired behavior;
- Behavioral practice, rehearsal, or shaping towards desired behavior;
- Systematic or graded exposure/desensitization of feared objects/situations (for phobias);
In reality, any psychological treatment that employs any of the techniques above to specifically target problematic thinking or behavior patterns can be considered a form of CBT. Rarely is therapy restricted to using one technique, but often encompasses several tools alongside some talk therapy.
CBT Therapist Tasks
In addition to evaluating the problem and selecting the most appropriate techniques, the CBT therapist performs other key tasks. The CBT therapist...
- helps clients tell their stories;
- educates clients about the clinical problem they are experiencing;
- explains problem connection to thought-feeling-behavior patterns;
- encourages clients to perform personal challenges or homework that supports change;
- ensures clients take credit for positive changes they themselves have brought about; and
- schedules follow-up sessions to help clients maintain change or prevent a relapse.
Clearly, unlike many talk or insight-oriented therapies, CBT requires the therapist perform as teacher, trainer, and director of the client and therapy. This technique and experience is much more structured, tightly focused and shorter term than traditional insight-oriented or talk-based psychotherapies. It provides effective treatment for adults and children in need of help overcoming depressive, anxiety, and behavior disorders who are neither able nor inclined to pursue longer-term, unstructured insight-oriented talk-based psychotherapies.
Further Reading on Psychological Treatment Issues
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