Cognitive Behavioral Therapy (CBT) is a form of behavioral treatment that helps people problem-solve by understanding the relationship between their beliefs, thoughts and feelings, and the behaviors that follow. It is a problem-focused, and action oriented approach, grounded in the belief that how and what a person thinks determines how they will act. For example, if a woman has depression and feels she is unimportant and invisible, when she goes out in public she will focus on the things that occur that support that belief system. Thoughts or actions that might disprove this belief system might be blocked or avoided, while she focuses on the groups of people having fun around her, exacerbating feelings of loneliness and rejection, and thoughts about being unimportant. By focusing and editing her experience through the filter of her negative beliefs about herself, the maladaptive belief system is strengthened and a vicious cycle of depression and negative thinking continue.
In CBT, there is a belief that people can adjust their thinking, which will directly influence feelings and behaviors. This adjustment process is called cognitive restructuring.
Some common cognitive errors and their associated dysfunctional assumptions include:
- Blaming: We hold other people responsible for our pain or blame ourselves for everyone else’s pain
- Shoulds: We have a list of rules about how ourselves and others should behave. People who break the rules make us angry and we feel guilty for breaking the rules ourselves.
- Excessive responsibility: “I am responsible for every failure and every bad thing that happens.”
- Polarized thinking: Viewing the world in extremes, black or white, with nothing in between.
- Filtering: We take the negative details in a situation and magnify them while filtering out all the positive aspects of a situation.
- Overgeneralization: We take a failure at one specific task and generalize it to our very self and identity. If something bad happens, we expect it to happen over and over again.
- Catastrophizing : We expect disaster to strike no matter what.
CBT offers a structured counseling approach based on an educational model. It helps to break down overwhelming problems into small, manageable parts. People engaged in CBT are asked to pay attention to and evaluate different emotional patterns and states. CBT therapists may employ common techniques such as:
- Challenging beliefs
- Putting thoughts “on trial”
- Socratic questioning
- Social, physical, and thinking exercises. These may help someone become aware of her emotional and behavioral patterns.
Homework is given to the person in treatment. It might include practical exercises, reading, or writing assignments. This helps reinforce the therapy. It challenges the person to continue working on his own, even after therapy comes to an end. Much of the research on the effectiveness of psychotherapy has been conducted using CBT, hence it has been identified as “evidence-based” practice.
CBT can be used to address the following issues:
- Chronic Pain
- Emotional Regulation
- Men’s Issues
- Mood Issues
- Self Harm
- Sexual Orientation
- Sleep Issues
- Social Anxiety
- Suicidal Thoughts
- Women’s Issues