Cognitive behavioral therapy is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events.
The term “cognitive-behavioral therapy (CBT)” is a very general term for a classification of therapies with similarities. There are several approaches to cognitive-behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy.
Cognitive-behavioral therapy does not tell people how they should feel. However, most people seeking therapy do not want to feel they way they have been feeling. The approaches that emphasize stoicism teach the benefits of feeling, at worst, calm when confronted with undesirable situations. They also emphasize the fact that we have our undesirable situations whether we are upset about them or not. If we are upset about our problems, we have two problems — the problem, and our upset about it. Most people want to have the fewest number of problems possible. So when we learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a better position to make use of our intelligence, knowledge, energy, and resources to resolve the problem.
Cognitive-behavioral therapy differs from other kinds of psychotherapy in that it emphasizes the self-help aspect of treatment. CBT focuses on practical, personal skills for dealing with stress and keeping your reactions in check.
CBT directly addresses a common pitfall of anxiety and depression: overreaction. Patients who are prone to overblown reactions and, consequently, feelings of hopelessness are taught mental techniques that direct these thoughts towards a more constructive mindset. An example will illustrate the process: Having made a mistake, a person believes, “I’m useless and can’t do anything right.” This, in turn, worsens the mood, leading to feelings of depression; the problem may be worsened if the individual reacts by avoiding activities and then behaviorally confirming his negative belief to himself. As a result, a successful experience becomes more unlikely, which reinforces the original thought of being “useless.” In therapy, the latter example could be identified as a self-fulfilling prophecy or “problem cycle,” and the efforts of the therapist and client would be directed at working together to change this. This is done by addressing the way the client thinks and behaves in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities. If, as a result, the client escapes the negative thought patterns and destructive behaviors, the feelings of depression may, over time, be relieved. The client may then become more active, succeed more often, and further reduce feelings of depression.
However, note that many doctors will not normally recommend CBT as a substitute for regular psychotherapy. But many mental health professionals agree that CBT can indeed increase the effect of regular therapy.
Also, there is a consensus that in healing anxiety and depression in mild cases where standard psychotherapy is not required (e.g., a patient recovering from an illness), some CBT sessions would be beneficial.
What other treatments are there and how do they compare?
CBT is used in many conditions, so it isn’t possible to list them all in this leaflet. We will look at alternatives to the most common problems – anxiety and depression.
CBT isn’t for everyone and another type of talking treatment may work better for you.
CBT is as effective as antidepressants for many forms of depression. It may be slightly more effective than antidepressants in treating anxiety.
For severe depression, CBT should be used with antidepressant medication. When you are very low you may find it hard to change the way you think until antidepressants have started to make you feel better.
Tranquillizers should not be used as a long term treatment for anxiety. CBT is a better option.
Problems with Cognitive behavioral therapy
If you are feeling low and are having difficulty concentrating, it can be hard, at first, to get the hang of CBT – or, indeed, any psychotherapy. This may make you feel disappointed or overwhelmed. A good therapist will pace your sessions so you can cope with the work you are trying to do. It can sometimes be difficult to talk about feelings of depression, anxiety, shame or anger.