CBT: What It Is and What It Can Do For You

 

Are there areas in your life that pose a challenge to you? Have you decided to face this challenge alone because you do not feel seeing a therapist is right for you? Cognitive-behavioral therapy (CBT) may be the answer that you are looking for.

Many people have the impression that seeing a therapist requires spending their time exploring their life history and attending sessions for a lengthy period. Others may be deterred by the thought of becoming vulnerable to a therapist, whom they view as an authority figure. CBT is a therapy modality that shatters these stereotypes of therapy.

CBT was discovered in the 1960s by Aaron Beck. A psychiatrist, Beck concluded that the clients that he was treating were running an internal dialogue in their minds. This inner dialogue was keeping them stuck in their issues; however, they were only revealing a small part of their thinking to him.

CBT and thought patterns

The following is an example of an internal dialogue: A client in therapy may wonder why the therapist is not saying much. This thought leads the client to think that the therapist is upset with her. In turn, this thought affects how the client feels about therapy.

Beck believed that internal dialogues are formed in childhood and become solidified as a thought pattern as people age. People develop associations between events, which becomes their way of thinking. An example would be a girl who did not receive affection from her parents but received attention when she did well in school. She is likely to start believing that in order to be accepted, she needs to achieve at high levels. CBT sees many psychological challenges as being the result of what we tell ourselves about a given situation.

CBT and behavior patterns

While CBT addresses disempowering thought patterns, it also addresses behavioral patterns. Just as with thought patterns, behavioral patterns are often formed in the early years. For example, a person with trust issues may engage in a pattern of behavior where they repeatedly test the loyalty of their partner.

Characteristics of Cognitive Behavioral Therapy

  • Unlike traditional therapy where the client discusses whatever comes to mind, CBT is for addressing more well-defined problems such as relationship issues, challenges at work, anxiety, depression, anger issues, alcohol or substance abuse, and phobias.
  • Sessions focus on what is happening now; delving in the past is only done as needed.
  • CBT sessions are collaborative. In CBT, both client and therapist work together to move the client toward the achievement of goals. Acting as a team, the client and therapist develop strategies to address the belief systems and behaviors that prevent the client from experience well-being.

The goal of CBT is empowerment. Clients develops an understanding of their beliefs and behaviors and develop strategies for creating change. In this manner, the client takes on an active role in therapy. Doing so leads clients to the ultimate goal, becoming their own therapist.

Typical Structure of a CBT Session

  • Problems are identified, and goals are developed. These problem areas become the focus for sessions.
  • During each session, time is provided to discuss insights or questions from the previous session.
  • Toward the end of each session, clients create homework assignments for themselves, where they apply the strategies that they learned.

CBT strategies

  • Challenging irrational thoughts
  • Confronting one’s fears
  • Relaxation techniques for the mind and body
  • Role-playing for challenging interpersonal interactions
  • Developing problem-solving skills for difficult situations

The client’s progress with homework is addressed in the following session. During early sessions, the assignment may be keeping a diary to record what triggers feelings of anxiety or depression. As the sessions progress, clients’ homework may be applying the coping skills they have learned when they experience anxiety or depression.

Structuring CBT sessions in this manner increases the efficiency of the therapy sessions. As the sessions progress,  the client becomes increasingly responsible for what is discussed during the sessions. By the time of the last session, the client is empowered enough to address difficulties on their own. Typically, a course of CBT consists of 20 sessions with one session per week.

Example of How CBT Can Help Someone With Stress

There are many CBT strategies.  The following example demonstrates use of the strategy where one replaces a disempowering belief with an empowering one.

In this example, a client has come to see a CBT therapist for help managing stress. The therapist begins by helping the client to identify the belief that is leading to the stress. In this example, the client believes that if she allows herself to relax, she will let down her guard, and thus not be “on top of my game”.

The therapist then helps the client reflect on how living by this belief has cost her in her life. While reflecting on the costs of this belief, the client gets in touch with the feelings she experiences recalling these situations.

The therapist then shifts the focus to encourage the client to consider all the ways she has benefited from this current belief. By comparing the costs and benefits of her belief, the client can assess as to whether or not it is worthwhile to maintain it. If the clients determine that the costs outweigh the benefits, the client can develop a more empowering belief to replace the old one. Perhaps her new belief is, “Learning to relax will allow me to make better choices in my life.”

The client would then be encouraged to imagine all the benefits she would gain by adopting the new belief. The potential cost of adopting the new belief is also explored. By comparing the costs/benefits of the two beliefs, the client will naturally move toward incorporating the belief that offers the greatest benefits.

Contact New Connections Counseling Center for help.

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