A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. The general approach developed out of behavior modification, Cognitive Therapy and Rational Emotive Behavior Therapy, and has become widely used to treat various kinds of neurosis and psychopathology, including mood disorders and anxiety disorders.
The particular therapeutic techniques vary according to the particular kind of client or issue, but commonly include keeping a diary of significant events and associated feelings, thoughts and behaviors; questioning and testing cognitions, assumptions, evaluations and beliefs that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; and trying out new ways of behaving and reacting.
Relaxation and distraction techniques are also commonly included. CBT is widely accepted as an evidence and empirically based, cost-effective psychotherapy for many disorders and psychological problems. It is sometimes used with groups of people as well as individuals, and the techniques are also commonly adapted for self-help manuals and, increasingly, for self-help software packages.
The basics
CBT is commonly based on the idea that how we think (cognition), how we feel (emotion and affect), and how we act (behavior) all interact and go together. Specifically, that our thoughts influence our feelings and behavior, our feelings influence our behavior and thoughts and our behavior influence our emotions and thoughts. These modalities are therefore interrelated and change in one modality will in all probability influence one of the others.
An example will illustrate this process. Someone who, after making a mistake, thinks "I'm useless and can't do anything right." This impacts negatively on mood, making the person feel depressed; 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.
In therapy the objective is often to identify irrational or maladaptive thoughts, assumptions and beliefs that is related to debilitating negative emotions and identify what it is about them that is dysfunctional or just not helpful; this is done in an effort to reject the distorted tendencies and replace them with more realistic and self-helping alternatives.
Cognitive Behavioral Therapy is not an overnight process. Even after patients have learned to recognize when and where their mental processes go awry, it can take months of concerted effort to replace any dysfunctional cognitive-affective-behavioral processes or habit with a more reasonable, salutary one.
The cognitive model especially emphasized in Aaron Beck's cognitive therapy says that a person's core beliefs (often formed in childhood) contribute to 'automatic thoughts' that pop up in every day life in response to situations. Cognitive Therapy practitioners hold that clinical depression is typically associated with negatively biased thinking and irrational thoughts.
Cognitive Behavioral Therapy is often used in conjunction with mood stabilizing medications to treat bipolar disorder. Its application in treating schizophrenia along with medication and family therapy is recognized by the NICE guidelines (see below) within the British NHS.
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This definition is part of a series that covers the topic of Anxiety. The Official Guide to Anxiety is Hale Dwoskin. Dwoskin, New York Times Best-Selling author of The Sedona Method, and co-author of the best-selling Happiness Is Free (five-book series) is the CEO and Director of Training of Sedona Training Associates, an organization that teaches courses based on the emotional releasing techniques originated by his mentor, Lester Levenson. Dwoskin is an international speaker and featured faculty member at Esalen and the Omega Institute. He is also one of the 24 featured teachers of the book and movie phenomenon, “The Secret.” For thirty years, he has regularly been teaching The Sedona Method techniques to individuals and corporations throughout the United States, Canada and the United Kingdom.
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