What is Cognitive Behavior Therapy CBT?

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Definition of cognitive therapy

Cognitive behaviour therapy is an action oriented form of psychosocial therapy that assumes that maladaptive or faulty thinking patterns cause maladaptive behaviour and "negative" emotions. Maladaptive behavior is behavior that is counter productive or interferes with everyday living. The treatment focuses on changing the individual’s thoughts (cognitive patterns) in order to change their behavior and emotional state.

Purpose of cognitive therapy

Theoretically, cognitive therapy can be employed in any situation in which there is a pattern of unwanted behavior accompanied by distress and impairment. It is a recommended treatment for a number of mental disorders, social phobia, obsessive compulsive disorder (OCD), eating disorder, substance abuse, anxiety or panic, agoraphobia, post traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD). Cognitive Therapy is also frequently used as a tool to deal with chronic pain for patients with illnesses such as rheumatoid arthritis, back pain, and cancer. Patients with sleep disorders may also find cognitive behavior therapy a useful tool treatment for insomnia.

Precautions

Cognitive Behavior therapy may not be suitable for some patients. Those who don’t have a specific behavioral issue they wish to address and those whose goals for therapy are to gain insight into the past, may be better served by psychodynamic therapy. Patients must also be wiling to take a very active role in the treatment process.

Cognitive behavioral intervention may be in appropriate for severely psychotic patients and for cognitively impaired patients (for example, patients with organic brain disease or a traumatic brain injury), depending on their level of functioning.

Description

Cognitive therapy combines the individual goals of cognitive therapy and behavioural therapy. Pioneered by psychologists Aaron Beck and Albert Ellis in the 1960's cognitive therapy assumes that maladaptive behaviors and disturbed mood or emotions are the result of inappropriate or irrational thinking patterns called automatic thoughts. Instead of reacting to the reality of a situation, an individual reacts to his or her own distorted viewpoint of the situation. For example, a person may conclude that he is "worthless" simply because he failed an exam or didn't get a date. Cognitive therapists attempt to make their patients aware of these distorted thinking patterns, or cognitive distortions and change them (a process termed cognitive restructuring).

Behaviour therapy or behaviour modification, trains individuals to replace undesirable behaviours with healthier patterns, unlike psychodynamic therapies it does not focus on uncovering or understanding the unconscious motivations that may be behind the maladaptive behavior. In other words, strictly behavioral therapists don't try to find out why their patients behave the way they do, they just teach them to change the behavior.

Cognitive behavioural therapy integrates the cognitive restructuring approach of cognitive therapy with the behavioural modification techniques of behavioural therapy. The therapist works with the patient to identify both the thoughts and the behaviors that are causing distress, and to change those thoughts in order to readjust the behavior. In some cases the patient may have certain fundamental core beliefs, called schemas, which are flawed and require modification. For example, a patient suffering from depression may be avoiding social contact with others, and suffering considerable emotional distress because of his isolation. When questioned why, the patient reveals to his therapist that he is afraid of rejection, of what others may do or say to him. Upon further exploration with his therapist they discover that his real fear is not rejection but the belief that he is hopelessly uninteresting and unlovable. His therapist then tests the reality of that assertion by having the patient name friends and family who love him and enjoy his company. By showing the patient that others value him, the therapist exposes the irrationality of the patient’s belief and provides him with a new model of thought to change his old behavior pattern. In this case, the person learns to think "I am an interesting and lovable person; therefore I should not have difficulty making new friends in social situations." If enough irrational cognitions are changed, this patient may experience considerable relief from his depression.