Considering Cognitive Behavioral Therapy (CBT): A Guide To Mental Health
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Cognitive behavioral therapy (CBT) has been around since the early 1960s and was developed by psychiatrist Dr. Aaron T. Beck at the University of Pennsylvania. Passing in 2021, Dr. Beck has provided significant advancements to the field of psychology, as CBT is one of the world's most widely used forms of therapy for mental health conditions.
Dr. Beck developed his idea for CBT after noticing that many of his clients had internal dialogues, with their thoughts impacting their feelings and actions. He called the process cognitive behavioral therapy counseling since it considered a client's cognitive thought processes and how they interacted with behavioral patterns. Dr. Beck, nicknamed the father of CBT, also founded the Beck Institute, a center dedicated to education on CBT and addressing automatic negative thoughts and negative thought patterns.
Understanding how CBT functions can help you decide whether trauma-focused cognitive behavioral therapy, a specific form of therapy, can be valuable for treating your symptoms or concerns related to trauma.
The history of Dr. Aaron Beck
Aaron believed that these automatic thoughts would directly impact an individual's behavior patterns and behavioral responses. For example, if a person believed they were inherently unlikeable, they might feel anxious and experience low self-esteem, prompting them to avoid others. Due to their avoidance, they might miss out on meaningful relationships, which might reinforce their thoughts. CBT challenges these thoughts and teaches clients new methods of coping with them. Cognitive behavior therapy not only challenges these beliefs but also provides clients with coping mechanisms. Furthermore, CBT therapy assists in dealing with overwhelming life stressors in a constructive manner by dissecting methods of thinking into different aspects.
Although Dr. Beck founded CBT, talk therapy was developed by Dr. Sigmund Freud in the 1890s. Soon after, Carl Jung and Alfred Adler also introduced conceptions of psychological findings. Carl Jung and Alfred Adler were associated with the development of psychodynamic therapy.
In the early 1920s, behaviorism was the primary type of psychology used and continued to be the focus until the late 1950s, when cognitivism and existential-humanistic therapy became widespread. Humanism became the focus for the next decade, consisting of empathic, positive therapeutic relationships and rational therapy of Albert Ellis, now referred to as rational emotive behavior therapy (REBT). With the advent of online therapy and various mental health treatment options, these approaches have become more available to people seeking help for psychological distress.
The history of cognitive behavioral therapy CBT
When Dr. Beck started his tenure at the University of Pennsylvania, he conducted the depression research clinic. After several years of practicing and teaching psychoanalysis, Beck found it challenging to use the standard approaches for treating depression and started searching for a more successful method to treat his clients, particularly in cases involving negative feelings and panic disorder. As he gained more insight into human emotions and unconscious drives, Dr. Beck found that the cognitive approach, often employed in short term therapy and CBT sessions, was more reliable and developed the Beck Depression Inventory (BDI).
BDI became a universal tool for diagnosing depressive disorders. He also started noticing a theme in which his clients were experiencing negative thoughts that had a negative influence on their emotions as well as their behaviors. He then began to utilize cognitive-behavioral therapy techniques, which were studied and utilized by many other professionals worldwide during therapy sessions. This approach has been particularly helpful in addressing issues such as stress management and substance use disorder.
What cognitive behavioral therapy techniques are used today?
In modern psychology, cognitive-behavioral therapy is used successfully for treating more than depression. CBT is widely used to treat anxiety, eating disorders, chronic pain, substance use disorders, phobias, panic attacks, post-traumatic stress disorder (PTSD), relationship issues, grief, sleep disorders, and bipolar disorder, among other concerns. Below are several techniques utilized in these treatments, which often involve dialectical behavior therapy as well. The therapy involves determining how many sessions are needed, depending on the individual's needs and health insurance coverage.
Untangling thought distortions while considering cognitive behavioral therapy
One of the main goals of CBT is untangling cognitive distortions, which are unwanted or unhelpful thought patterns. Understanding what cognitive distortions look like and learning to label them can help you challenge them when they occur. When considering cognitive behavioral therapy, recognizing how it addresses these distortions can guide you in deciding if CBT is the right approach for your needs.
Journaling
Studies have found that expressive writing through a technique like journaling can help individuals express emotions and improve mood. By paying attention to and keeping track of your moods and emotions, you can trace them to common causes. You can also use the journal to track the times and dates of these occurrences and how you responded to them. If you want to, you can discuss these entries with your cognitive behavioral therapist to further understand how your mind processes thoughts.
Cognitive restructuring
Cognitive restructuring (sometimes called cognitive reframing) is used after you have identified cognitive distortions. You and your therapist may discuss how the distorted thinking pattern started and how it makes you feel about yourself. In doing so, you may be able to target negative beliefs about yourself that could be affecting your self-esteem. It's just one of many cognitive psychology examples of a potentially effective treatment for those experiencing mental health challenges.
Exposure and response prevention (ERP)
There are several types of exposure therapy utilized in CBT. If you are experiencing a phobia, fear, or compulsive pattern, your therapist can help you reduce fear by repeatedly exposing you to stimuli that scare you. They can start small and build up to more significant fears over time. Exposure therapy is especially effective in treating obsessive-compulsive disorder (OCD).
Progressive muscle relaxation
For those familiar with mindfulness, progressive muscle relaxation (PMR) is similar to the body scan mindfulness process. As you go through, you can identify each muscle group and relax them one at a time until your whole body is relaxed. PMR can be done at home or in a therapist's office.
Relaxed breathing
Breathwork is often used in mindfulness practice, meditation, and yoga. There are many ways to relax your breathing, including guided imagery, audio recordings, YouTube videos, or therapy. Relaxed breathing can be used alone or with PMR.
Common exercises used by cognitive-behavioral therapists
There are many CBT exercises that therapists teach their clients to help them cope with their thoughts and emotions. While specific exercises are structured for certain issues, many can be used to target unwanted thought patterns or behaviors, including the following.
Cognitive pie charts
Cognitive pie charts help clients re-examine how they think by allowing them to write down their thoughts in a visual pie chart. They can assign a certain percentage to each thought to see which has the most power over their behaviors and mood.
Constructive worrying
For clients who experience anxiety, worry, or frequent fear, the constructive worrying exercise allows them to focus on the worry for a specific timeframe before putting it out of their minds. For example, they could fill out a worksheet of what they're worrying about and draft three solutions for each worry. After 30 minutes of writing, they must put the worksheet away and commit to putting the worries out of their mind until the next worry session.
Treating thoughts as guesses
Cognitive-behavioral therapy or cognitive psychotherapy often teaches clients to consider their thoughts a guess instead of a fact. For example, if you want to learn to dance but have trouble in your first dance class, tell yourself you're guessing that you struggle to dance but that it may be possible with work. Adding a positive spin on it can be more effective than deciding you can't dance as a fact and not trying.
Considering cognitive behavioral therapy? Here’s how CBT works
CBT functions on the premise that how you think and what you believe impacts your actions. It treats specific symptoms by choosing goals you want to achieve to succeed. This type of therapy can be in the form of individual face-to-face therapy, group sessions, couples therapy, or family therapy.
CBT is structured and teaches skills and strategies to target negative thoughts and behaviors. Although many believe that feelings are directly caused by how others treat us, our thoughts and behaviors may also drive our feelings. CBT shows us strategies to take control of our thoughts and, in turn, change our reactions
Cognitive behavioral therapy CBT in other settings
Cognitive-behavioral therapy is not only used to support individuals. The practice of CBT can be valuable in marriage or family therapy, as well. In addition, it can be utilized for children and adolescents.
CBT for anxiety in young people
Young people are commonly affected by anxiety disorders. Treating adolescent anxiety can be challenging because hormonal changes, peer pressure, and new relationships can cause stress. However, CBT has proven effective in doing so.
CBT for post-traumatic stress disorder
Cognitive behavioral therapy is a well-established treatment for post-traumatic stress disorder (PTSD). It helps individuals process and reframe distressing thoughts and memories associated with traumatic events, enabling them to reduce avoidance behaviors and emotional numbness.
Counseling options to improve mental health
If you're considering CBT, you're not alone. According to The New York Times, 69% of all therapists use or are trained in CBT for their clients. As a heavily researched form of psychotherapy, it can benefit various symptoms, diagnoses, and stressors, making it a versatile option. However, despite its popularity, many individuals face barriers to in-person CBT due to cost, availability, or a lack of availability, but you can search for "cognitive therapy near me" and find a licensed therapist in your local area.
Seeking mental health treatment from an online therapist
You can also consider online CBT if you have been considering CBT but don't know how to make in-person therapy work. One recent study found that online CBT is effective in treating long-term exposure to stress. Another study found it as effective as in-person therapy for treating symptoms of anxiety and depression.
When you sign up for an online platform like BetterHelp for individuals, Regain for couples, or TeenCounseling for teens aged 13 to 19, you can get matched with one of over 30,000 therapists. Many of these therapists are trained in CBT and other popular therapy methods. You can reach out to your therapist anytime through the messaging option for advice throughout the week.
Takeaway
Cognitive behavioral therapy (CBT) is a popular form of therapy used to treat a variety of mental health problems, including anxiety, depression, eating disorders, bipolar disorder, and obsessive-compulsive disorder. CBT is generally based on the idea that people can learn to recognize and challenge inaccurate thoughts, which may lead to more desirable thoughts and behaviors.
If you’re interested in learning more about CBT treatments but don’t feel comfortable with traditional therapy at this time, you may benefit from speaking to an online therapist. With BetterHelp, you can be matched with a therapist who has experience using CBT to treat your specific areas of concern. Take the first step toward finding an online therapist who practices CBT and reach out to BetterHelp today.What do you do during cognitive behavioral therapy?
During cognitive behavioral therapy (CBT) sessions, you will work with your therapist to examine the interaction between your behaviors, thoughts, and feelings. You will likely identify unhelpful thought patterns, and work to reframe them with your therapist.
Outside of sessions, many cognitive behavioral therapy providers will assign their clients homework with the goal of eventually problem solving and healthily navigating life challenges on their own.
What are examples of behaviors addressed in CBT treatment?
Behaviors like avoidance, anger, procrastination, or irritability are often linked to unhelpful thought patterns (ex: “I’m terrible at everything, what’s the point of trying?”) and emotions like sadness, anxiety, or hopelessness.
Through CBT, people can learn how to stop relying on maladaptive coping mechanisms (like avoidance), reframe unhealthy thought patterns, and build greater self-awareness. Oftentimes, the development of these skills and tools helps resolve problematic behaviors.
What are the 5 steps of CBT?
Cognitive behavioral therapy (CBT) is a type of short-term psychotherapy that can be broken down into these five stages:
Stage One: Assessment of the client and building a strong therapeutic alliance.
Stage Two: Collaborative identification of challenges, creating SMART goals, and formulating a treatment plan.
Stage Three: Developing and practicing strategies to challenge maladaptive thought patterns, utilize healthy coping skills, and use behavior therapy techniques such as exposure or desensitization.
Stage Four: Maintenance of healthy coping skills and self-awareness and learning to identify triggers and address them proactively.
Stage Five: During stage five of cognitive behavioral therapy, goals are evaluated, milestones and recognized, and the client is left with lifelong cognitive therapy skills that can help them manage symptoms of depression, chronic pain, post-traumatic stress disorder, anxiety, and many other challenges.
How to explain CBT to those with post-traumatic stress disorder?
Many therapists explain to their clients that CBT is a short-term, collaborative, goal-oriented approach to talk therapy. They might draw a triangle to show the connection between thoughts (cognitions) creating feelings, feelings (emotions) creating behaviors, and behaviors reinforcing thought patterns.
A therapist treating a client with post-traumatic stress disorder, for example, will likely explain the relationship between blaming oneself for the trauma, fear, and avoidant behaviors.
How to use CBT in daily life?
People with anxiety, depression, traumatic stress disorders, and other challenges often go to cognitive behavioral therapy to learn how to manage their symptoms and heal. Outside of therapy sessions, the skills learned in therapy can be applied to daily life to get the most benefit out of them.
For example, when you have a negative thought, it can be helpful to question its validity and reframe it. If you think, “I’ll never be any good at this,” you could instead remind yourself, “This is hard now, but with practice, I can get better.” This method of self-talk can help shift negative emotions into more constructive ones.
Other CBT techniques, like mindfulness, deep breathing, and problem-solving, can help people in their everyday lives, especially in stressful situations or challenging social situations. CBT helps individuals develop healthier behavioral patterns and respond more effectively to difficult situations, reducing distress and improving emotional health over time.
How to treat a client using CBT?
Cognitive behavioral therapy (CBT) is often used to address mental disorders, mental illness, and other psychological problems—such as depression, anxiety disorders (like social anxiety, social phobia, or generalized anxiety disorder), eating disorders, and post-traumatic stress disorder (PTSD). Psychological therapy like CBT follows several core principles, helping individuals recognize unhelpful behavior and develop learned patterns for healthier coping strategies.
In some cases, CBT may be combined with other forms of treatment, such as psychiatric medications, for better results. A therapist helps guide clients through structured sessions designed to teach people how to manage difficult situations and improve their ability to engage in social situations in everyday life.
How successful is cognitive behavioral therapy?
Cognitive behavioral therapy is currently considered the gold standard of psychotherapy or psychological therapy due to the robust evidence supporting its effectiveness for many psychological problems, including mental illness, anxiety, depression, and post-traumatic stress disorder.
It follows several core principles, helping replace unhelpful behavior with learned patterns for better coping. CBT can also be combined with other forms of treatment, such as psychiatric medications, for improved results. Many people find it useful in daily life, especially in handling social situations with more confidence.
What is the role of the counselor in cognitive behavioral therapy?
Cognitive behavioral therapists work collaboratively with their clients to help them identify psychological problems and maladaptive thought patterns, develop new skill sets, and achieve their goals. They may use other forms of therapy to improve results, helping clients manage psychological problems and develop healthier thinking patterns.
Can you do cognitive behavioral therapy on your own?
Some people might have success incorporating self-directed CBT techniques into their lives. However, working with a licensed cognitive behavioral therapist will likely be more effective, especially at first. These professionals hold at least a master’s degree in psychology, specialized training to address psychological problems, and supervised clinical hours providing CBT for clients.
What therapy is used to stop worrying and anxiety?
People who worry a lot, to the point where it’s uncontrollable or more significant than the situation warrants, may have a type of anxiety called generalized anxiety disorder (GAD). One of the most common and effective types of therapy for GAD is cognitive behavioral therapy.
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