What Is Cognitive Behavioral Therapy? Definition And Applications
Updated March 06, 2020
Reviewer Lauren Guilbeault
There are many different types of therapy, and some are more suited for certain conditions than others. Cognitive behavioral therapy, or CBT, is a type of talk therapy, or psychotherapy, that can help with many emotional and mental conditions or issues. In fact, CBT therapy is more than just one type of therapy; it is a group of different techniques that psychologists, therapists, and counselors use to modify thoughts, behaviors, feelings, and emotions.
What Is CBT?
The definition of cognitive behavioral therapy (CBT) is a short-term psychotherapy treatment that uses a practical and intensive approach to solving issues such as depression, anxiety, addiction, and other behavioral or emotional concerns. It is based on the cognitive model of emotional responses and is more of a brief type of treatment in which the patient learns to challenge and change their unhealthy or unhelpful attitudes, beliefs, thoughts, and emotions to improve the patient's behaviors and emotional regulation. There have been numerous studies and research that showed CBT could lead to significant improvement in daily functioning and the patient's quality of life.
How Does Cognitive Behavioral Therapy Work?
Although it was originally designed for treating depression, it has been found that CBT is helpful in many situations such as anxiety, eating disorders, addictions, post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), obsessive-compulsive disorder (OCD), psychotic disorders, and conduct disorders like aggression in adolescents. In fact, CBT is the recommended treatment in many of these disorders before considering medication or other more intensive treatments. Some of the reasons that CBT is introduced include:
- Managing symptoms of mental illnesses
- Preventing relapse of mental illness symptoms
- Treating a mental condition when medication is not a good choice
- Learning new techniques for dealing with stress
- Identifying ways to manage emotions
- Resolving relationship issues
- Learning better ways to communicate with others
- Coping with loss or grief
- Overcoming emotional issues related to violence, abuse, or neglect
- Dealing with serious or chronic medical illness
- Managing chronic physical symptoms
Most CBT therapists use CBT as a way to change the patient's cognitive distortions, giving them a better way of thinking to replace the negative thoughts they are having. For example, some patients may stress themselves unnecessarily over things that the rest of us naturally do not even think about. They will magnify a small incident and make it into a full-blown disaster that they cannot stop thinking about. One example is the patient who goes over conversations in their head that they had with someone (or everyone) and keep going over it for days or weeks, trying to think of some way that they could have done things differently. A slight disagreement over a movie or book that they had with their spouse that the spouse has completely forgotten five minutes later can continue in the patient's head for days, weeks, or months. There are many cognitive distortions, which include:
- Heaven's Reward Fallacy
With this fallacy, the patient may believe that their good deeds and niceness will reward them and that nothing bad will ever happen to them. While it is true that being nice is a good thing, there is nobody keeping score, and bad things do happen to good people. This type of thinking will lead to bitterness and depression when that reward does not come.
- Never Being Wrong
When someone believes that they are always right, they are constantly trying to prove their actions and opinions are better than everyone else's. Not only is this unhealthy for the patient, but it is also not a great personality trait either. Going to any lengths to prove they are right can be a full-time job and a major source of stress and anxiety.
Constantly labeling things is a recipe for disaster. For example, calling yourself stupid or failure will eventually cause you to believe that you are. If the patient thinks they are hopeless and cannot do things right, they will not even try to do anything. Everyone has flaws but it does not define who we are, and everyone has both good and bad qualities.
- Fallacy Of Change
Some people think that they can change people. Believing that if they help someone or encourage them enough that the person will be what they want them to be. Trying to pressure someone into doing things your way or being how you want them to do not work. People only change if and when they want to change.
- Emotional Reasoning
With this type of thinking, the person believes that if they feel a particular way, that it must be the truth. For instance, if a person feels that they are boring or dull, they believe that everyone sees them that way because it is a fact. They may believe that someone is mad at them when in reality that person has no ill will towards them at all. Believing something does not make it true.
- Should Have Or Shouldn't Have
Although it is common and natural to sometimes think about how you should have or should not have done something differently, some individuals take it to the extreme. They have a certain set of rules for themselves and the rest of the world, and if you do not play by their rules, they get angry. Similarly, if they do not follow their own rules, they feel overwhelming guilt.
- The Blame Game
With this fallacy, the individual believes that everything that happens to them is someone else's fault. For example, if a person does not get a job they applied for, they may blame it on the interviewer, thinking that they did not give them a fair chance when in fact it was just because they did not have the right experience. Thinking that everything that happens to you because of something that someone else does or thinks is unrealistic and causes undue stress and negativity.
- The Fairness Fallacy
If an individual thinks that everyone has to play by their rules, or it is not "fair" is a fairness fallacy that brings on resentment and arguments with those who do not agree. Believing that you know what is fair and being unable to change or listen to reason can cause disappointment and unhappiness. Life is not fair, and if a person goes around thinking that there is a conspiracy against them or that everyone is against them, it can lead to disaster.
- Controlling Fallacy
We have all heard of people being controlling and may even be a bit controlling ourselves, but the control fallacy describes an individual who sees themselves as a helpless victim and believes that fate or destiny is against them. They think it is impossible to change things in their life because they have a preset destiny so they will not even try.
Someone who thinks that everything is about them has a fallacy of personalization. Thinking that every little thing that happens is your fault or because of something that you did is unrealistic. The individual may believe that someone's positive or negative response is because of something they said or did when in reality it had nothing to do with them.
- Making A Mountain Out Of A Molehill
Catastrophizing, or expecting disaster all the time can cause chronic anxiety and depression. The saying "making a mountain out of a molehill" is pretty self-explanatory. It just means that the individual always expects things to go wrong or they take a small problem and turn it into a major issue. They can take a common issue like missing a phone call from a friend and go over and over it again and again in their head until they imagine the worst. Like that the friend hates them and will never speak to them again.
- Jumping To Conclusions
Similar to catastrophizing and personalizing, believing that you know what a person is thinking is a fallacy that can take over your thoughts and put ideas into your head that do not need to be there. The person who believes that they know what others are thinking may believe that an individual dislikes them or is ignoring them when the person does not see them and say hi. In other words, the patient may see a friend across a room and believe that a friend saw them but is avoiding them when they did not see them in the first place.
- Thinking In General
Overgeneralizing things means that the person is concluding things based on just one thing that happens. They may conclude that something bad will happen every time they see a blue car because they saw a blue car right before they had a car accident. They will expect the same thing to happen every time they see a blue car. This, of course, is completely unrealistic and can lead to OCD or phobias as well as anxiety and depression.
- Everything Is Black And White
Some individuals believe that things are either good or bad, with nothing in between. There is no middle ground or a gray area, only black or white. In other words, people (including themselves) are either perfect or failures. Someone cannot be good at something; they are either perfect at it with no mistakes or they are horrible at it. For example, if a professional piano player makes one mistake, the individual thinks that they are a failure at piano playing. When the truth is, we all make mistakes. Nobody is perfect.
When a person hears only one part of the story and ignores the rest, that is filtering. In other words, they hear only what they want to hear. Some people call it selective hearing. They will filter out whatever they do not want to hear or see and only concentrate on the rest. Like only thinking about the negative aspects of life and ignoring the positive.
CBT Therapy Techniques
Part of the CBT technique is to learn coping strategies to solve present problems and control behavior. A therapist may choose to do one-on-one therapy face-to-face in the office or online, or they may think that group therapy is better for a certain problem or individual. Basically, CBT is a form of problem-specific talk therapy that focuses on a goal that the patient sets out to achieve. Some of these techniques include:
- Multimodal therapy including biological, interpersonal, cognition, imagery, sensation, affect, and behavior.
- Dialectical behavior therapy to address thinking patterns
- Rational emotive behavior therapy (REBT) to address emotions
- Practicing skills to increase positivity
- Keeping a daily journal of thoughts and feelings
- Desensitizing or gradual exposure to things that cause fear or anxiety
- Ways to calm the body and mind such as yoga or meditation
- Role-playing activities
- Consistent feedback
- One-on-one counseling
- Group therapy
Whether you have one of the mental or emotional health conditions listed above or if you have any other concerns about your mental or emotional well-being, it is important to talk to a professional. If you feel something is wrong or you just feel "off," contact BetterHelp who can help you find the best counselor or therapist to address your concerns.
- Is what is being communicated clinically accepted? YES
- Is the content factual? YES
- Are you comfortable with what is being communicated? YES