What Is CBT Therapy?
Cognitive behavioral therapy (CBT) is a structured, evidence-based treatment that approaches mental health issues by changing the way you behave.
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Overview
Cognitive behavioral therapy (CBT) is a structured, evidence-based treatment that
approaches mental health issues by changing the way you behave. This form of psychotherapy is frequently used to treat conditions such as anxiety, depression, and OCD. It has also proven efficient when dealing with substance use disorder.
CBT therapy is a short-term, goal-oriented therapy that aims to change thought patterns. It is a psychologists guide treatment used to identify negative behaviors and thought patterns, replacing them with healthier ones. Rather than exploring the roots that led to the reinforcement of the behavior, CBT therapy focuses on strategies that modify current thoughts.
Cognitive behavioral therapy is done under licensed therapists and counselors who use
exposure therapy and cognitive restructuring. This article will offer insight into how
CBT works for different types of patients and how specialists use it to enforce positive
behavior.
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How Does CBT Work?
Cognitive behavioral therapy (CBT) works by identifying unhelpful thoughts and
behaviors and modifying the patterns. The process goes through current problems,
implementing behavior modification strategies to break harmful habits, addictions, and
thought processes.
Cognitive restructuring is used to change the way someone sees a situation, modifying a
negative outlook into a better and potentially realistic one.
For CBT to function, it requires a close collaboration between the patient and their
therapist. The latter will act as a guide that helps patients identify problematic thoughts
and behavior, for which they can suggest coping strategies. This includes writing in a
journal or learning new behaviors, which will be reviewed during every session.
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Core Principles of CBT
The core principles of CBT address thoughts and emotions, learned behavior issues, and
coping strategies. Once CBT identifies patterns, therapy corrects distortions by
enforcing emotional regulations.
Principle I: Thoughts, Behaviors, and Emotions Are Interconnected
CBT works on the principle that our way of thinking affects both our behavior and
emotions. If someone firmly thinks that they are afraid of a certain object or activity,
they will go out of their way to avoid it.
Similarly, if they believe that they need a certain substance to reach a balance, they will
continue consuming it, despite the potential harm. By modifying the thought pattern,
patients improve their actions and make better decisions with therapy.
Principle II: Psychological Issues Are Reinforced by Learned Behavior
Distorted thinking and learned behavior can lead to psychological issues and
exaggerated thought patterns. A person might avoid a situation they are not familiar
with rather than address it, despite its resolution having a potentially good impact. CBT
recognizes these patterns so individuals can have healthier reactions.
Principle III: Healthier Coping Strategies Can Be Taught
CBT relies on the principle that practical skills can be taught to change a person’s
thought pattern. Cognitive restructuring plays an important role here, as negative
thoughts are gradually replaced with constructive, realistic ones.
Psychologists focus on behavioral motivation and mindfulness to ground the patients,
improving their moods and motivation.
The CBT Thought-Behavior Cycle
Individuals with disruptive thought patterns experience emotions and behaviors that go
in a cycle. CBT is used to break that cycle.
Thoughts affect the way you feel about something, leading to the birth of emotions.
Those emotions influence the way you behave in response to a specific thought or
action. The right action leads to a positive situation, whereas the wrong one makes
matters worse, continuing the cycle.
For example, an individual who believes they are not good enough can experience
anxiety in social situations.
A study done by Alisa R. Garner and Gregory L. Stuart from the Department of
Psychology, University of Tennessee-Knoxvill, followed a patient who worried
excessively in social interactions. This led him to engage in avoidance behavior,
ultimately reinforcing the anxiety.
As cognitive behavioral therapy reshaped his responses, the patient was able to
identify emotional triggers and consciously change their behavioral responses. The
study found that 62% 1 of patients with general anxiety disorder can break the thought-
behavior cycle by using cognitive therapy.
What Conditions Does CBT Treat?
CBT treats a broad range of mental and emotional issues that are influenced by negative
or disruptive thought patterns. This includes the following:
● Depression: Triggered by a feeling of worthlessness and hopelessness.
● Anxiety: Triggered by a sense of worry.
● PTSD: Triggered by a feeling of hypervigilance after past trauma.
● OCD: Triggered by fear of interrupting compulsive behavior.
● Phobias: Triggered by fear of potential exposure to the stimulus.
● Substance Use Disorder: Triggered by reinforced belief that certain substances are necessary.
CBT reduces symptoms by challenging these automatic responses using cognitive restructuring.
For greater effectiveness, it is combined with medication such as antidepressants or
mood stabilizers, and mindfulness therapy. Depending on the issue, group therapy is
used as a way to reinforce positive behavior.
CBT for Anxiety and Depression
CBT is used in the treatment of anxiety and depression by challenging the thought
pattern. By identifying the pattern and consistently replacing it with healthier thoughts,
patients reframe their thoughts into something more realistic.
During these sessions, therapists enforce behavioral activation to increase their
engagement during meaningful activities. Neglected positive activities are identified and
gradually introduced into the routine, rebuilding confidence. Patients are encouraged to
track their moods through journaling, reducing the hold of cognitive distortions.
CBT for Trauma and PTSD
CBT reframes trauma by helping PTSD patients regain control over their thoughts,
reducing distress exposed to certain triggers. These conditions appear when traumatic
memories remain unprocessed, leading to intrusive thoughts and vigilance that result in
avoidance.
One of the most effective methods for trauma processing and post-traumatic stress
disorders is exposure therapy. Through this type of therapy, patients go through
emotional regulation and gain resilience by verbally recounting their trauma or
engaging in associated real-life situations. This desensitizes the response, decreasing
distress.
CBT Techniques and Strategies
CBT challenges thoughts through several techniques that aim to modify the behavior. This includes the following:
● Cognitive restructuring: Identifies and challenges irrational thoughts
● Exposure therapy: Implements repeated exposure to stimuli to increase desensitization.
● Mindfulness: Focuses on awareness of the moment and acceptance of emotions without dismissing them.
● Behavioral activation: Encourages participation in meaningful activities.
The techniques are tailored to various conditions, with each patient requiring a different
approach. As patients practice skills during treatment sessions, thought behavior is
modified.
Cognitive Restructuring
Cognitive restructuring changes irrational thoughts by enforcing thought challenging,
which reduces cognitive biases. Therapy replaces distortions as patients change beliefs
with time, reducing the response.
For example, someone has the distorted thought that no one likes them, which is why
they are ignored at social gatherings. Cognitive restructuring identifies distortion and
examines the evidence, challenging the thought. The thought may be reframed with a
balanced thought along the lines of “While not everyone talks to me, some still do.”
Exposure Therapy for Anxiety and Phobias
Exposure therapy gradually reduces avoidance behavior in anxiety patients by promoting systematic desensitization.
Data from the University Counseling Center of Athens shows that an average of 12% 2 of
adults will develop social anxiety at some point in life.
The same study suggests that the 20 sessions of CBT that include exposure therapy are
sufficient to significantly reduce the symptoms, improving the patient’s quality of life.
A fear hierarchy is created to rank one’s fears from most to least distressing ones.
Gradual exposure is implemented, starting with the least disturbing ones, increasing the
tolerance to specific triggers.
Repeated exposure reduces the fear response, with therapists implementing relaxation
techniques to minimize said response.
Behavioral Activation for Depression
Behavioral activation encourages patients to take part in positive activities. This is helpful for patients with depression. Therapy builds engagement and patients regain motivation as CBT increases activity levels.
A study published by Nature Medicine that covered 93,000 3 people showed that engaging in positive behavior increased happiness, reducing depression rates.
A good strategy involves listing activities that previously brought joy, and choosing one manageable hobby to perform per day. Patients track their mood and gradually increase
engagement as the activities become easier.
Mindfulness in CBT
CBT integrates mindfulness as a way to manage stress because it enforces present- moment awareness. Rather than choosing to ignore an overwhelming thought or experience, mindfulness observes it objectively, decreasing the emotional reaction.
Mindful breathing is a common strategy for self-regulation. It calms the nervous system
as you go through a thought.
Thought diffusion is also used to acknowledge the thought and let it drift (e.g.,
imagining the thought on a leaf and letting it fly).
How Long Does CBT Take?
CBT takes between 5 to 20 weeks to show significant improvement. The length of the treatment depends on different factors, including the following:
● Therapy Goals: CBT is used to target specific short and long-term concerns. Mild anxiety is frequently solved with a few sessions, whereas OCD or PTSD requires extensive treatments.
● Response to Progress: Individual progress varies from one patient to another, depending on their exposure and ability to reroute their neural pathways. Some patients need more time to implement these changes, especially if they are exposed to triggers outside therapy.
● Frequency and Duration of Sessions: The average CBT session lasts between 45 to 60 minutes, spread once a week. An intensive program that offers bi-weekly sessions finalizes twice as fast, shortening the time frame.
● Symptom Severity: Addictions and long-standing mental health issues spanning over years can hijack the neural pathways of the brain, requiring an extended session duration and timeline.
CBT follows structured sessions, but therapists also recommend booster sessions to prevent a relapse.
The Benefits and Limitations of CBT
CBT is beneficial because it is a structured, evidence-based form of therapy to improve coping. By implementing the right strategy, therapy reduces relapses as it changes the
thought process.
For CBT to be effective, patients must also learn about its limitations. Active participation is needed, and severe mental health conditions require additional support. Combination treatments that include medicine and other alternatives are more effective in getting the desired results.
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