Cognitive Behavioural Therapy (CBT) is a widely used and effective form of psychotherapy that helps individuals manage their emotions, thoughts, and behaviours.
This article provides an overview of CBT, explores the range of disorders it can address, and delves into what you can expect during a typical CBT session.
Understanding CBT: A Framework for Change
CBT proved effective in the short-term for “a broad range of medical problems such as psychosomatic illnesses (e.g., chronic fatigue syndrome, irritable bowel syndrome, and fibromyalgia), psychiatric disorders (e.g., anxiety, depression, and developmental disability), and socio-behavioral problems (drug abuse, smoking, and problem gambling).”
CBT is grounded in the core belief that our thoughts, feelings, and actions are interconnected. Negative thought patterns can fuel emotional distress and unhealthy behaviours, creating a self-perpetuating cycle. CBT aims to break this cycle by empowering individuals to identify these negative patterns and develop tools to replace them with more balanced and helpful ones.
Here's a breakdown of how CBT works:
Cognitive Restructuring
This core technique involves identifying and challenging distorted thinking patterns or "cognitive distortions" that contribute to emotional distress. Examples of cognitive distortions include catastrophizing (assuming the worst will happen), overgeneralization (assuming one negative event means everything is bad), and black-and-white thinking (seeing things only as extremes, good or bad). Through collaborative exercises, therapists help clients develop more realistic and empowering interpretations of situations.
Behavioural Activation
CBT recognizes the link between behaviour and mood. Engaging in activities you enjoy can boost positive emotions, while avoidance can worsen negative feelings. Therapists work with clients to identify activities that align with their values and goals, and then create a plan for gradual re-engagement in these activities.
Exposure Therapy
This technique is particularly helpful for anxiety disorders. Clients are gradually exposed to situations or triggers that evoke anxiety, in a safe and controlled environment. Through this process, they learn to manage their anxiety response effectively.
Relaxation Techniques
CBT often incorporates relaxation techniques like deep breathing exercises or progressive muscle relaxation to help individuals manage stress and anxiety in the moment.
Randomized controlled trials have found that CBT proved effective in the short-term for “a broad range of medical problems such as psychosomatic illnesses (e.g., chronic fatigue syndrome, irritable bowel syndrome, and fibromyalgia), psychiatric disorders (e.g., anxiety, depression, and developmental disability), and socio-behavioral problems (drug abuse, smoking, and problem gambling).”
Disorders Effectively Treated with CBT
CBT's versatility allows it to be used for a wide range of mental health conditions. Here are some common examples:
Anxiety Disorders
Generalized Anxiety Disorder (GAD)
GAD is characterized by excessive and persistent worry about various things, even when there's no clear reason for concern. CBT helps individuals with GAD identify the underlying worries, challenge negative thought patterns associated with them, and develop coping mechanisms to manage anxiety in daily life. Techniques like cognitive restructuring and relaxation training are often employed.
Panic Disorder
Panic disorder involves recurrent unexpected panic attacks, which are sudden surges of intense fear or discomfort accompanied by physical symptoms like heart palpitations, shortness 1 of breath, and dizziness. CBT helps individuals understand the nature of panic attacks, challenge catastrophic interpretations of bodily sensations, and gradually expose themselves to situations they avoid due to fear of panic.
Social Anxiety Disorder (SAD)
SAD is marked by intense fear of social situations where one might be scrutinized or judged by others. CBT helps individuals with SAD identify negative thoughts and beliefs about social interactions, develop social skills, and gradually confront feared social situations through exposure therapy.
Obsessive-Compulsive Disorder (OCD)
OCD is characterized by intrusive, unwanted thoughts (obsessions) that cause distress, and repetitive behaviours (compulsions) performed to reduce that distress. CBT for OCD typically involves exposure and response prevention (ERP), where individuals are gradually exposed to their obsessions without engaging in their compulsions, helping them break the cycle of obsessions and compulsions.
Mood Disorders
Depression
Depression is a mood disorder characterized by persistent sadness, loss of interest in activities, feelings of hopelessness, and low energy. CBT helps individuals with depression identify negative thought patterns that contribute to their low mood, challenge these thoughts, and engage in activities that promote positive emotions. Behavioural activation plays a crucial role in encouraging engagement in pleasurable activities.
Bipolar Disorder
Bipolar disorder involves extreme shifts in mood, from periods of elevated mood (mania or hypomania) to periods of depression. While medication is essential for managing bipolar disorder, CBT can be a valuable adjunct therapy. It helps individuals identify triggers for mood episodes, develop coping strategies for managing mood swings, and improve adherence to medication regimens.
Eating Disorders
Anorexia Nervosa
Anorexia nervosa is characterized by an intense fear of gaining weight, distorted body image, and severe restriction of food intake. CBT helps individuals with anorexia address distorted thoughts and beliefs about weight and body shape, develop healthier eating patterns, and improve coping skills for managing emotions.
Bulimia Nervosa
Bulimia nervosa involves recurrent episodes of binge eating followed by compensatory behaviours like vomiting, excessive exercise, or misuse of laxatives to prevent weight gain. CBT helps individuals with bulimia identify triggers for binge eating, develop strategies to resist urges to binge and purge, and improve body image and self-esteem.
Binge Eating Disorder
Binge eating disorder is characterized by recurrent episodes of binge eating without regular compensatory behaviours. CBT helps individuals with binge eating disorder identify triggers for binge eating, develop healthier eating habits, and learn coping skills for managing emotions without resorting to food.
Post-Traumatic Stress Disorder (PTSD)
PTSD can develop after experiencing or witnessing a traumatic event. Symptoms include flashbacks, nightmares, avoidance of reminders of the trauma, hypervigilance, and emotional numbing. CBT for PTSD often involves trauma-focused cognitive therapy, which helps individuals process traumatic memories and challenge negative thoughts and beliefs related to the trauma. Exposure therapy may also be used to help individuals gradually confront trauma-related cues and situations.
A review of CBT for the treatment of PTSD has found that there is “robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents.”
Substance Abuse
CBT helps individuals identify triggers for substance use, develop coping mechanisms to resist cravings and urges, and improve relapse prevention strategies. CBT also addresses underlying issues like depression or anxiety that may contribute to substance use.
… there is “robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents.”
What to Expect During a CBT Session
A typical CBT session will usually last 45-60 minutes. Here's a breakdown of what you might encounter:
Introduction and Review
Checking In
This is an opportunity to discuss any changes in your mood, thoughts, or behaviours, as well as any significant events that have occurred.
Reviewing Homework
If you were given any "homework" assignments in the previous session (more on this later), the therapist will review your progress and discuss any challenges you encountered.
Collaborative Goal Setting
Setting an Agenda
You and your therapist will work together to set an agenda for the session, outlining the topics you'll discuss and the goals you hope to achieve.
Prioritizing Concerns
If you have multiple concerns or issues you want to address, you and your therapist will prioritize them and decide which one to focus on during the session.
Therapeutic Techniques
Identifying Negative Thoughts
Your therapist will guide you through this process, helping you recognize common cognitive distortions like catastrophizing, overgeneralization, or black-and-white thinking.
Challenging Negative Thoughts
Once negative thoughts are identified, you'll work with your therapist to challenge their validity and develop more balanced and realistic alternatives. This might involve examining evidence for and against the thought, considering different perspectives, or reframing the thought in a more positive way.
Behavioural Experiments
In some cases, your therapist might suggest conducting "behavioural experiments" to test the validity of your negative thoughts. For example, if you have social anxiety and believe that everyone will judge you negatively, you might agree to engage in a social interaction and observe what actually happens.
Exposure Therapy
If you're dealing with anxiety or phobias, your therapist might use exposure therapy techniques. This involves gradually exposing you to feared situations or stimuli in a safe and controlled environment, helping you to overcome your fear and anxiety.
Skills Training
Depending on your needs, your therapist might also teach you specific skills to manage your symptoms, such as relaxation techniques, assertiveness training, or problem-solving skills.
Homework/Assignments:
Practicing Skills
Your therapist will often give you homework assignments to help you do this.
Examples of Homework
Homework might include keeping a thought journal to track your thoughts and feelings, practicing relaxation techniques regularly, or gradually exposing yourself to feared situations.
Summary and Planning:
Reviewing Key Points
At the end of the session, you and your therapist will summarize the key points discussed and the progress you've made.
Planning for the Next Session
You'll also discuss what you'll focus on in the next session and review your homework assignments.
Addressing Questions
This is also a good time to ask any questions you have or express any concerns.
Important Considerations
Active Participation: CBT requires active participation from you. The more you engage in the process and complete your homework assignments, the more effective the therapy will be.
Therapeutic Relationship: You should feel comfortable and safe sharing your thoughts and feelings with your therapist.
Pace of Therapy: The pace of therapy will vary depending on your individual needs and the specific issues you're addressing. Some people may see significant improvement in a few weeks, while others may require longer-term therapy.
Reaching Out for Help
CBT offers a powerful toolkit for managing a wide range of mental health challenges. If you're struggling with negative thoughts, emotional distress, or unhealthy behaviors, consider seeking professional help.
Radcliffe Psychotherapy Clinic therapies like CBT to help individuals achieve lasting positive change. With experienced and compassionate therapists, We provide a supportive and collaborative environment where you can develop the skills and strategies needed to thrive.
If you're ready to take the first step towards a healthier and more fulfilling life, we encourage you to reach out. Contact Radcliffe Psychotherapy Clinic today at (289) 801-4133, admin@angerandanxiety.com; or book a consultation at https://sra.janeapp.com/.
Don't hesitate to seek help. You don't have to face your challenges alone.