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Cognitive Behavioral Therapy (CBT)


Cognitive Behavior Therapy (CBT) is widely used therapy that focuses on changing unproductive cognitive distortions such as thoughts, beliefs, attitudes and behaviors in order to improve emotional regulation and develop personal coping strategies that aim to solve problems.  CBT was originally used to treat depression however it has expanded to treat a number of mental health conditions including anxiety.  CBT is a psycho-social intervention and includes many cognitive and behavior psychotherapies that treat psychopathologies using evidenced-based techniques and strategies.

Unlike psychoanalytic therapy where the therapist looks for the unconscious meaning behind behaviors and formulates a diagnosis, CBT is a “problem focused” and “action oriented” form of psychotherapy.  It is used to treat specific symptoms related to a diagnosed mental disorder.  The therapist assists the patient in finding and practicing effective strategies to address goals and reduce symptoms of the disorder.  CBT is based on the belief that psychological disorders are developed and maintained due to thought distortions and maladaptive behaviors.  Furthermore, CBT directs reduction of associated distress and symptoms by teaching new information-processing skills and coping mechanisms (reshaping negative/inaccurate thinking).

Clinical studies have shown that CBT alone has been effective in treating less severe forms of depression, anxiety, posttraumatic stress disorder (PTSD), tics, substance abuse, eating disorders, and borderline personality.  Other research suggests that CBT is most effective when combined with medication for treating mental disorders such as Major Depressive Disorder.  CBT is the first method of treatment for a majority of psychological disorders in children and adolescents, including aggression and conduct disorder.

According to the system created by Kanfer and Saslow, CBT can be seen as having six phases; assessment, reconceptualization, skills acquisition, application of skills, maintenance and post-treatment follow-up.  After identifying the behaviors that need changing, whether it be in excess or deficit, it is critical to have a baseline in order to identify if the intervention was successful or not.  Baseline is measured by frequency, duration, or intensity.

There are a variety of procedures for delivering Cognitive Behavioral Therapy. Interventions that are cognitively oriented include “self-instructions (i.e. distraction, imagery, motivational self-talk), relaxation and/or biofeedback, development of adaptive coping strategies (minimizing negative or self-defeating thoughts), changing maladaptive beliefs about pain and goal setting”.  Interventions that are more behaviorally oriented may use exposure therapy.  CBT can be used in both individual or group settings.

CBT can be combined with diverse but related techniques such as dialectical behavior therapy, acceptance and commitment therapy.  Some clinicians encourage a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.

Catherine Poulos NPP

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