What is Cognitive Behaviour Therapy (CBT)?
Cognitive Behaviour Therapy (CBT) is a short-term, structured approach that focuses on understanding and changing both how you think (“cognitive”) and what you do (“behaviour”) in order to resolve current life difficulties and reduce psychological symptoms and distress. CBT provides you with a new way of understanding and approaching your problems as well as targeting change in the unhealthy patterns that maintain your problems. Treatment is collaborative and emphasizes skill-building and problem-solving to improve functioning.
How does CBT work?
CBT operates on the premise that our thoughts, behaviours, and feelings (including emotions, and physical sensations) are interrelated. Therefore, making changes in what we think can change our feelings and behaviours. Likewise, changing our behaviour can affect the way we think and feel.
CBT emphasizes the importance of our interpretation of events rather than the event itself. For example, some people may interpret their own shortcomings or mistakes as perfectly normal parts of being human, whereas others might interpret similar shortcomings as meaning “I’m a failure”, or they may assume “If others see my flaws, then they won’t like me”. In each case, the mistake or shortcoming may be the same but how we make sense of it can greatly influence how we then feel and act. The particular meaning we give to a situation can be influenced by past learning and beliefs, our mood, or other contextual factors such as life events or circumstances.
What happens in CBT?
In CBT you will learn to closely attend to how you are thinking, feeling, and behaving in your daily life. Regular self-monitoring helps you to identify negative or unhelpful patterns and to break them down into separate parts so that they are easier to work with and change. With the help of your therapist, you will learn how to reevaluate your thinking and to develop alternative thoughts that are more balanced (i.e., take into account information not previously considered). Developing greater flexibility in how you think about experiences opens up new options for responding. Reevaluating your thinking does not mean merely replacing upsetting thoughts with positive ones but gaining greater clarity and balance in your beliefs, predictions, and assumptions. You will also learn new behaviours such as gradually approaching things you have feared and avoided (e.g., situations, objects, difficult emotions or physical sensations), or practicing skills such as relaxation or assertiveness. As you learn to question and challenge thoughts and behaviours, you will be able to interrupt and change recurrent negative cycles of experience.
In order to be most effective, CBT typically requires you to consistently practice the strategies learned in therapy outside of session. Homework between sessions helps bring your new skills into your daily life so you are better equipped to handle problems on your own. It can also speed up your progress in therapy.
Is CBT effective?
CBT has been extensively evaluated in numerous controlled outcome studies and is an empirically supported treatment for mood and anxiety disorders as well as for a range of other psychological problems. Research has demonstrated that CBT is as effective as medication for the treatment of anxiety disorders and mild to moderate depression, without the associated side effects, and it helps to prevent future relapse. A typical course of short-term treatment is between 8 to 20 sessions; however, treatment duration is dependent on many factors such as the chronicity and severity of the problem and the consistency of between-session practice.