Cognitive Behavioural Therapy

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Cognitive behavioural therapy (CBT) is a psychotherapeutic intervention that aims at challenging and changing your thoughts and behaviours, especially the ‘unhelpful’ ones which are destructive and distorted, and replaces them with much more helpful, healthier thought and behavioural patterns.

CBT is relatively shorter in duration and is quite efficacious for a myriad of mental health problems. It uses the biopsychosocial approach for the treatment. Both cognitive and behavioural techniques are used. All of that makes CBT a comprehensive and easy approach to adopt which can be applied to a variety of disorders. CBT is also proven to be very efficacious according to the research into the outcome and the application of the treatment.

Uses of CBT

CBT is a solution-focused & goal-directed treatment that is short in duration and helps you pinpoint the source of the problem quickly and efficiently. It requires a limited, small number of sessions for the completion of the whole treatment. It is thus one of the most preferred forms of psychotherapy for many disorders. The disorders where CBT can most effectively help improve the patient’s condition are as follows:

• Depression
• Anxiety Disorders
• Phobias
• Panic Attacks
• Post-Traumatic Stress Disorder (PTSD)
• Bipolar Disorder
• Eating Disorders (like anorexia or bulimia)
• Sleep Disorders (like insomnia, sleep apnea, parasomnia)
• Schizophrenia
• Psychosis
• Obsessive-Compulsive Disorder (OCD)
• Sexual Disorders
• Addictions, and drug abuse
• Borderline Personality Disorder (BPD)

It can also be specifically used as a tool for managing some emotional and/or challenges. CBT practitioners may also refer to the principles of therapy as lifestyle guides. They can be applied in many contexts, for instance:

• Equipping oneself with tools to lead a better, happier life in general
• Managing life challenges, difficulties, stressful environments or events.
• Managing anger
• Managing conflict in all sorts of situations, or relationships
• Coping with grief, loneliness
• Coping with trauma
• Coping with a medical illness
• Managing the symptoms of a mental disorder better
• Preventing relapse of a mental disorder

What are the Types of CBT?

CBT principles are based on the fact that a person’s problems are based in the psychological, social and biological realms. Moreover, these problems are instilled in their thought processes and behavioural patterns which have to be reformed and unlearnt. There are many tools, techniques and concepts which can be applied for the same. These concepts are also involved in the following variations of psychotherapy:

• Cognitive Therapy

The cause of psychological distress, according to cognitive therapy, resides in an individual’s distorted thinking patterns, emotional responses, and behaviours. These are refuted through a process of non-directive questioning.

• Rational Emotive Behaviour Therapy (REBT)

REBT locates the causes of distress in irrational thoughts and beliefs of an individual which are tackled through an ABC analysis, which is the antecedent-belief-consequence analysis.

• Dialectical Behaviour Therapy (DBT)

DBT involves usage of mindfulness and emotional regulation to address the unhelpful thoughts and behaviours of an individual.

• Multimodal Therapy

Multimodal therapy involves addressing seven distinct, yet connected modalities that are behaviour, sensation, cognition, imagery, drug/biological factors, and interpersonal relationships and behaviour.

How CBT Works

Cognitive Behavioural therapy is, as stated earlier, a very problem-focused and goal-directed psychotherapeutic approach. It has a basic principle that the way we think and perceive our life circumstances and situations, even the minutest details, have a drastic impact on how we behave and feel. It requires a lot of effort on part of the client as they are the ones working on themselves, while the therapist acts as an enabler. It is very present-orientated and the past is only relevant to the extent of understanding and identifying current behavioural and thought patterns that one could have picked up earlier.

Through CBT, the client learns to develop cognitive reflexibility, which ultimately helps them overcome their cognitive distortions. Cognitive distortions, like catastrophizing, looking at things only in black and white, over-generalizing, personalizing, jumping to conclusions, being too negative or unrealistically positive, having self-esteem issues i.e an inferiority complex or a superiority complex, etc., affect our behaviour and moods drastically. When we become more aware of ourselves, and look at things around us differently and adopt a degree of openness in life, we’re able to fully transform the way we think and become healthier, wholesome, and more compassionate individuals. CBT equips us with many tools and regular exercises which one can adopt to live a better life.

The CBT therapist merely guides the session and helps you structure your thinking just by asking you open-ended questions, and you yourself identify your own unhealthy patterns. Upon identifying such problems, and fully understanding them, the therapist teaches you techniques to address these problems. Once these techniques are fully established and turn into habits which replace the earlier unhealthy habits, the treatment comes to an end. A follow up is also recommended for the prevention of relapse.

CBT for Children

CBT uses the same basic principles on children that it does on adults. All our thoughts, emotions, behaviours are interconnected and constantly affect each other, according to the CBT principles. Thus, for children, the core principles that are applied are the same. CBT is a very effective therapeutic approach for children with anxiety disorders, depression, PTSD, behavioural problems and substance abuse.

While the basic principles used in CBT for children are the same, there are some differences on other levels. The commonalities, however, are:

• The treatment remains goal-directed throughout the course of it, and the child, his/her parents, and the therapist together mark their goals and assess the process.
• The therapist aims to simply enable and guide the client in his/her journey towards self-awareness, self-development, and learning positive behaviours and cognitive tools.
• The child behavioural therapist and client both develop a deep therapeutic relationship in which the client has respect for the therapist’s knowledge and expertise of the subject matter, and the therapist appreciates and acknowledges the client’s ability to understand himself/herself the best.
• The therapy is present-oriented and short-term. There are also more than often homework assignments for the client to work upon before the next session.

Along with individual or group CBT, the following approaches are also used:

• Inclusion of parents in the process
• Medication
• Motivational-Enhancement Therapy (MET)
• Play Therapy