Cognitive-behavioral therapy is an approach used in the therapy of emotional and behavioral disorders. It aims to help people with mental health problems such as depression, post-traumatic stress disorder, and bipolar disorder.
Table of Contents:
- What is CBT
- Basics of CBT
- Principles underlying Cognitive behavioral therapy
- CBT Treatment
- How does CBT help with substance abuse disorder?
- Pros and cons of CBT
- Frequently Asked Questions
What is CBT?
CBT is a form of psychotherapy that aims to reduce one's psychological symptoms by changing how one think and behave. It deals with the present thoughts, feelings, and actions and those from the past, present, and future.
CBT therapists will help you discover where your behaviors are coming from in their sessions and find healthier ways to cope up with life. In the therapy process, you will be expected to keep a log or diary of your thoughts and behaviors used in your sessions.
One of the significant goals of therapy is to help clients achieve greater flexibility, spontaneity and respond appropriately to responsibilities. The therapy does not focus on changing negative thoughts or emotions but rather on acting in situations.
A CBT therapist will help you to learn to have better interpersonal relationships, which is an integral part of leading a meaningful life.
CBT helps the client understand the thoughts and feelings that lead them to experience negative moods. For example, if you have trouble with your job, CBT will help you analyze the thoughts and feelings causing your distress. CBT may be used in combination with other types of therapy.
History of CBT
CBT was first introduced by Aaron T. Beck, who theorized that depression was caused by negative thoughts or cognitions that resulted in feelings of guilt, hopelessness, and worthlessness.
CBT has its roots in behavior therapy which was developed at the beginning of the 20th century. This early school believed that psychology should concentrate on behavior rather than inner workings (the psyche). Behavior therapy focuses on the way people think and react to situations.
Basics of CBT
CBT is based on the concept that thoughts, feelings, and behaviors are interconnected. A simple example of this is the phrase "you are what you eat." The inference is that what you eat impacts how you feel, which in turn influences your behavior.
In CBT, these three areas—thoughts, behaviors, and emotions—are placed under the following categories:
- Behavioral manifestations: These can be physical symptoms of anxiety or depression, such as headaches or back pain. For instance, a person might have a headache but also believe that every time she feels her head will explode. This conclusion leads her to experience headaches when exposed to certain situations.
- Emotional manifestations: These include emotional states such as sadness, anxiety, and anger. In the example discussed above, the she would have a headache, a physical manifestation of anger. She might also believe that every time she feels her head explode, she will experience sadness.
- Cognitive manifestations: These are thoughts that cause emotional and behavioral reactions, such as the belief that one's head will explode if she hugs someone or experiences a loss of self-control when she's angry.
With these three elements defined, one can understand the role of CBT in therapy.
Principles underlying Cognitive behavioral therapy
Although Cognitive behavioral therapy is not the only treatment for mental disorders, it does have its critics. The following are some of the principles underlying this approach:
- CBT is based on an ever-evolving understanding of human behavior, constantly changing with time and experience.
It means that the theory is constantly being revised to reflect new research findings. It makes the therapist more scientifically-minded.
The patients' problems are assessed and evaluated using the best research methods available, then a conceptualization and treatment plan is devised which best fits the evidence. The conceptualization is revised as new data emerges.
- CBT requires a solid therapeutic alliance.
It is because the therapist must trust the client just as much as the client trusts the therapist. The therapeutic alliance includes collaboration between two people, allowing both parties to understand each other's problems better and work together towards common goals.
This collaboration is considered a cornerstone of therapy, and it would be impossible if there were a lack of common goals or a lack of trust between therapist and patient.
- CBT involves active participation from both patients and therapists.
The combination of self-scrutiny and reflection helps both individuals reach their goals, which are generally more significant than they thought.
This active participation is helpful because it helps the patients understand that they are in charge of their lives even if the problems are beyond the scope of their control. Also, a teamwork approach is advocated instead of a traditional doctor-patient relationship.
- CBT is a goal-oriented and problem-solving approach, meaning that it puts the patient in charge of their own life.
It means that CBT emphasizes goals, with the therapist acting as a guide, but the final responsibility for success is placed with the individual. On the other hand, the patient is also responsible for the therapy being a success because, in this treatment, the patient is an active participant in therapy.
CBT is meant to be a collaborative effort between the patient and the therapist with final responsibility in the patient's hands. The emphasis placed in CBT is on a practical rather than a philosophical or theoretical approach.
- CBT initially emphasizes the present rather than the past.
It is because it relies on current problems and their solutions. The past is viewed to understand how we feel at present and why we behave in specific ways.
Although CBT only emphasizes the past when there is a causal relationship between the present and the past, it will also focus on the present.
- CBT is educational, and aims to teach clients new ways to cope with their feelings, thoughts, and behaviors.
It is because it helps the patients master their own emotions and themselves. In this way, the patient becomes a more active participant in their treatment, more independent, and can make a difference in their lives.
It also ensures that the patient learns from his own mistakes and past experiences hence preventing future ones.
- CBT strives to be time-limited rather than a lifelong process.
It means the therapy is about problem-solving rather than encouraging patients to live with their anxiety and depression, a lifelong process.
In CBT, the patient's behavior is changed from being a symptom of anxiety or depression to being an active participant in their treatment, which is the ultimate goal. It focuses on achievable goals rather than aims for lifetime change. The clients are under close supervision so that they know when to stop.
- CBT sessions are well planned and structured.
The importance of structure permeates all aspects of CBT, beginning with the initial interview onward. The therapist begins by clarifying the session's goal, clarifying the patients' understanding of what is expected from them, and formulating strategies for attaining these goals.
The therapist encourages the patient to contribute to this planning stage by asking what they think would work best. After that, the therapist will structure the session by creating a hierarchy of competency, help the client to work on one goal at a time, and begin with what they are most comfortable with.
- CBT teaches patients to recognize, evaluate, and change their thoughts, feelings, and behaviors.
It involves teaching the patient to recognize their negative thoughts and thinking patterns and then evaluate them to reach a conclusion that would help them manage these thoughts or change them.
It helps the person get control over their emotions and behavior. Furthermore, in this way, CBT helps the person recognize the role of their thoughts in their emotional disorders.
- CBT uses different techniques like role play, homework, anxiety management training, behavioral experiments, systematic desensitization, and relaxation training to help the patients realize their determinism.
Seeing the results of their actions, working towards their own goals, and experiencing their abilities to change, helps the people become aware of what they are capable of.
This awareness creates more freedom by allowing them to be at their best. In addition, CBT tries to help them accept their limitations and learn how to live with them, rather than being a lifelong struggle.
CBT helps people become aware of what they can do for themselves and try to be the best despite their limitations. In this way, everyone is given a chance without subjecting them to an endless struggle. This approach is meant as a starting point because the world is never black and white, there are always different shades of gray, and it is impossible not to make mistakes.
The CBT Treatment involves a series of procedures that you might go through.
- You will be asked why you are seeking treatment.
- You will be asked to fill in a questionnaire to help the therapist understand how your behavior is linked to your experience of thoughts, feelings, and emotions.
- You will be given homework assignments designed to test your understanding of the material you have learned in the session. Your homework will cover material covered in much greater detail in subsequent sessions.
- You will be given several taped assignments to listen to for homework that will help you learn about your thought processes, emotions, and behavior.
- You will discuss the noticed changes with your therapist, and your therapist may ask you to change the taped assignments, the homework, or the sessions as a result of these discussions.
CBT can be either individual or group therapy, depending on what is most suitable for the patient. In some cases, the patient may have to meet with a therapist both individually and as a group member. In either form, it is still considered as effective as individual sessions.
Note: There is no evidence to show whether CBT is more effective than other treatments. However, recent studies have shown that it can yield long-lasting benefits in reducing anxiety and depression and improving general functioning and quality of life.
The positive outlook that CBT gives to its patients suggests that it can help children and adults to improve their coping mechanisms, develop new behavior patterns and improve their emotional stability.
Can CBT help with substance abuse disorder?
CBT is considered one of the more effective ways of treating individuals with substance abuse disorder because it focuses on their thoughts, feelings, and behavior.
Substance abuse disorder is a chronic mental health condition that occurs when a person continues to use drugs despite the negative consequences to their well-being.
They have a strong desire to continue using these substances. Because of their continued use of the substance, people with substance abuse disorder have a distorted view of reality as they do not see the adverse effects of their behavior.
CBT helps them to see the short-term effects of their behavior rather than focusing on the negative consequences they are experiencing. It can help people learn how to manage their emotions in different situations to feel less overwhelmed when they are in stressful situations.
How does CBT help with substance abuse disorder?
There are several ways in which CBT may help with substance abuse disorder. Firstly, it may help patients become better aware of their substance use effects on their daily lives.
For example, they may be mindful of how this affects their relationships and their ability to function in everyday life because of drug use. This way, patients become more aware of the adverse effects of substance abuse on them, which can help them curb their desire to continue using these substances.
In addition, CBT may help them to see the adverse effects that their substance use has on their relationships with others and their ability to fit into society at large.
The therapist may encourage patients to take a more active role in helping themselves by sharing their own experiences with these issues. In this way, they can talk about their concerns and how they want to manage them.
It helps the patient come up with new ways of coping and solving these problems. Secondly, CBT may help them look at why they have an intense desire to continue using these drugs despite the harm that it can cause them.
It may help provide insight into what factors are causing these intense feelings and thoughts, how negative thoughts affect their behavior, and how to manage their emotions less intensely.
This kind of insight can help patients break through the negative thoughts about themselves that are causing their intense cravings for drugs so they can start seeing themselves more positively instead.
This can help them understand the adverse effects of substance use on their lives and avoid these. Furthermore, this kind of insight helps them develop new coping methods with these emotions, so they do not have such intense feelings.
It can help patients to manage themselves much better than before and stop using drugs altogether.
Pros and Cons of CBT
Although CBT is an effective treatment for substance abuse disorder, it is not without disadvantages and challenges. It can be quite the opposite when it comes to the pros and cons discussed in this article.
Some of the pros of CBT are:
- It is very effective because it focuses on the behavioral patterns that lead to substance abuse disorder. This way, patients get better insight into why they continue to use these substances despite the harm they can cause them.
- CBT allows patients to learn new ways of coping with their emotions to feel less overwhelmed when in stressful situations.
- It can be completed in a relatively short amount of time.
- It has been proven to be very successful for people with substance abuse disorder.
- It can be helpful for all kinds of patients with different issues related to substance abuse disorder.
- It focuses on the individual’s strengths and inner motivations to help them overcome their problems rather than focusing on their weaknesses or deficit in behavior, thoughts, or emotions.
Some of the cons of CBT are:
- It may focus too much on the patient blaming themselves for their substance abuse issues rather than addressing the problem at hand.
- It requires patients to be very motivated to complete the program. It means they need to be self-aware and open about dealing with their substance abuse disorder.
- Therapists need to keep patients on track if they are not motivated or make progress in their treatment.
- CBT may be difficult to understand and may not be easily accessible to all kinds of patients.
- Who will most benefit from CBT?
Those with substance abuse disorder are motivated and have good insight into their condition.
- How long does CBT take to work?
It may take a few weeks or months before the patient feels more in control of their situation and desires to stop using drugs entirely.
- Is CBT similar to other types of therapy?
It is very different from other therapies because it focuses on the positive rather than the negative. It gives people the opportunity to look at their situation differently and see what they can do to solve their problems.
Overall, CBT is an effective way to address substance abuse disorder because it focuses on the individual’s thoughts, emotions, and behaviors. It helps people learn better ways of coping with their emotions, not feeling overwhelmed when stressed.
CBT may help patients avoid using these substances despite the negative consequences of using them in their lives. This way, patients can learn to put an end to their substance abuse disorder.