Understanding Cognitive Behaviour Therapy

What is Cognitive Behaviour Therapy?

Cognitive-behavioural therapy (CBT) is a client-centered, interactive treatment method that focuses on how a patient’s thoughts and feelings shape their environment. CBT is primarily concerned with teaching the patient to investigate their own beliefs and emotions to identify maladaptive or harmful behavioural patterns. This approach most commonly involves talk therapy, but may also extend to written activities, mindfulness, and rewarding positive behaviour. CBT is not a prescriptive therapy, meaning that the patient is encouraged to set their own therapeutic goals and ideas for success. It is the clinician’s job to support the patient in their endeavour.

How does CBT work? What happens between the therapist and the patient?

Talk therapy between the client and clinician is at the heart of CBT. As a client, you are encouraged to enter a therapeutic session and bring topics that are meaningful or concerning – no matter how big or small. You may want to speak about your family life, relationships or difficulties at work. Any subject that is important for you should be an area of interest for your clinician. In turn, the clinician may ask questions about a situation – how you felt at the time or why you reacted in a certain way. Your responses help the clinician understand your motives and emotions in a given context and allow for more in-depth exploration of a client’s behaviours.

While talk therapy is the most common form of CBT, clinicians use other tools and activities too. One technique is to ask patients to keep a thought record for when they are experiencing emotional distress. The patient is asked to write down their thoughts to better understand how specific beliefs may contribute to patterns of negative emotion or pain. In this way, the client is better equipped to evaluate their choices and possibly change patterns of thinking and behaviour that cause distress and difficulty.

Another tool of CBT is to test assumptions.

If, for example, a patient believes that he or she has no friends and is disliked by his or her peers, the clinician may ask the patient to make a concerted effort to talk with and get to know others. Once the patient engages in behaviour that challenges preconceived, false beliefs, they may be able to overcome negative thought patterns and develop new, positive ones.

It is often difficult to monitor ourselves, and so the cognitive-behavioural therapist exists to guide the patient’s understanding in a supportive and positive environment.

Because of the extremely personal nature of CBT, the client-clinician relationship is an essential component of therapy. Patients need to feel trust in their clinician and know that the information they share is confidential and protected. This rapport may take time to develop. In CBT, a mutually receptive and trusting relationship is a cornerstone of therapeutic success.

Can CBT help me with depression?

Absolutely! CBT was created specifically for treating depression and is considered the most efficacious treatment for depression today. One of the most common and debilitating symptoms of depression is a negative self-conception. People may come to view themselves negatively through several maladaptive thinking patterns such as self-blame, pessimistic future projections and hyperbolizing their inadequacies. CBT seeks to clarify these thinking patterns by bringing them to the foreground, questioning their validity and helping the patient create positive self-conceptions- what is called cognitive restructuring. The tools patients learn to use in CBT can be utilized for their whole lives to help combat depression long after the completion of therapy.

Can it help with anxiety?

Yes! CBT is considered safe and efficacious for treating many anxiety-related disorders like General Anxiety Disorder, Panic Disorder, Social phobia and other specific phobias.

CBT for anxiety encompasses additional therapeutic components. The clinician may employ exposure therapy (a facet of behavioural therapy), which works by helping the client to face their fears gradually while learning to adapt their fearful reactions. For instance, a clinician may encourage their client to talk about or imagine the situation or cue that sparks anxiety, thus helping the patient slowly become more comfortable with an anxiety-provoking concept and thus become more emotionally and physically tolerant or to create a less extreme anxiety reaction. The clinician may also teach various methods for coping with anxiety like breathing exercises, muscle relaxation and cognitive affirmations for safety and wellness.

How long does it take to feel a difference?

For many reasons, there is no set timeline for when CBT will “work.” First, every patient has a personal idea of success. Depending on what issues are presented to work on, it may take months or years to process and progress to your therapeutic goal. These goals often change throughout therapy, and you may identify and develop new goals as you work with your clinician.

Second, every patient is different. Some may quickly take to opening up and build trust with a clinician, while others may need time to develop that confidence. There is no expectation here.

However, CBT is well accepted by patients because it focuses on the experience of the patient and their definition of well-being.

Because trust, support, and acceptance are essential tenets of CBT, patients tend to find this environment a positive influence in their lives and a source of comfort.