Cognitive Behavioural Therapy (CBT) is a drug-free treatment that focuses on thoughts, feelings, behaviour, physical sensations and the environment, and their connections to each other. CBT has been found to be highly effective in treating a variety of problems, such as Depression, Anxiety Disorders, Obsessive-Compulsive Disorder (i.e. uncontrollable disturbing and repetitive thoughts and behaviours), and Eating Disorders.
A recent study found that CBT was as effective as some medications in changing brain chemistry. The study also found that the combination between medication and CBT yielded the best and most enduring results in treating Depression. Cognitive-Behavioural Therapy is the psychosocial treatment of choice when people cannot or do not wish to take medication. Alternately, it can be provided in conjunction with medication to ensure the best treatment outcome.
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The principles upon which CBT is based:
- Moods are largely affected by thoughts. The way you make sense of an experience and what you say to yourself about a past, present, or an anticipated experience, will determine how you feel.
- When you feel sad or depressed, your thoughts will most likely tend to be negative. You will perceive yourself, the world, life in general, and the future, in a negative way.
- If you are depressed, chances are that your automatic thoughts will consist of Cognitive Errors. Cognitive Errors are mistakes in the interpretation of internal or external stimuli. Examples of the most common Cognitive Errors are as follows:
- All or Nothing: you see things in black-or-white. If your performance falls short of perfect, you see yourself as a total failure.
- Overgeneralization: you see a single undesirable event as a never-ending pattern of defeat.
- Mental Filter: you pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the effect of a drop of ink that discolours the entire glass of water.
- Disqualifying the Positive: you reject positive experiences by insisting they “don’t count” for some reason. In this way, you can maintain a negative belief that is contradicted by your everyday experience.
- Jumping to Conclusions: you make a negative interpretation even though there are no definite facts that convincingly support your conclusion through:
- Mind Reading: you arbitrarily conclude that someone is reacting negatively to you, and you do not bother to check this out.
- The Fortune-Teller Error: you anticipate that things will turn out badly, and you feel convinced that your prediction is an already established fact.
- Catastrophization or Minimization: you exaggerate the importance of undesirable things, or you inappropriately dismiss desirable things as unimportant. Catastrophization is also the tendency to create the worst case scenario in your mind in ambiguous situations. For example, if someone is late and cannot be reached on the phone you immediately think they have been in a car crash.
The Process of Cognitive-Behavioural Therapy
Therapy can start by accessing behaviours, the person’s thought process, or the environment. For example, sources of stress may be looked at, and possible changes in lifestyle may be discussed, such as regular exercise. Similarly, a process of evaluation of the thoughts process and the cognitive errors that the person tends to engage in is conducted.
Finally, ways to replace these errors with more effective and helpful ways of thinking is learnt. Cognitive-Behavioural therapy is a short-term structured process. Usually, 12-16 sessions are needed to achieve a significant reduction of symptoms. The therapist who provides CBT should have the relevant knowledge and experience in this type of therapy, in order to maximize treatment results. By the same token, successful clients are those who are highly motivated and fully cooperate with the treatment plan.
- Beck, J., and Beck, A. (2011). Cognitive behavioural therapy: Basics and beyond. The Guilford Press.