What is Cognitive-Behavioral Therapy or “CBT”?
Cognitive-Behavioral Therapy, like all talk therapies is focused on improving your mental health and well-being. It is an approach that is supportive, understanding, and nonjudgmental with the aim of helping you improve and meet your goals, be they short term or long term goals. What is more unique to CBT, is that it is often briefer in number of sessions, and focuses primarily on current issues you are struggling with, in order to help you feel better in the here and now. This is done through first talking with you about you, your current difficulties and symptoms (an “initial assessment”), your strengths and struggles, your background, and then teaching skills to help you make changes, specifically in your thinking patterns (cognitions) and behavior patterns, to help you get past whatever patterns you feel “stuck” in.
Cognitions are our thoughts. We all think, all day long, so, we often take for granted our thoughts, how many we have throughout a day, their content, and how powerful our thoughts are in helping us (or hurting us). The cognitive therapy, or “C” of CBT means helping you develop a better awareness of your thoughts by “monitoring” them, and then recognizing those that are healthy versus less healthy. We all have helpful and not-so-helpful thoughts, but if you are struggling with Anxiety or Depression, or just not meeting goals or feeling as motivated as you would like, you are likely engaging in more unhealthy/negative thinking. Our thoughts strongly influence our mood (happy, sad, angry, scared, anxious, depressed, etc) and our behavior, that is, whether we feel motivated to get up and go or confront something, versus procrastinate, avoid, or withdraw. Thought such as, “I am worthless, I am unlovable, I am ugly, I am a failure, or I can’t do that” are going to make us feel down, unmotivated, and perpetuate avoidance, and avoidance can easily run away with itself. Through “cognitive restructuring” or “challenging,” one is taught how to look at and evaluate their thinking, so that it becomes more balanced, healthy and encouraging, more often than not.
The behavioral part, or “B” of CBT means looking at your behaviors, through monitoring them, and assessing what are more or less healthy behaviors in your life. This could include sleep patterns, eating patterns, activity patterns, and or social/relational patterns. If you are struggling with an Anxiety Disorder, your behavior may include a lot of avoidance or “safety behaviors” (which are like crutches or security blankets) that may band-aid the problem in the short term, but maintain and exacerbate anxiety in the long run. It is human nature to avoid fearful things and confrontation, but the longer it goes on, the worse your anxiety becomes. This is also true for Depression, the more avoidant, withdrawn or less active you are, the likelihood the depression will linger or intensify. Thus, CBT helps you identify your existing behavioral patterns and then develop a behavioral plan to engage in more positive/proactive activities on a regular basis. This is often done in a gradual way, and with tools to help you feel like you can achieve these steps (no one needs to feel even more pressured or overwhelmed, but you DO want to feel like you are making progress). In Anxiety Disorders where avoidance is common, a “hierarchy” of avoided situations/places is generated to help you gradually confront your fears. Exposure therapy is a form of CBT often useful for helping with Panic attacks, Phobias, Social Anxiety, Obsessive Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD), in which the client is encouraged to go TO the situations, in vivo, with the therapist often present to help them. Exposure Response Prevention, or ERP, is a form of exposure therapy used in treating OCD.
CBT has been well researched and proven highly effective in treating Anxiety and Mood Disorders. It can be helpful with or without medication, and is often used in combination to maximize the effects of each.
Contact Libby Tannenbaum PhD for more information on cognitive-behavioral therapy or to set up an appointment.