What Is Cognitive Behavioral Therapy (CBT)?
Last Updated: November 13, 2023
Cognitive behavioral therapy (CBT) is a common mental health treatment modality. It has a lengthy history of use in counseling and therapy practice. Since its inception, CBT has been well-studied, and research shows that it is effective in treating several emotional and mental health problems. It is based on the belief that thoughts, emotions and behaviors are interconnected.
What Is Cognitive Behavioral Therapy?
Cognitive behavioral therapy is often referred to by the acronym CBT. This modality is based upon the belief that mental health improves when we correct distorted thinking patterns and negative belief systems. The idea is that when people have unhealthy thinking patterns, it affects their emotions and behavior, which in turn, leads to distress.
This therapeutic modality has been around since the 1960s. While it is often utilized to treat depression, its use has expanded. Recently, studies have found that beyond depression, CBT can treat anxiety disorders, personality disorders, eating disorders and substance abuse. CBT can also be used alongside medication to treat bipolar disorder and schizophrenia.
Origins and History of Cognitive Behavioral Therapy
CBT’s roots go back to 1960 when Aaron Beck developed the modality after realizing that patients with depression often made statements that were not based on reality. He called these statements “cognitive distortions,” and he viewed depression as a cognitive disorder.
Based upon his clinical observations, Beck developed cognitive therapy, and in 1979, he published a book on his modality after research showed it was effective. Beck’s cognitive therapy was not only supported by research; it also came with a detailed treatment manual that described the specific protocol for delivering this therapy.
It is noteworthy that before Beck developed cognitive therapy, he was trained in psychoanalysis, which originated with the ideas of Freud. Beck’s research failed to confirm the psychodynamic theory that depression was a result of aggressive drives, so he transitioned to a focus on cognitive theories.
Types of Cognitive Behavioral Therapy
CBT is a therapeutic modality based on the idea that correcting distorted or unhelpful thinking patterns reduces psychological distress. The theories behind CBT have been applied to multiple different types of therapy. While numerous different therapy types use CBT principles, they all fall under the same umbrella.
Some specific CBT types include:
- Rational Emotive Behavior Therapy (REBT): REBT was developed by Albert Ellis. This form of CBT uses the ABC approach. A stands for activating event; B represents beliefs about the event, and C represents consequences arising from these beliefs. REBT helps people to recognize that irrational beliefs have effects, including distress, anxiety and feelings of depression.
- Cognitive Therapy: This is Beck’s original therapy, which centers on the belief that emotional problems arise when people have cognitive biases or faulty ways of thinking. These biases can be corrected for healing. For example, someone who engages in a cognitive bias called “catastrophizing” tends to jump to the worst conclusion when something negative happens. This way of thinking can be corrected so that one does not always assume the worst.
- Exposure Therapy: Also a type of CBT, exposure therapy is commonly used to treat phobias or obsessive-compulsive disorder. This modality gradually exposes someone to a situation or object that causes fear, so they can learn to become less sensitive to it.
- Dialectical Behavior Therapy: Often referred to by the acronym DBT, dialectical behavior therapy uses principles from CBT, combined with mindfulness interventions. DBT teaches patients new ways of thinking to improve their interpersonal skills and ability to manage stress and emotions.
- Acceptance and Commitment Therapy (ACT): ACT utilizes components from CBT to help people overcome distress and make behavioral changes. This therapy teaches people to cope with negative emotions and experiences by developing an acceptance of them, rather than trying to avoid them.
- Trauma-Focused CBT: As its name might suggest, trauma-focused CBT treats symptoms of trauma. More specifically, it helps people to reflect on and correct unhelpful thinking patterns and avoidance behaviors linked to trauma.
- Mindfulness–Based Cognitive Therapy: Mindfulness-based cognitive therapy (MBCT) combines CBT approaches with mindfulness-based approaches to treat conditions like depression. Mindfulness-based approaches allow patients to become more aware of the present moment, which includes their current way of thinking. The CBT components of this method help patients to change negative modes of thinking. The mindfulness approach also allows patients to appreciate negative ways of thinking without being emotionally reactive to them.
How CBT Works
While the exact methods used to bring about change can vary among different CBT modalities, some general features are standard to all CBT methods. CBT approaches begin with an assessment process, during which the therapist gathers information about the patient’s history and current systems. Then, the therapist helps the patient to identify and correct negative thinking patterns.
The belief is that patients will experience less distress when correcting distorted thinking patterns. Ultimately, the therapist will collaborate with the patient to help them develop healthier coping skills and meet treatment goals. The therapist may educate patients about distorted thinking patterns and help them identify them in their own lives. Then, patients can correct their thinking and change associated behaviors, such as avoiding their fears.
Cognitive Behavioral Therapy Techniques
CBT programs use specific techniques in sessions. These are described in more detail below:
- Mindfulness Interventions: Several forms of CBT use mindfulness interventions. These interventions teach patients to become mindful of the present moment. Patients are also taught to accept their thoughts and emotions rather than judging them negatively. This process can help people to become less emotionally reactive to stress and other negative events or feelings.
- Cognitive Restructuring: One of the core components of CBT approaches is changing distorted or irrational thinking patterns. Given this fact, many CBT programs use some form of cognitive restructuring. This process involves identifying distorted thinking patterns and then replacing them with healthier ways of thinking. Over time, the brain is restructured so that distorted thoughts are not automatic. Instead, a patient will be able to think in a more balanced and healthy way.
- Skills Training: CBT offers patients an opportunity to learn new skills. These include skills for problem-solving, as well as coping skills that can be applied to manage stress. Some CBT approaches may teach specific skills like relaxation or mindfulness.
- Role-Playing: During sessions, the therapist may have a patient do role-playing exercises. This gives the patient an opportunity to use their problem-solving skills in conversation. These skills can then be applied to daily life outside of therapy.
- Homework: The CBT practitioner may give homework at the end of a session. This provides an opportunity for patients to practice specific skills learned during sessions. For instance, a patient may be asked to keep a thought log in which they record their irrational thoughts and give an example of a healthier “replacement thought.”
- Exposure: Some CBT programs involve an element of exposure, in which patients come face-to-face with an object or situation that causes fear or distress. Exposure often occurs in a gradual fashion. For example, a patient may begin by thinking about a scenario that causes distress. Next, they may view videos or pictures of the scenario. Finally, they may be asked to face the scenario in real life.
What to Expect During a CBT Session
CBT can be delivered in both individual and group formats, but regardless of the mode of delivery, there are some basic processes you can expect. In the first session, you can expect to provide some information about the problems that have brought you to therapy. You will also work with the therapist to develop goals for treatment.
CBT is often delivered in one-hour sessions once per week. The number of sessions required depends upon your unique needs and circumstances. Some people may need just a few sessions, whereas others may need to spend more time in treatment. That being said, CBT is designed to be a short-term therapeutic modality. Once you develop goals for treatment, you will learn new skills and journal about your thoughts and emotions as you progress through therapy.
Goals and Benefits of CBT
CBT comes with several goals and benefits. These include:
- Reducing symptoms of depression or whatever mental or emotional health problem you’re experiencing
- Learning more effective problem-solving skills
- Developing healthier ways of coping with stress
- Becoming less emotionally reactive to daily stressors
Effectiveness of Cognitive Behavioral Therapy
CBT has been recognized for decades as an effective psychological treatment method. A recent meta-analysis, which reviewed the results of just over 400 different studies, concluded that CBT is effective for treating depression. Research shows that it is moderately to largely more effective than no treatment or “treatment as usual.”
The meta-analysis also found that CBT was more effective than other therapeutic modalities, but only slightly so. Over the long term, CBT is more effective than medication for treating depression symptoms.
Some experts have even referred to CBT as being the “gold standard” treatment for psychological problems. This is because CBT is arguably the most well-researched therapeutic modality that exists, and no other therapies have been found to be superior to this method.
CBT in Addiction and Mental Health Treatment
CBT has been found to be effective in treating both mental health and substance use disorders. CBT can be offered in individual and group formats, so rehab centers offering CBT may incorporate this approach in a group format to serve multiple patients at once. In addiction treatment, CBT may be used in relapse prevention to help patients develop coping skills and change distorted thoughts about substance misuse.
- Anxiety disorders
- Eating disorders
- Marital problems
- Severe mental health disorders, such as bipolar disorder and schizophrenia
- Obsessive-compulsive disorder
- Chronic pain
Find Cognitive Behavioral Therapy Treatment Providers in Kansas City
If you’re looking for a Missouri-based CBT therapist, an Internet search is a great place to start. Many counseling centers list therapist biographies, which are likely to include a description of the therapist’s usual treatment approaches. You can also use government search tools to locate a treatment provider.
If you’re looking for CBT services in the heart of Missouri, The Recovery Village Kansas City is here to help. We can treat mental health disorders as well as co-occurring addictions, and we have therapists trained in the CBT modality. We accept most insurances to make treatment affordable. Contact one of our Recovery Advocates today to get started.
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