Cognitive Behavioural Therapy
Back in 1960s when Dr. Aaron Beck was a psychiatrist in University of Pennsylvania and practice psychoanalysis, he tried to study the pattern of depression. This is during his study he coined the term negative or automatic thoughts and explained its importance in establishing its roots that cause problem. He also discovered that we are not fully aware of these thoughts. Hence is the main reason why some people cannot report what they are feeling and why they are feeling in that particular way even if they try not to. This is the result of series of thoughts that start automatically in our mind and that cause them to feel bad.
Beck during his early research was convinced with the idea that people with depression or anxiety have a scheme of negative thoughts. He also explained the phenomena of cognitive triad that is associated with their mental issues and hence affects them poorly. He said that in the initial period of their problem they only have negative view about themselves but later on as they proceed and out of their negative thoughts when they behave poorly they have a negative outcome which cause the person to have a pessimistic view of the world around him and lastly when nothing seems to work out for them the gloominess creates pessimistic view about the future in the person which creates a cycle.
Beck reported that identifying these thoughts is the key in understanding and overcoming difficulties. If you could challenge these thoughts and their way of thinking then you will be able to change their thinking pattern from negative to positive and can contribute to the improvement in their health. He also said that for breaking this cycle of negative thoughts challenging is the most effective way. He worked with the patients suffering from depression and anxiety by challenging their thoughts and then breaking their cognitive triad and this worked with most of the cases. He later on named this treatment as cognitive therapy.
CBT emphasize on the theory that it’s not the event itself that cause problem, but how we perceive the event and the meaning we give them. Beck at the end suggested that if we want to treat the person we need to work with the way they think and perceive the events and then help them to understand their own false beliefs and adapting more functional and appropriate belief system that will help them to overcome their suffering.
Cognitive behavioural therapy is a time-sensitive, structured, action-oriented session plan to teach the client to focus on identifying and restructuring negative patterns of thoughts and behaviour and reset their thoughts and reactions. Cognitive behavioural therapy is a form of talk therapy that helps the person focus on how thoughts, beliefs and attitude affect feelings and behaviour. CBT helps the person in developing a healthy thought pattern, better coping skills for dealing with their problems.
Where CBT can be effective-
The APA (American Psychological Association) reported that CBT can be effective with variety of disorders and mental illness. Some specific are
alcohol or drug abuse,
Brief of CBT session-
As have discussed that our thoughts and feelings are the reason behind the way we behave. The CBT aims to teach the person that they cannot control every aspect of the world around them but can have power over how they perceive, make sense of the event and deal with the matters that concern them. It focuses on breaking the chain of negative automatic thoughts.
CBT enables the person to examine their thoughts and motivate them to look at the evidence from reality that may or may not support their way of thinking. This helps them look more objectively and realistically that contribute to their feeling of anxiety and depression. Awareness about their dysfunctional beliefs helps them in changing their feeling and moods, and enables them to start engaging in healthier thinking pattern.
Usually the therapy is time bound with 5-20 sessions of 40-50 minutes per session. In each session the client and the therapist actively participates in discussing the problems that require attention and immediate treatment. Both mutually set the goals and search out the means of achieving those goals with the help of various techniques. The therapist gives the clients some homework which they have to do before the next session. The CBT requires active participation of both the therapist and the client.
Techniques used in CBT-
Validity testing: the therapist writes down the evidences which are in favor and against of what a person thinks and the beliefs he/she holds. Writing downs these against and for points helps the person to look at the situation with different perspective. A new window for lighting down their perspective.
Cognitive rehearsal: the therapist asks the person to rehears positive thoughts in his/her mind and recall any problematic event and see the impact of these positive thought on the same situation. Imaging yourself in the situation while doing these therapies empower the chances of positive changes.
Writing down a thought journal: therapist asks the person to keep a record of his/her day to day life activities and the thoughts, and behavior he/she exhibited while he encounters the situations. The therapist reviews the journal and sees the quality of thoughts, frequency and the pattern of behavior shown by the person in the particular event or situation. This also helps in knowing the progress of the person.
Home assignment: the work which therapist gives to the person to complete at home to practice their new learning and positive thought cycle. This assignment is usually based on the problem they have tackled during their recent session.
Role play exercise: the therapist now exchanges his role with the person. The person behaves as a therapist and the therapist plays the role of client. Both of them discuss the problem and now the new therapist would provide the solution with a therapist perspective which will help him/her to look at the problem with a different perspective which was previously blocked by pessimistic thinking pattern.