Cognitive Behavioral Therapy Research Paper

Cognitive Behavioral Therapy Research Paper

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors, and thoughts. Unlike traditional Freudian psychoanalysis, which probes childhood wounds to get at the root causes of conflict, CBT focuses on solutions, encouraging patients to challenge distorted cognition's and change destructive patterns of behavior.Cognitive Behavioral Therapy Research Paper

CBT rests on the idea that thoughts and perceptions influence behavior. Feeling distressed, in some cases, may distort one’s perception of reality. CBT aims to identify harmful thoughts, assess whether they are an accurate depiction of reality, and, if they are not, employ strategies to challenge and overcome them.Cognitive Behavioral Therapy Research Paper

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CBT is appropriate for people of all ages, including children, adolescents, and adults. Evidence has mounted that CBT can benefit numerous conditions, such as major depressive disorder, anxiety disorders, post-traumatic stress disorder, eating disorders, obsessive-compulsive disorders, and many others. Research also indicates that CBT can be delivered effectively online, in addition to face-to-face therapy sessions.Cognitive Behavioral Therapy Research Paper

The Benefits of Cognitive Behavioral Therapy

The tools deployed in CBT—which include learning to identify and dispute unrealistic or unhelpful thoughts and developing problem-solving skills—have been used to treat a broad range of mental health challenges. CBT is now considered among the most efficacious forms of talk therapy, especially when clients incorporate strategies into their daily life. This effort to gain insight into one’s cognitive and behavioral processes and modify them in a constructive way often involves ongoing practice, but is favored by many clients as it can require fewer therapy sessions than other modalities.

Cognitive behavioral therapy (CBT) is a type of psycho therapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. CBT is commonly used to treat a wide range of disorders, including phobias, addictions, depression, and anxiety.1Cognitive Behavioral Therapy Research Paper

Cognitive behavior therapy is generally short-term and focused on helping clients deal with a very specific problem. During the course of treatment, people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior and emotions.2

Cognitive Behavioral Therapy Basics

The underlying concept behind CBT is that our thoughts and feelings play a fundamental role in our behavior.2 For example, a person who spends a lot of time thinking about plane crashes, runway accidents and other air disasters may find themselves avoiding air travel.

The goal of cognitive behavior therapy is to teach patients that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.

Cognitive behavior therapy has become increasingly popular in recent years with both mental health consumers and treatment professionals. Because CBT is usually a short-term treatment option, it is often more affordable than some other types of therapy. CBT is also empirically supported and has been shown to effectively help patients overcome a wide variety of manipulative behaviors.2

Automatic Negative Thoughts

One of the main focuses of cognitive behavioral therapy is on changing the automatic negative thoughts that can contribute to and exacerbate emotional difficulties, depression, and anxiety. These negative thoughts spring forward spontaneously, are accepted as true, and tend to negatively influence the individual's mood.

Through the CBT process, patients examine these thoughts and are encouraged to look at evidence from reality that either supports or refutes these thoughts. By doing this, people are able to take a more objective and realistic look at the thoughts that contribute to their feelings of anxiety and depression. By becoming aware of the negative and often unrealistic thoughts that dampen their feelings and moods, people are able to start engaging in healthier thinking patterns.2Cognitive Behavioral Therapy Research Paper

Types of Cognitive Behavior Therapy

According to the British Association of Behavioral and Cognitive Psychotherapies, "Cognitive and behavioral psychotherapies are a range of therapies based on concepts and principles derived from psychological models of human emotion and behavior. They include a wide range of treatment approaches for emotional disorders, along a continuum from structured individual psychotherapy to self-help material."

There are a number of specific types of therapeutic approaches that involve CBT that are regularly used by mental health professionals. Examples of these include:

  • Rational Emotive Behavior Therapy (REBT): This type of CBT is centered on identifying and altering irrational beliefs. The process of REBT involves identifying the underlying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought patterns.
  • Cognitive Therapy: This form of therapy is centered on identifying and changing inaccurate or distorted thinking patterns, emotional responses, and behaviors.3
  • Multimodal Therapy: This form of CBT suggests that psychological issues must be treated by addressing seven different but interconnected modalities, which are behavior, affect, sensation, imagery, cognition, interpersonal factors and drug/biological considerations.4
  • Dialectical Behavior Therapy: This type of cognitive-behavioral therapy addresses thinking patterns and behaviors and incorporates strategies such as emotional regulation and mindfulness.

While each type of cognitive-behavioral therapy offers its own unique approach, each centers on addressing the underlying thought patterns that contribute to psychological distress.

The Components of Cognitive Behavior Therapy

People often experience thoughts or feelings that reinforce or compound faulty beliefs. Such beliefs can result in problematic behaviors that can affect numerous life areas, including family, romantic relationships, work, and academics.

For example, a person suffering from low self-esteem might experience negative thoughts about his or her own abilities or appearance. As a result of these negative thinking patterns, the individual might start avoiding social situations or pass up opportunities for advancement at work or at school.

In order to combat these destructive thoughts and behaviors, a cognitive-behavioral therapist begins by helping the client to identify the problematic beliefs. This stage, known as functional analysis, is important for learning how thoughts, feelings, and situations can contribute to maladaptive behaviors.5 The process can be difficult, especially for patients who struggle with introspection, but it can ultimately lead to self-discovery and insights that are an essential part of the treatment process.Cognitive Behavioral Therapy Research Paper

The second part of cognitive behavior therapy focuses on the actual behaviors that are contributing to the problem. The client begins to learn and practice new skills that can then be put in to use in real-world situations.2 For example, a person suffering from drug addiction might start practicing new coping skills and rehearsing ways to avoid or deal with social situations that could potentially trigger a relapse.2

In most cases, CBT is a gradual process that helps a person take incremental steps towards a behavior change. Someone suffering from social anxiety might start by simply imagining himself in an anxiety-provoking social situation.

Next, the client might start practicing conversations with friends, family, and acquaintances. By progressively working toward a larger goal, the process seems less daunting and the goals easier to achieve.2

The Process of Cognitive Behavior Therapy

  • During the process of CBT, the therapist tends to take a very active role.
  • CBT is highly goal-oriented and focused, and the client and therapist work together as collaborators toward the mutually established goals.
  • The therapist will typically explain the process in detail and the client will often be given homework to complete between sessions.
  • Cognitive-behavior therapy can be effectively used as a short-term treatment centered on helping the client deal with a very specific problem.2Cognitive Behavioral Therapy Research Paper

Uses of Cognitive Behavior Therapy

Cognitive behavior therapy has been used to treat people suffering from a wide range of disorders, including:

  • Anxiety
  • Phobias
  • Depression
  • Addictions
  • Eating disorders
  • Panic attacks
  • Anger

CBT is one of the most researched types of therapy, in part because treatment is focused on highly specific goals and results can be measured relatively easily.

Compared to psychoanalytic types of psychotherapy which encourage a more open-ended self-exploration, cognitive behavior therapy is often best-suited for clients who are more comfortable with a structured and focused approach in which the therapist often takes an instructional role. However, for CBT to be effective, the individual must be ready and willing to spend time and effort analyzing his or her thoughts and feelings. Such self-analysis and homework can be difficult, but it is a great way to learn more about how internal states impact outward behavior.

Cognitive behavior therapy is also well-suited for people looking for a short-term treatment option for certain types of emotional distress that does not necessarily involve psychotropic medication. One of the greatest benefits of cognitive-behavior therapy is that it helps clients develop coping skills that can be useful both now and in the future.2Cognitive Behavioral Therapy Research Paper

Criticisms of Cognitive Behavior Therapy

Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simply becoming aware of these thoughts does not make it easy to alter them. CBT doesn't tend to focus on potential underlying unconscious resistances to change as much as other approaches such as psychoanalytic psychotherapy.6

It is important to note that CBT does not just involve identifying these thought patterns; it is focused on using a wide range of strategies to help clients overcome these thoughts. Such strategies may include journaling, role-playing, relaxation techniques, and mental distractions.7

A Word From Very well

Cognitive-behavior therapy can be an effective treatment choice for a range of psychological issues. If you feel that you might benefit from this form of therapy, consult with your physician and check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a professional in your area.

Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

It is important to emphasize that advances in CBT have been made on the basis of both research and clinical practice. Indeed, CBT is an approach for which there is ample scientific evidence that the methods that have been developed actually produce change. In this manner, CBT differs from many other forms of psychological treatment.

CBT is based on several core principles, including:

  1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
  2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.
  3. People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.Cognitive Behavioral Therapy Research Paper

CBT treatment usually involves efforts to change thinking patterns. These strategies might include:

  • Learning to recognize one's distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
  • Gaining a better understanding of the behavior and motivation of others.
  • Using problem-solving skills to cope with difficult situations.
  • Learning to develop a greater sense of confidence is one's own abilities.

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:

  • Facing one's fears instead of avoiding them.
  • Using role playing to prepare for potentially problematic interactions with others.
  • Learning to calm one's mind and relax one's body.

Not all CBT will use all of these strategies. Rather, the psychologist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.

CBT places an emphasis on helping individuals learn to be their own therapists. Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions and behavior.Cognitive Behavioral Therapy Research Paper

CBT therapists emphasize what is going on in the person's current life, rather than what has led up to their difficulties. A certain amount of information about one's history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.

Cognitive behavioral therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel. It is used to help treat a wide range of issues in a person’s life, from sleeping difficulties or relationship problems, to drug and alcohol abuse or anxiety and depression. CBT works by changing people’s attitudes and their behavior by focusing on the thoughts, images, beliefs and attitudes that are held (a person’s cognitive processes) and how these processes relate to the way a person behaves, as a way of dealing with emotional problems.

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An important advantage of cognitive behavioral therapy is that it tends to be short, taking five to ten months for most emotional problems. Clients attend one session per week, each session lasting approximately 50 minutes. During this time, the client and therapist are work together to understand what the problems are and develop new strategies for tackling them. CBT introduces patients to a set of principles that they can apply whenever they need to, and that’ll last them a lifetime.

Cognitive behavioral therapy can be thought of as a combination of psychotherapy and behavioral therapy. Psychotherapy emphasizes the importance of the personal meaning we place on things and how thinking patterns begin in childhood. Behavioral therapy pays close attention to the relationship between our problems, our behavior and our thoughts. Most psychotherapists who practice CBT personalize and customize the therapy to the specific needs and personality of each patient.Cognitive Behavioral Therapy Research Paper

The History of Cognitive Behavioral Therapy

Cognitive behavioral therapy was invented by a psychiatrist, Aaron Beck, in the 1960s. He was doing psychoanalysis at the time and observed that during his analytical sessions, his patients tended to have an internal dialogue going on in their minds — almost as if they were talking to themselves. But they would only report a fraction of this kind of thinking to him.

For example, in a therapy session the client might be thinking to herself: “He (the therapist) hasn’t said much today. I wonder if he’s annoyed with me?” These thoughts might make the client feel slightly anxious or perhaps annoyed. He or she could then respond to this thought with a further thought: “He’s probably tired, or perhaps I haven’t been talking about the most important things.” The second thought might change how the client was feeling.

Beck realized that the link between thoughts and feelings was very important. He invented the term automatic thoughts to describe emotion-filled thoughts that might pop up in the mind. Beck found that people weren’t always fully aware of such thoughts, but could learn to identify and report them. If a person was feeling upset in some way, the thoughts were usually negative and neither realistic nor helpful. Beck found that identifying these thoughts was the key to the client understanding and overcoming his or her difficulties.

Beck called it cognitive therapy because of the importance it places on thinking. It’s now known as cognitive-behavioral therapy (CBT) because the therapy employs behavioral techniques as well. The balance between the cognitive and the behavioral elements varies among the different therapies of this type, but all come under the umbrella term cognitive behavior therapy. CBT has since undergone successful scientific trials in many places by different teams, and has been applied to a wide variety of problems.

The Importance of Negative Thoughts

CBT is based on a model or theory that it’s not events themselves that upset us, but the meanings we give them. If our thoughts are too negative, it can block us seeing things or doing things that don’t fit – that disconfirm – what we believe is true. In other words, we continue to hold on to the same old thoughts and fail to learn anything new.

For example, a depressed woman may think, “I can’t face going into work today: I can’t do it. Nothing will go right. I’ll feel awful.” As a result of having these thoughts – and of believing them – she may well ring in sick. By behaving like this, she won’t have the chance to find out that her prediction was wrong. She might have found some things she could do, and at least some things that were okay. But, instead, she stays at home, brooding about her failure to go in and ends up thinking: “I’ve let everyone down. They will be angry with me. Why can’t I do what everyone else does? I’m so weak and useless.” That woman probably ends up feeling worse, and has even more difficulty going in to work the next day. Thinking, behaving and feeling like this may start a downward spiral. This vicious circle can apply to many different kinds of problems.

Where Do These Negative Thoughts Come From?

Beck suggested that these thinking patterns are set up in childhood, and become automatic and relatively fixed. So, a child who didn’t get much open affection from their parents but was praised for school work, might come to think, “I have to do well all the time. If I don’t, people will reject me.” Such a rule for living (known as a dysfunctional assumption) may do well for the person a lot of the time and help them to work hard.Cognitive Behavioral Therapy Research Paper

But if something happens that’s beyond their control and they experience failure, then the dysfunctional thought pattern may be triggered. The person may then begin to have automatic thoughts like, “I’ve completely failed. No one will like me. I can’t face them.”

Cognitive-behavioral therapy acts to help the person understand that this is what’s going on. It helps him or her to step outside their automatic thoughts and test them out. CBT would encourage the depressed woman mentioned earlier to examine real-life experiences to see what happens to her, or to others, in similar situations. Then, in the light of a more realistic perspective, she may be able to take the chance of testing out what other people think, by revealing something of her difficulties to friends.

Clearly, negative things can and do happen. But when we are in a disturbed state of mind, we may be basing our predictions and interpretations on a biased view of the situation, making the difficulty that we face seem much worse. CBT helps people to correct these misinterpretations.Cognitive Behavioral Therapy Research Paper

Cognitive Behavior Therapy (CBT) is a psychotherapy that has been shown to be effective in over 2,000 research studies. It is a time-sensitive, structured, present-oriented psychotherapy that helps individuals identify goals that are most important to them and overcome obstacles that get in the way. CBT helps people get better and stay better.

CBT is based on the cognitive model: the way that individuals perceive a situation is more closely connected to their reaction than the situation itself.

One important part of CBT is helping clients figure out what they most want from life and move toward achieving their vision. They learn skills to change thinking and behavior to achieve lasting improvement in mood and functioning and sense of well-being.

CBT uses a variety of cognitive and behavioral techniques, but it isn’t defined by its use of these strategies. We do lots of problem solving and we borrow from many psychotherapeutic modalities, including dialectical behavior therapy, acceptance and commitment therapy, Gestalt therapy, compassion focused therapy, mindfulness, solution focused therapy, motivational interviewing, positive psychology, interpersonal psychotherapy, and when it comes to personality disorders, psycho dynamic psychotherapy.

Whether you’re suffering from panic attacks, obsessive thoughts, unrelenting worries, or an incapacitating phobia, it’s important to know that you don’t have to live with anxiety and fear. Treatment can help, and for many anxiety problems, therapy is often the most effective option. That’s because anxiety therapy—unlike anxiety medication—treats more than just the symptoms of the problem. Therapy can help you uncover the underlying causes of your worries and fears; learn how to relax; look at situations in new, less frightening ways; and develop better coping and problem-solving skills. Therapy gives you the tools to overcome anxiety and teaches you how to use them.

Anxiety disorders differ considerably, so therapy should be tailored to your specific symptoms and diagnosis. If you have obsessive-compulsive disorder (OCD), for example, your treatment will be different from someone who needs help for anxiety attacks. The length of therapy will also depend on the type and severity of your anxiety disorder. However, many anxiety therapies are relatively short-term. According to the American Psychological Association, many people improve significantly within 8 to 10 therapy sessions.Cognitive Behavioral Therapy Research Paper

While many different types of therapy are used to treat anxiety, the leading approaches are cognitive behavioral therapy (CBT) and exposure therapy. Each anxiety therapy may be used alone, or combined with other types of therapy. Anxiety therapy may be conducted individually, or it may take place in a group of people with similar anxiety problems. But the goal is the same: to lower your anxiety levels, calm your mind, and overcome your fears.

Cognitive behavioral therapy (CBT) for anxiety

Cognitive behavioral therapy (CBT) is the most widely-used therapy for anxiety disorders. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions.

CBT addresses negative patterns and distortions in the way we look at the world and ourselves. As the name suggests, this involves two main components:

Cognitive therapy examines how negative thoughts, or cognitions, contribute to anxiety.

Behavior therapy examines how you behave and react in situations that trigger anxiety.

The basic premise of CBT is that our thoughts—not external events—affect the way we feel. In other words, it’s not the situation you’re in that determines how you feel, but your perception of the situation. For example, imagine that you’ve just been invited to a big party. Consider three different ways of thinking about the invitation, and how those thoughts would affect your emotions.

Cognitive behavioral therapy (CBT) is a short-term form of behavioral treatment. It helps people problem-solve. CBT also reveals the relationship between beliefs, thoughts, and feelings, and the behaviors that follow. Through CBT, people learn that their perceptions directly influence how they respond to specific situations. In other words, a person’s thought process informs their behaviors and actions.Cognitive Behavioral Therapy Research Paper

Cognitive behavioral therapy is not a distinct treatment technique. Instead, it is a general term which refers to a group of therapies. These therapies have certain similarities in therapeutic methodology. The group includes rational emotive behavior therapy, cognitive therapy, and dialectical behavior therapy.

How Cognitive Behavioral Therapy Works

Cognitive behavioral therapy is grounded in the belief that how a person perceives events determines how they will act. It is not the events themselves that determine the person's actions or feelings. For example, a person with anxiety may believe that “everything will turn out badly today.” These negative thoughts may influence their focus. They may then only perceive negative things that happen. Meanwhile, they may block out or avoid thoughts or actions that could disprove the negative belief system. Afterward, when nothing appears to go right in the day, the person may feel even more anxious than before. The negative belief system may get stronger. The person is at risk of being trapped in a vicious, continuous cycle of anxiety.

Cognitive behavioral therapists believe we can adjust our thoughts. This is thought to directly influence our emotions and behavior. The adjustment process is called cognitive restructuring. Aaron T. Beck is the psychiatrist widely considered to be the father of cognitive therapy. He believed a person’s thinking pattern may become established in childhood. He found that certain cognitive errors could lead to depression or dysfunctional assumptions.

Common cognitive errors and their associated dysfunctional assumptions include:Cognitive Behavioral Therapy Research Paper

  • Self-references: "People always focuses attention on me, especially when I fail."
  • Selective abstraction: "Only my failures matter. I am measured by my failures."
  • Overgeneralizing: "If something is true in one setting, it is true in every setting."
  • Excessive responsibility: "I am responsible for every failure and every bad thing that happens."
  • Dichotomous thinking: Viewing the world in extremes, black or white, with nothing in between.

The cognitive behavioral process is based on an educational model. People in therapy are helped to unlearn negative reactions and learn new ones. These are positive reactions to challenging situations. CBT helps break down overwhelming problems into small, manageable parts. Therapists help people set and reach short-term goals. Then the therapist gradually adjusts how the person in treatment thinks, feels, and reacts in tough situations. Changing attitudes and behaviors can help people learn to address specific issues in productive ways.Cognitive Behavioral Therapy Research Paper

CBT Techniques

Cognitive behavioral therapy involves more than sitting and talking about what comes to mind. This structured approach keeps the therapist and the person in treatment focused on the goals of each session. This ensures the time spent in therapy is productive. The person in therapy benefits from a collaborative relationship. They can reveal personal issues without fear of judgment. The therapist helps them understand the issues at hand. However, they do not tell the person in therapy which choices to make.

CBT techniques incorporate many different therapeutic tools. These tools help people in therapy evaluate their emotional patterns and states. CBT therapists may employ common techniques such as:

  • Journaling
  • Challenging beliefs
  • Mindfulness
  • Relaxation
  • Social, physical, and thinking exercises. These may help someone become aware of their emotional and behavioral patterns.

Homework is completed by the person in treatment. It might include practical exercises, reading, or writing assignments. This helps reinforce the therapy. The homework is done outside of the scheduled time for therapy. Homework is a crucial aspect of many CBT treatment plans. It challenges the person to continue working on their own, even after therapy comes to an end.

Most people who receive cognitive behavioral therapy do so for an average of 16 sessions. Each of these lasts about an hour. People in treatment learn new coping skills to handle their issues. They develop more positive beliefs and behaviors. Some even resolve long-standing life problems.Cognitive Behavioral Therapy Research Paper

Mental Health Conditions Treated with CBT

Some factors make people more likely to benefit from CBT. People with clearly defined behavioral and emotional concerns may find CBT helpful. Those with specific problems that affect their quality of life can also benefit from cognitive behavioral therapy. Under these conditions, the therapist and the person in treatment know which issue to target. This makes CBT’s problem-solving and goal-oriented approach a good fit. CBT is used to effectively treat many conditions, including:

  • Depression
  • Anxiety
  • Mood issues
  • Post traumatic stress
  • Obsessions and compulsions
  • Chronic fatigue syndrome (CFS)
  • Irritable bowel syndrome (IBS)
  • Substance dependency
  • Phobias
  • Disordered eating
  • Persistent pain
  • Erratic sleep patterns
  • Sexual issues
  • Anger management issues

CBT is used to treat many mental health issues. But as with any type of therapy, benefits are greatest when people commit fully to the process.

History of Cognitive Behavioral Therapy

Albert Ellis, PhD first presented his rational approach to therapy at the 1957 American Psychological Association convention. He had first learned and practiced various forms of psychoanalytic treatment. But Ellis grew dissatisfied with the lack of efficiency and effectiveness of classical analysis. Ellis agreed with Freud that irrational forces may have significant effects on thoughts and behavior. But he came to believe these forces were not due to unconscious conflicts in early childhood. Ellis had seen too many people in therapy who understood their childhood experiences and unconscious processes. But they remained in a troubled state. With this in mind, Ellis chose to challenge the belief system of people with seemingly irrational thoughts. He encouraged people in therapy to actively work against those beliefs.Cognitive Behavioral Therapy Research Paper

Around the same time, Aaron Beck was developing his own approach to therapy. Like Ellis, Beck was a student of the psychoanalytic approach. But evidence from his work on dreams and idealization material led Beck away from psychoanalysis. He formulated a cognitive theory. Beck discovered he could train people in therapy to analyze and test their maladaptive cognition's. He learned that doing so could improve their attitudes and emotions. Cognitive therapy garnered worldwide attention. It sparked extensive research efforts. The approach incorporates various behavioral elements. Due to this, it is widely known as cognitive behavioral therapy.

In addition to Ellis and Beck, others contributed to the development and global recognition of CBT. Some of these contributors include Maxie Maultsby, Michael Mahoney, Donald Meichenbaum, David Burns, Marsha Linehan, and Arthur Freeman.

Who Provides Cognitive Behavioral Therapy?

A growing number of mental health professionals use cognitive behavioral therapy. This is often what makes up most of their regular sessions. Other therapists incorporate CBT techniques into their practices. They may use it alongside other approaches.Cognitive Behavioral Therapy Research Paper

A variety of training and certification programs exist for therapists who wish to further their training in CBT. The National Association of Cognitive-Behavioral Therapists (NACBT) is one of the most well-known CBT organizations. It provides four certifications for qualified cognitive behavioral therapists to earn including:

  • Diplomate in Cognitive-Behavioral Therapy
  • Certified Cognitive-Behavioral Therapist
  • Certified Cognitive-Behavioral Group Therapist
  • Certified Cognitive-Behavioral Group Facilitator

The highest certification awarded by the NACBT is the Diplomate in Cognitive-Behavioral Therapy. The Academy of Cognitive Therapy (ACT) is another well-known organization that offers training and certification in cognitive therapy. ACT and NACBT certifications may demonstrate a higher level of dedication to and specialized training in CBT. But no certification is required for a therapist to practice CBT.

Concerns and Limitations of Cognitive Behavioral Therapy

CBT is not a quick fix for behavioral and mental health issues. Therapists need to demonstrate considerable expertise in the approach. People in therapy will benefit most when they cooperate fully with the treatment program. People with certain complex mental health needs may not be able to benefit right away from cognitive behavioral therapy. This could include people with issues that stem from severe trauma. In some cases, emotional issues must be addressed before cognitive work can begin.Cognitive Behavioral Therapy Research Paper

Some people have vague feelings of unhappiness, without clearly defined symptoms. They may also have limited success with cognitive behavioral therapy. People with long-term health issues such as irritable bowel syndrome or chronic fatigue syndrome can use CBT to better cope with their condition. But the physical symptoms of these conditions cannot be cured with CBT.

Finally, CBT can help people develop more positive thought patterns and behaviors. But without a more traditional approach to therapy, they may not gain deeper insights into the psychological and emotional causes of their behavior.

If you or someone you care about experience an emotional problem it won’t be long before you hear that cognitive behaviour therapy, or CBT, is probably the treatment of choice.

Research over the last 40 years or so has found CBT to be helpful for all manner of problems, including anxiety, depression, insomnia, pain, anger, sexual problems, and the list goes on. But what exactly is it?Cognitive Behavioral Therapy Research Paper

CBT is probably best understood by what it is trying to achieve. The main premise of CBT is that problems develop as a consequence of learnt ways of thinking (cognition) and behaving, and that learning new ways of thinking and behaving will have more helpful impacts on emotions and well-being.

Cognition: the C in CBT

The cognitive element of CBT refers to our thoughts, mental images, self-talk and core beliefs about ourselves (I’m ok, or I’m not), other people (they are generally friendly or they’re not) and the world around us (the future is bright or it’s not).

The more threatening our thoughts (I’m going to be criticised), the more anxious we will feel. The more hopeless we believe the future is (there’s no point), the more depressed we will feel. The more strongly we believe things should be different (the world must not be this way!), the more frustrated and angry we will feel.

The way we think is guided by what we pay attention to (a tendency to focus on negative things?), the way we interpret what is happening around us (seeing the glass half-full?) and the experiences we are most likely to remember (such as the times things went bad rather than the times things went well).

We all use particular styles of thinking from time to time that can get us into trouble. We are “catastrophising” when we blow things way out of proportion (things are rarely that bad). Using words like “never” and “always” is a good sign we’re thinking in an overgeneralised way (most bad things happen somewhere between never and always).

It’s important to remember that thoughts are, well, just thoughts. They are not immutable facts.

Most of the thoughts we have throughout the day are random streams of consciousness that are simply the output of creative minds. And many people can interpret exactly the same situation in many different ways.

Behaviour: the B in CBT

The behavioural aspect of CBT is based on learning theory. If you’ve heard of Pavlov’s dogs then you know about classical conditioning. Pavlov rang a bell just before he gave his dogs some food. Eventually the dogs started to salivate when they heard a bell ring (even if no food was given). They learnt that the bell signalled food. (Voila! Classical conditioning.)

Emotional responses can be classically conditioned in a similar way. As a simple example, someone with a dog phobia might recall being bitten as a child (perhaps by one of Pavlov’s dogs?). A cognitive behaviour therapist might speculate that the child developed a classically conditioned fear response to the dog.Cognitive Behavioral Therapy Research Paper

Just like the bell triggered Pavlov’s dogs to salivate, an image or thought of a dog can trigger fear (even if the dog has no intention of biting).

Pavlov found that if he repeatedly rang the bell without providing food eventually the dogs stopped salivating when they heard the bell. They learnt that the bell no longer signalled food.

Similarly, if we repeatedly expose someone with a dog phobia to dogs without them being bitten, then they will learn that dogs are not dangerous and the fear response will stop being triggered. It turns out that repeated exposure to any feared object or situation (in the absence of the fear coming true) can effectively diminish the fear response.Cognitive Behavioral Therapy Research Paper

A cognitive behaviour therapist is interested in all the things we do (or avoid doing) to manage the difficulties life throws our way. This might include unhelpful behaviors such as always avoiding the things we fear, excessively using drugs or alcohol, being controlling or violent towards others, and the list goes on.

Avoidance denies us any chance to challenge our fears and build confidence that we can cope. Alcohol and drugs might feel good and distract us in the short term, but ultimately our problems still exist and might be even worse in the longer term.

Being controlling towards others might help us feel powerful and in control in the short term, but this can conceal an underlying core belief of vulnerability (if I don’t control my environment, then perhaps it will control me).

These problems are only likely to be resolved when the fears driving these unhelpful behaviors are directly challenged and modified.

Therapy: the T in CBT

Cognitive behaviour therapists help clients better understand why they might have developed particular problems and, more importantly, what vicious cycles are maintaining them.

The most important questions for treatment are:

  1. How do our thoughts, behaviors, physiology, interpersonal relationships and emotions interact to maintain problems in our lives?
  2. How can we break these cycles?

Here are some things you can expect from a competent cognitive behaviour therapist.

A strong therapeutic relationship: Cognitive behavioral therapists appreciate that therapy can be emotional and difficult. They know their client needs to trust them before they will be able to work effectively together. Empathy, genuineness, unconditional positive regard and warmth need to be there in spades.Cognitive Behavioral Therapy Research Paper

Collaboration: CBT involves a close working relationship between the client and therapist. The client is seen as an expert in their lives and the therapist is seen as an expert in evidence-supported treatments. Both forms of expertise are equally important to achieve a good outcome.

Goal-setting: CBT aims to be an efficient and time-limited form of therapy. A cognitive behavioral therapist will be very interested in what you would like to achieve from therapy. Together you will plan how to get there and how long it should take.

There is some flexibility if progress is slower than expected, but for most problems the therapist thinks in weeks or months rather than years.Cognitive Behavioral Therapy Research Paper

Monitoring and evaluation: Cognitive behavioral therapists don’t rely on their own judgement about when clients problems have resolved; the therapist might be wrong. Rather, they measure change from the client’s perspective.

The therapist might ask the client to complete some monitoring or questionnaires during therapy so that progress can be tracked.

Cognitive behavioral therapists don’t blame the client if the problem isn’t improving. The therapist takes responsibility for changing what is done in therapy to ensure things get back on track.

Practical skills: CBT aims to teach clients to relate differently to their thoughts, physical sensations, emotions and behaviors so that they don’t get caught up in them in problematic ways.

One technique might involve identifying negative thoughts and challenging them by recognizing when they are overly catastrophic and generating more realistic and helpful alternatives.Cognitive Behavioral Therapy Research Paper

The techniques covered in CBT will depend on the nature of the problem, but you can expect to leave therapy with a toolkit full of helpful skills.

Between-session tasks: Clients never come to therapy just to feel good for the hour they are in the therapists office. They come to improve their lives out in the real world. For this reason, cognitive behaviour therapists encourage clients to apply their new skills between sessions and report back on how it went. This is where much of the hard work, learning and changes occur in CBT.

Here and how focus: CBT acknowledges the role that past experiences play in shaping who we are, but at the same time recognizes that little can be done to change what has already occurred.

Instead, CBT focuses on identifying what is left behind from these experiences in the form of core beliefs about ourselves, others, and the world, and how these beliefs impact on present-day experiences.Cognitive Behavioral Therapy Research Paper

Modifying these core beliefs can change our emotional responses to memories of earlier negative experiences, and can change the way we respond to challenges in our lives now and into the future.

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The process of therapy is challenging and takes courage. A cognitive behavioral therapist’s role is to guide, support and cheer-lead when required. CBT’s overarching aim is to increase clients coping self-efficacy – their confidence in their own ability to manage their problems on their own.

If a cognitive behavioral therapist has done a good job, the client should leave therapy knowing that they are responsible for the benefits they have achieved from therapy and that they can continue to build on these gains well into the future.Cognitive Behavioral Therapy Research Paper