Cognitive Behavioral Therapy

CBT is among the most widely used and empirically supported form of psychotherapy. It has roots in both the Stoic philosophy of the ancient Greeks that emphasized the importance of constructive, non-reactive thinking and modern learning theory. CBT is differentiated from many other forms of psychotherapy because of its emphasis on problem solving in the present (rather than past events) and its suitability to be utilized within a scientific framework and verified through research. CBT has been documented to be effective with both children and adults. It has been applied to psychological conditions like Anxiety Disorders, Obsessive-Compulsive Disorder, Mood Disorders, Autism, and Tourette’s Syndrome, to name but a few. CBT has also been helpful in interpersonal and marital issues, health problems such as stress, and enhancing performance in sports, academics, and work. Pediatric application of CBT can be a powerful tool to help children. Restructuring thinking patterns and changing behavior at an early age, can lead to healthier and more functional coping mechanisms for life.

The “C” in CBT stands for “Cognition” which is a synonym for “Thought.” The approach starts with the notion that many kinds of psychological problems are related to habitual errors in thinking. Examples include magnification of minor problems into major issues and jumping to conclusions without sufficient evidence. In cognitive therapy such errors are identified and then challenged and re-structured though a kind of mental exercise program. These exercises are taught and practiced during and in-between sessions. It has been found that problems such as depression, anxiety, and anger as well as a host of others have characteristic erroneous thought patterns called “schemas.” The good news is that research shows that correcting faulty thoughts and schemas can greatly help a variety of symptoms and problems and lead to lasting positive changes in functioning and quality of life.

Behavioral Therapy, or the “B” in CBT, is the term used to describe a variety of strategies designed to increase positive behaviors and decrease negative ones. Some well-known examples of Behavioral Therapy are Assertiveness Training, Habit Reversal Training, Stress Inoculation, Behavioral Contracting, Progressive Muscle Relaxation, Relapse Prevention, Panic Control Treatment, Exposure and Ritual Prevention, and Token Economies. This approach emphasizes objective goals that can be measured and observed (e.g. increasing number of social interactions that last more than five minutes) rather than subjective abstractions (e.g. becoming happier). Behavior therapy examines the functional relationships between stimuli that occur prior to the target behavior (antecedents) and how the behavior is reinforced or punished (consequences). Understanding these relationships via data collection leads to a theory about how the problem behavior was acquired and why it is persisting. The end product is implementation of an intervention plan to modify the undesirable behavior. A major advantage of behavior therapy is that progress may be charted in an immediately useful manner.

Research indicates that altering behavior or thoughts directly leads to improvements. Further, there is a growing proof that modifying thoughts and behaviors can affect neurological processes in a similar way that meditation can benefit a physiological measure like blood pressure. Some may be concerned that CBT is like a “band-aid,” meaning that treatment without uncovering “deeper” causes is superficial. Fortunately for those considering CBT, evidence is lacking that this is true. Overall, CBT is a well-proven form of treatment for a wide range of psychological conditions.