Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy, commonly known as CBT, is a widely recognized and highly effective evidence-based psychotherapy. Developed in the 1960s by Dr. Aaron Beck, CBT is based on the cognitive model which shows how our perceptions of situations affects how we feel, act, and respond physiologically (Beck, 2020).

What is CBT?

The CBT Triangle shows how our thoughts, feelings, and behaviors are all connected to each other

CBT is an evidence-based therapeutic approach that is based on the principle that our thoughts influence our feelings, which in turn affect our actions. It is designed to help you identify and challenge negative thought patterns and behaviours that contribute to emotional distress. By reframing your negative thinking patterns, you can rewire your brain to have more helpful, positive and realistic thoughts.

Negative automatic thoughts can form an ‘internal monologue’ that negatively influence how we automatically interpret situations, react and feel. CBT helps you become more aware of our automatic thoughts and cognitive distortions: for e.g. all-or-nothing thinking, overgeneralization, disqualifying the positive, personalisation, and catastrophizing thoughts.

Examples of Cognitive Distortions

Part of CBT is to identify these unhelpful, inaccurate thoughts, then challenging and changing the content of these thoughts which can profoundly shape the way we feel and behave. This process is also known as cognitive restructuring. CBT allows us to develop a more balanced and healthier way of thinking and behaving, leading to improved mental and emotional well-being.

CBT: An Evidence-Based Practice

CBT has been extensively researched and proven effective in treating a wide range of mental health disorders (Hofmann et al., 2012). CBT has shown to be effective for the treatment of:

• Depression

• Anxiety disorders, such as generalized anxiety disorder, panic disorder, social anxiety disorder

• Post-traumatic stress disorder (PTSD)

• Obsessive-compulsive disorder (OCD)

• Eating disorders (e.g., Anorexia Nervosa, Bulimia Nervosa)

• Substance use disorders

• Insomnia

• Phobias

Structured, Goal-oriented

CBT stands out from many other types of psychotherapy because of its clear structure and goal-oriented approach (Beck, 2020). This structured nature is designed to maximize the effectiveness of treatment. It typically involves a limited number of sessions, depending on what you need and your goals. CBT helps you develop coping strategies and problem-solving skills to alleviate the symptoms and emotional distress of the issues you struggle with.

How Can CBT Help You?

CBT can be a powerful tool that can significantly help with emotional healing and improve your quality of life:

1. Enhanced self-awareness: CBT can help you gain a better understanding of your thoughts, emotions, and behaviours, and how they interact.

2. Improved emotional regulation: By learning to identify and challenge negative thought patterns, you can learn to better manage emotional responses to situations (Berking & Whitley, 2014).

3. Effective problem-solving: CBT equips you with practical problem-solving skills that can be applied to various life challenges.

4. Increased resilience: Coping strategies learned in CBT can help you better manage stress and adversity (Southwick et al., 2012).

5. Better relationships: By improving communication skills and challenging negative interpersonal thoughts, CBT can lead to healthier, more satisfying relationships.

6. Long-lasting results: Skills learned in CBT can be applied long after therapy has ended, providing ongoing benefits and relapse prevention (Salzer et al., 2011).

What to Expect from CBT

During therapy, you can typically expect:

• Time-limited therapy: CBT is generally short- to medium-term, often lasting between 12 to 20 sessions, although this can vary depending on what you need.

• Present-focused treatment: While past experiences may be discussed, CBT focuses mainly on current challenges and future goals.

• Skill development: You’ll learn practical skills and techniques to manage your thoughts, emotions, and behaviours.

• Structured approach: A clear and goal-oriented structure, with each session building upon the previous one.

Sample CBT Techniques and Exercises

1. Cognitive restructuring: Learn to identify and reframe negative thought patterns into more balanced, realistic ones

2. Behavioural activation: Therapeutic technique that systematically increases engagement in rewarding activities to alleviate depressive symptoms

3. Exposure therapy: Specialised therapy to learn to gradually face fears in a controlled, safe environment to reduce anxiety

4. Mindfulness-based techniques: Practice mindfulness and relaxation techniques to reduce stress and anxiety

5. Activity scheduling and journaling: Documenting, planning and tracking daily activities to improve mood and increase motivation

Books to Explore on CBT

If you're interested in learning more about CBT, here are some excellent books to explore:

• Feeling Good: The New Mood Therapy  by Dr. David D. Burns

• Mind Over Mood: Change How You Feel by Changing the Way You Think  by Dennis Greenberger and Christine A. Padesky

• The CBT Toolbox: A Workbook for Clients and Clinicians  by Jeff Riggenbach

• The Cognitive Behavioural Workbook for Anxiety  by William J. Knaus