COGNITIVE BEHAVIOURAL THERAPY (CBT) - AN OVERVIEW

DR. AMAKU CHIEMEZIE

6^TH FEBRUARY, 2024

DEFINITION

• Cognitive behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change the destructive, unhelpful or disturbing thought patterns that have a negative influence on their behavior and emotions.
• CBT is a type of ‘talk’ treatment that helps people learn how to identify and change maladaptive thought patterns that have a negative influence on behavior and emotions

• CBT combines cognitive therapy with behavioral therapy.
• It identifies maladaptive patterns of thinking, emotional responses, or behaviours and replaces them with more desirable patterns.
• CBT focuses on changing the automatic negative thoughts that can contribute to and worsen emotional problems like depression, and anxiety.
• These spontaneous negative thoughts also have a detrimental influence on our mood.
• Using CBT, faulty thoughts are identified, challenged, and replaced with more objective, realistic thoughts.�

CORE CONCEPTS OF CBT�

• CBT is largely based on the idea that one’s thoughts, emotions, and actions are connected.
• So what one thinks and feels about something can affects what one does.
• But another key concept of CBT is that these thought and behavior patterns can be changed.
• According to the American Psychological Association, the core concepts of CBT include:

1. psychological issues are partly based on unhelpful ways of thinking

2. psychological issues are partly based on learned patterns of behavior

3. those living with these issues can improve with better coping mechanisms and management to help relieve their symptoms

CBT can be used as a short-term treatment to help individuals learn to focus on present thoughts and beliefs.

USES OF CBT

• Addiction
• Anger issues
• Anxiety
• Bipolar disorder
• Depression
• Eating disorders
• Panic attacks
• Personality disorders
• Phobias

USES OF CBT

• Chronic pain
• Divorce or break-ups
• Grief or loss
• Insomnia
• Low self-esteem
• Relationship problems
• Stress management

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Types of Cognitive Behavioral Therapy

• Cognitive therapy centers on identifying and changing inaccurate or distorted thought patterns, emotional responses, and behaviors.
• Dialectical behavior therapy (DBT) addresses destructive or disturbing thoughts and behaviors while incorporating treatment strategies such as emotional regulation and mindfulness.
• Mindfulness-based cognitive therapy (MBCT) MBCT uses mindfulness techniques and meditation along with cognitive therapy. This subtype can be particularly effective for people who deal with post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD).

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• Multimodal therapy suggests that psychological issues must be treated by addressing seven different but interconnected modalities: behaviour, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.⁴
• Rational emotive behavior therapy (REBT) involves identifying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought pattern.
• Exposure therapy. This type of therapy involves slowly introduces anxiety-inducing activities/situations into a patient’s life for measured periods of time (one to two hours up to three times a day). This subtype can be particularly effective for people who deal with phobias or obsessive compulsive disorder (OCD)

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Cognitive Behavioral Therapy Techniques�

• CBT does more than to identify thought patterns.
• Strategies used in CBT to help patients overcome these patterns include: 

1. Practicing New Skills

• In cognitive behavioral therapy, people are often taught new skills that can be used in real-world situations. Eg, someone with a substance use disorder might practice new coping skills and rehearse ways to avoid or deal with social situations that could potentially trigger a relapse.

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2. Role-playing: Here, the patient and the therapist act out scenarios to challenge negative thought patterns and behaviours.

3. Identification of Negative Thoughts

• The patient is taught what negative thoughts are and helped to identify them. But taking the time to identify these thoughts can also lead to self-discovery and provide insights that are essential to the treatment process

4. Goal-Setting

• In Goal setting, the patient is taught how to make and differentiate long from short term goals.
• The patient is taught how to achieve these goals using the set SMART acronym (specific, measurable, attainable, relevant, and time-based/bound), focusing on both the process/outcome.

5. Journaling:

• This involves identifying the negative distortions, jotting and then challenging them with more balanced and realistic thoughts.

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6. Problem-Solving

• Helps to reduce the negative impact of psychological and physical illness.

Problem-solving in CBT often involves five steps:

• Identify the problem
• Generate a list of potential solutions
• Evaluate the strengths and weaknesses of each potential solution
• Choose a solution to implement
• Implement the solution

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7. Self-Monitoring (diary work)

• It involves sharing with the therapist, behaviours, symptoms, or experiences tracked over time.
• This can provide therapist with the information needed to provide the best treatment for the patient.
• Others include:

8. Engaging in relaxation techniques/strategies.

9.Using mental distractions

10. Home works

BASIC PRINCIPLES OF COGNITIVE THERAPY

• Core beliefs
• Client’s automatic thought
• Cognitive distortions
• CORE BELIEFFS
• Core beliefs lead to automatic thoughts
• These core beliefs remain dormant until activated by stress or negative life events.
• Categories of core beliefs (Unlovable, Worthless, Helpless)

AUTOMATIC THOUGHTS

COGNITIVE DISTORTION

COGNITIVE DISTORTIONS

COGNITIVE CONCEPTUALIZATION

• It is the building of a mental picture or constructing an idea or theory.
• It helps the therapist to better understand the patient and build a framework for therapy or treatment.

BENEFITS OF CBT

• The overall course of therapy is short. The duration of therapy tends to be shorter than in other types — typically five to 20 sessions in all.
• CBT may be more affordable than other options that take place over a longer period of time.
• It may also be more affordable if done in a group setting.
• CBT reaps long-term results. Research on depression shows that people who have had CBT are less likely to relapse than people who took antidepressant medications with no therapy.
• Sessions are flexible and offered in various formats. Eg, you can go to in-person sessions that are either individual or group. Some people even get CBT online or via phone.

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• Skills learned in therapy can be applied directly to everyday life. The goal of CBT is to give tools to the person receiving therapy. These tools help them take control of their issues during the course of therapy and beyond.
• Playing an active role in healing may be empowering to people who get CBT. With time, the goal for people in therapy is to overcome issues on their own using the tools they picked up in their sessions.
• CBT can be used with or without medication. Some people may only need CBT while others may find it a useful complement to medications they are taking.

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In Conclusion

QUESTIONS?