What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that is used as a first line treatment for a variety of emotional and behavioral problems. It is an evidence-based therapy that has been proven effective in treating depression, anxiety, eating disorders, substance abuse and many other mental disorders and behavioral problems.
CBT is based on the understanding that modifying maladaptive thoughts can lead to positive changes in emotions and behavior. Its main focus is on the client as a whole, rather than specific disorders, in order to identify what thoughts and behaviors need to be fixed.
How does CBT help?
In CBT the therapist helps the client or group of clients to identify current emotional and behavioral problems and change the thoughts and behaviors that cause them. Cognitive behavioral therapy posits that maladaptive thoughts, known as cognitive distortions, exacerbate and intensify emotional and behavioral problems. Cognitive distortions are exaggerated or irrational thought patterns that perpetuate unpleasant mood states such as anxiety and depression.
A common example of a cognitive distortion is catastrophizing. People who catastrophize expect the worst to happen at every turn or exaggerate the importance of insignificant events. Catastrophizing leads us to believe that things are far worse than they actually are, resulting in excessive fear and impaired decision making.
CBT helps the client by teaching them new and more effective ways of thinking about themselves, their surroundings and current, past and future life events. A client who is prone to catastrophizing would first be taught to notice when the catastrophizing thoughts begin to surface. Fear and anxiety are mitigated by considering other possible outcomes and making a distinction between an unpleasant event and a catastrophe. CBT also assists the client in developing skills for effectively coping with stress and other life challenges.
What does the client learn in CBT?
CBT can help the client learn to:
- Manage symptoms of mental illness
- Prevent a relapse of mental illness or substance abuse
- Use various techniques for coping with stress and emotional pain
- Effectively resolve interpersonal conflicts
- Manage difficult emotions such as anger and sadness
- Cope with trauma or grief
- Cope with a medical condition
- Overcome anxiety and phobias
- Replace maladaptive behaviors with healthy ones
How is CBT administered?
Cognitive behavioral therapy is usually administered face-to-face in individual (one on one) sessions or in a group. At Adolescent Growth both methods are utilized. Clients receive individual therapy three times per week and attend CBT groups six times per week. They also engage in family therapy up to two times per week.
Our treatment team will begin by gathering information about the client in order to determine what their major struggles and concerns are. This process begins even before admission through a pre-assessment evaluation which is completed by the client’s primary caregiver. Questions that are asked regard current and past physical and emotional health, behaviors and past life experiences.
One of the most important facets of administering CBT, especially with youth, is building a rapport. As soon as your child walks through the door our staff has begun engaging with them, getting to know them and building a solid foundation of empathy and trust:
“ I have opened up to my therapist here more than ever before. I have shared my joys, laughter and pains and sorrows and I never felt that I was not accepted. That meant a lot to me.”
- Adolescent Growth Graduate
Steps involved in CBT
There are several steps that take place in CBT. The order in which they are undergone is non linear and often some steps are repeated or revisited several times. These steps include the following:
- Identify sources of unpleasant emotions and stress.
Usually one of the first steps in CBT is looking at your life and identifying major stressors. These can include things like medical conditions, ongoing interpersonal conflicts, substance abuse issues, mental illnesses, academic problems, divorce of parents or family problems, etc.
You and your therapist will spend time together identifying and discussing aspects of your life which are sources of stress and unpleasant emotions such as sadness, anger, anxiety, grief and fear. You may know going into therapy what your major stressors are, but sometimes new ones come up or are identified as therapy continues.
- Notice and describe your thoughts, feelings and beliefs about these stressors.
Your CBT therapist may ask you to reflect on your life stressors and help you identify your core thoughts, emotions and beliefs about them. Contrary to popular belief, this is not an end in itself. CBT is a practical and action-oriented treatment that focuses on identifying problem thoughts and behaviors and fixing them. This step is important for helping you and your therapist hone in on the thoughts and beliefs that contribute to your suffering t in order to challenge, restructure and change them.
- Identify maladaptive or problematic thought patterns
Your CBT therapist is keenly interested in identifying the thought patterns that inform your emotional and behavioral problems. CBT is built upon the knowledge that these problem patterns of thinking are the cause of maladaptive behavior and emotional pain.
- Challenge maladaptive or problematic thought patterns
Your therapist will encourage you to examine the beliefs you have identified as troublesome and challenge them. This is a difficult step. Many of the thoughts and beliefs that are causing you trouble are patterns of thinking that you have had ingrained in you for a very long time. Perhaps they were learned in childhood or developed in response to an experience you were unable to cope with or process at the time.
You will spend a great deal of your time in CBT therapy working on this step. Your therapist understands that it is easier said than done and will afford you all of their patience, empathy and understanding along the way.
Who can benefit from CBT?
CBT has been clinically shown to be effective for a large number of mental and behavioral problems including: