Whether searching through provider bios or hearing about your therapist’s treatment plan at your first psychotherapy appointment, you’ll likely come across a therapy called cognitive behavioral therapy (CBT). This post will cover the basics of CBT to help you make more informed decisions regarding therapists and treatment plans as you navigate your way through your mental-wellness journey. Specifically, we will answer the following questions.
CBT is a form of psychotherapy based on the idea that our thoughts, emotions, and behaviors are interconnected and that while we can’t directly control our feelings, we can adapt our unproductive thoughts and behaviors. In turn, these impact our emotions, which improve our mood and support more positive thoughts and actions.
CBT utilizes a variety of techniques to help patients identify and alter their unproductive thoughts and behavioral patterns. In one of the more common techniques, therapists help patients recognize common “cognitive distortions” (i.e., unhelpful or irrational ways of thinking).
For example, your therapist might provide you with worksheets and exercises designed to highlight distorted thoughts that can result in stress and anxiety, which might include:
Other CBT techniques include:
Because of its general structure and because so many mental health conditions are characterized by maladaptive cognitive, emotional, and behavioral patterns, CBT can treat many mental illnesses. While it is primarily used for anxiety and depression, it can also be helpful for:
It’s important to note that when used for conditions other than depression and anxiety, practitioners often deploy a specialized version of CBT. For example, Teressa Carter LCSW, a Texas-based therapist here at Heading Health, is trained in TF-CBT, a trauma-focused form of the therapy.
It’s also worth bearing in mind that CBT isn’t just for treating mental health conditions. It can also help those who haven’t been diagnosed with a mental illness as they deal with other difficulties.
CBT can be helpful for:
The effectiveness of CBT depends on many factors, including condition type, severity, and whether it’s combined with medication. With that said, it is generally a highly effective therapy.
For depression, some studies have found CBT to be as or more effective than any other form of therapy or psychiatric treatment. Findings are similar for anxiety-related disorders. CBT is often used as a first-line treatment, with over half of patients responding to the therapy.
The effects of CBT appear to last for a significant period of time as well, with one experiment finding that the treatment’s effects can last a year or more. CBT also works well when combined with psychiatric interventions. In addition to first-line medications such as Prozac and Zoloft, recent experiments suggest that ketamine-based therapies, which can provide rapid and robust relief from treatment-resistant depression and suicidal ideation, can enhance the effects of CBT.
Aside from being highly effective, CBT has several notable benefits that help explain why it’s such a popular choice among mental health practitioners.
Some therapies don’t have a precise end date. CBT is designed to occur over a defined period of time, leaving patients with the tools they need to continue to apply its techniques on their own without the aid of a therapist. On average, CBT training occurs over 12-20 sessions.
CBT is a highly customizable therapy. Whether you’re dealing with anxiety, depression, or insomnia, its wide array of strategies and techniques can be tailored to suit your needs.
Though CBT works well (and sometimes better) when combined with medications, many individuals find it highly effective on its own. For example, one study found that patients with OCD who underwent CBT both with and without medications had comparable improvements in their symptoms.
Over the course of the COVID-19 pandemic, we saw a sharp rise in the use of CBT in virtual settings as in-person sessions became unsafe. Fortunately, we learned it’s still a highly effective treatment. This makes sense when you think about how the treatment works. Whether at home or in person, patients are thoughtfully and carefully guided through one of CBT’s many techniques, whose effectiveness doesn’t appear to depend on the proximity of the therapist and the patient.
CBT doesn’t work on its own. If you don’t keep up with CBT activities like journaling, restructuring your cognitive distortions, engaging in exposure therapy, or taking part in whatever other techniques your therapist has decided are likely to be most effective in your case, you won’t see results.
While the treatment is typically limited to 12 to 20 weekly sessions, you likely won’t experience a complete improvement in your symptoms within the first few meetings. Instead, you’ll progress gradually from one appointment to the next. “The routes of your progress will develop, grow, and strengthen over many weeks,” shares Ken Brown LPC. “This base of tools and strategies will support your mental wellness long after your initial treatments have ended.”
Though CBT is effective, applying its techniques and making the necessary changes can be difficult. For example, exposure therapy requires patients to deliberately place themselves in specific situations that stress them out. This can be pretty challenging. As you go through treatment, it’s important to be prepared for some discomfort before things get better.
Despite the effectiveness of CBT, it’s not the right therapy for everyone. Fortunately, if you find that you aren’t getting the results you were looking for, there are several options you can try, which include:
CBT is a popular and evidence-based form of psychotherapy that emphasizes the interconnectedness between our thoughts, feelings, and behaviors. It deploys specialized techniques that take advantage of our ability to modify our thoughts and behaviors to improve our mood and mental well-being. The therapy is effective for many conditions, from anxiety to depression to phobias and substance use disorders.
Aside from being highly effective, CBT has the advantage of being relatively brief, customizable, beneficial without medication, and successful in virtual and in-person settings.
In essence, it can be used right away to start influencing change. So even while you are in continued therapy, the tools from a CBT therapy session can be put into practice and then discussed and refined over time with a therapist.
Despite its benefits, patients should be aware that change may still seem to be gradual. Changing thoughts and behaviors that are well-established requires dedicated work. While it can be challenging and patients must put the work in to see results, CBT does offer hope of finding a new outlook on life.
In addition to the standard CBT and its variants focused on treating specific disorders, several other related therapies are often considered forms of CBT. These CBTY spin-offs and related therapies take the theoretical essence or have similarities to CBT and expand it with additional ideas and techniques.
Developed by Dr. Patricia Resick, this therapy is highly effective against PTSD. Throughout the treatment, patients identify and challenge unhelpful beliefs related to the trauma.
This form of therapy builds on CBT by combining it with mindfulness meditation to help patients pay attention to and learn from their thoughts and feelings in a non-judgmental way. The treatment utilizes several techniques, from meditation to body-scan exercises, to yoga.
Rather than focusing on identifying and modifying unhelpful ways of thinking, DBT teaches people how to regulate their emotions, live in the present moment, and tolerate feelings of stress.
Instead of targeting our specific worries and fears, metacognitive therapy addresses general beliefs about worrying. It proposes that anxious and depressed individuals worry as much as they do because they believe doing so will help them avoid negative outcomes. MCT aims to undermine these erroneous beliefs.
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