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Cognitive Behaviour Therapy, or CBT, is one of the most popular forms of psychotherapy today, for numerous mental health issues. It's an evidence-based treatment and plenty of research has supported its success.

The term therapy gets used a lot, but many people don't fully understand its scope. It's not a "one size fits all" approach. So, while CBT may have worked well for your friend, it might not give you the same results. This is why it's imperative to work with your therapist to ensure you are getting the right form of treatment. Just as you should trust your doctor to properly diagnose and treat a physical condition, it's important to allow your therapist to recommend the best therapy. After all, this is the expert you are going to for help. You can express your interest in CBT, but be open to other forms of therapy if your therapist does not believe CBT is right for you.

How CBT Works

The process behind CBT is that our thoughts affect our feelings, which affect our behaviors. For example, you may think if you go to a party, everyone will ignore you, so you feel anxious and defeated, and thus decide you will not go to the party. This formula is essential because some therapies start by focusing on feelings rather than thoughts and might work to help a client feel less anxious first. Proponents of CBT, therefore, believe that CBT is more effective because it is straightforward and can be taught easily to most clients. It is easier to state a thought and examine it than it is to try to explore a feeling. And with chronic depression, it's imperative to identify and examine all the thoughts that are part of the depression, as there is likely not going to be just one.

CBT aims to break the link between cognition (the thinking processes) and behaviour (action following thoughts and feelings) when under mental stress. CBT is a type of psychotherapy which focuses the client on the connection of thoughts, emotions and behaviours. CBT works to help clients monitor and understand the thoughts they have, which then creates the feelings and behaviors they find uncomfortable or problematic.

What Does CBT Treat?

Cognitive behaviour therapy has been used successfully to treat depression, anxiety, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), various phobias, eating disorders, sleep problems and substance abuse. CBT has also been shown to help people with medical conditions like irritable bowel syndrome, chronic fatigue syndrome and chronic pain conditions. In these cases, CBT helps clients change irrational or unhealthy thoughts to rational, healthy ones, which therefore reduces negative feelings and increases positive behaviours.

Continuing with the example above, the client is able to say, "There is no reason to believe that everyone will ignore me. If for some reason I feel like I am being left out, I can talk to my friend Rachel since I know she will be there. I can do this." At that point, the client is going to feel less anxious and defeated and is more likely to attend the event. In other words, CBT helps people change patterns of thought to produce new emotions and different behaviors.

Is CBT Effective?

The simple answer is yes, it is effective. Many people choose between CBT, medication or a combination of the two. This is something that depends on your unique situation and the advice of your doctor and therapist. CBT has been shown to be an effective treatment with and without medication.

The more complicated answer to CBT's effectiveness depends on a variety of factors. The client has to work on the skills their therapist teaches them all week, not just in session. This requires commitment from the client to examine and challenge thoughts continuously. The client has to believe it can work for them and be willing to explore changes. The client also must have some patience. It takes time to change thought patterns. If you go into CBT expecting significant success after one or two sessions, you are likely to be frustrated. Finding out if CBT is right for you, opposed to other forms of therapy, involves talking with someone with proper training in CBT for an evaluation and then getting started with the work.

What Does CBT Involve?

Different therapists may proceed differently using CBT, often depending on the needs of the patient. CBT is typically introduced with an explanation of the process, the length of time that may be necessary for treatment, and a full exploration of underlying thoughts that may be causing the presenting problem. CBT incorporates the use of homework to record feelings and thoughts, journaling, relaxation techniques, learned coping skills and in some cases, mindfulness. The basis of CBT is that there are common cognitive distortions (the negative thoughts) that lead to negative feelings and behaviors, and these distortions must be challenged. A common one is called magnification, where the individual has a negative event occur, and it feels insurmountable instead of being viewed as a single event and a solvable problem.

There are many different exercises your therapist may teach you on how to challenge these thoughts. It may be writing down the idea and looking at the evidence. Is there any information that supports this negative thought? Is there evidence that disproves the negative thought? If the worst thing happens, then what? The purpose is to take the power of these overwhelming feelings and learn to view problems as solvable. There are many other exercises your therapist can with you. As mentioned before, CBT as a whole is not a one size fits all, and neither are the various techniques and exercises that are part of CBT.


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