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What Is CBT? | Psychology Today
What Is CBT?
Cognitive Behavioral Therapy (CBT) is an effective combination of talk therapy and behavioral therapy. CBT is a type of psychotherapy in which patients reframe negative thinking patterns into positive thoughts. Transforming one’s thoughts will ultimately result in positive actions and behaviors in difficult moments.
CBT can be useful to individuals suffering from eating disorders, depression, and anxiety. During CBT, patients have the opportunity to work with a therapist to find the source of negative thinking and transform those thoughts into a positive, growth mindset. The ultimate goal of CBT is to replace negative thoughts and actions with productive behaviors that make the individual feel equipped to overcome any difficult moment.
Individuals will recognize how their thinking influences their emotions and will establish personalized coping mechanisms. Working with a therapist to find effective and personalized coping mechanisms will ultimately help individuals identify and manage thoughts, emotions, and behaviors in real-world situations.
Components of CBT Used in Eating Disorder Recovery
The following are the 4 steps of CBT used in eating disorder recovery:
Identifying the sources of negativity.
Individuals work with a therapist to identify patterns of negative thinking and beliefs. During this component, the therapist and individual evaluate all possible sources of destructive eating patterns and negative thoughts about body-image.
Analyzing the individual’s environmental and social factors that elicit destructive eating patterns is the first step in understanding the source of negative thinking. Together, patients and therapists will examine the person’s daily routine and identify environmental factors, people, or stressors in their lives that prompt poor eating choices and self-doubt.
Becoming mindful of the emotions and beliefs associated with the sources of negativity.
After identifying the sources of destructive eating patterns, the next step of CBT is to identify the emotions and beliefs associated with the social and environmental factors that cause unhealthy behaviors.
When patients understand the emotions and beliefs connected to the source of destruction, they are better able to reframe their negative thoughts by practicing positive self-talk. Individuals assess how they feel in real-world situations that trigger unwanted thoughts and emotions and create ways to respond in a productive way. This emotional assessment is a vital step in learning how to substitute poor eating behaviors with habits that cultivate self-compassion.
Recognizing and reframing negative thinking patterns.
Therapists will encourage individuals to practice reframing negative thinking patterns into positive thoughts. This can only occur after individuals fully understand the sources of destructive eating patterns and the emotions and beliefs associated with the environmental and social factors that cause their eating disorder.
Individuals will verbally practice positive self-talk and will be encouraged to keep a journal in-between therapy sessions. Patients will write down productive ways to respond in the difficult moments and situations that will arise in the real world. Writing down positive self-talk responses in the context of all potential scenarios is an effective method in helping the individual change negative thinking patterns in a real-life moment.
Practicing positive thinking and personalized coping mechanisms in real-world situations.
Therapists will guide sessions by helping the individual set personalized goals and solutions to manage the stress and anxiety associated with harmful environmental and social triggers. Individuals will practice verbally responding in stressful situations by reframing their thoughts to gain control of their emotions and behaviors. Patients will practice using their personalized coping mechanisms in real-world situations. Coping mechanisms can include self-soothing techniques, meditation, or engaging in other activities that the individual enjoys.
In order to fully experience the benefits of CBT, it is absolutely essential that patients practice reframing their thoughts through positive self-talk and writing in journals in-between therapy sessions. They must continuously practice being mindful of emotions and thoughts by transforming them into productive behaviors.
How CBT is Helpful in Overcoming Eating Disorders
CBT can be a useful tool to help patients overcome their eating disorder. It allows individuals to understand their eating disorder by examining the sources of their negative thoughts. Patients will actively practice how to respond in all situations that elicit destructive eating patterns.
Research has shown that CBT can help individuals who have gained weight during recovering from anorexia avoid a relapse and maintain a healthy weight. Additionally, CBT also helps patients struggling with bulimia and binge-eating disorder by its effectiveness in understanding the present moment and how to respond in a more productive way. CBT is a successful technique to ensure emotions, behaviors, and interpersonal relationships are effectively managed in a meaningful way to help people recover from their eating disorder.
The goal of CBT is to ultimately empower individuals to feel healthier in mind and in behavior. Learning to take control of one’s thoughts will help to instill the willpower and strength to overcome any eating disorder. CBT is an effective way to meet the needs of all individuals suffering from unhealthy thoughts and eating patterns.
Greta Gleissner is the Founder of Eating Disorder Recovery Specialists, a nationwide network of eating disorder treatment specialists that provide meal coaching and recovery skills such as CBT, DBT, ACT, MI, etc. EDRS works alongside treatment programs, teams and families to provide transitional aftercare support for post-residential treatment clients.
How, When, and Why It Works
Cognitive behavioral therapy (CBT) is an evidence-based and widely used form of psychotherapy that’s helped many people around the world.
Therapists use cognitive behavioral therapy to help people with mental and physical health challenges like:
- chronic pain
- irritable bowel syndrome (IBS)
The goal of CBT is to help you adapt and change your mindset and behaviors by reassesing distorted thought patterns.
Whether you’re living with a mental health condition or just keep finding yourself worrying about the little things, CBT could be a helpful tool if you’re looking for an evidence-backed therapy to relieve persistent mental health symptoms.
Basically, CBT works by identifying, tackling, and changing unhelpful thinking so that your mindset, behaviors, and overall well-being improve with practice.
When you change the way you feel about specific situations, for example, it will likely be easier to adapt your behaviors in the future.
In mental health conditions like depression, anxiety, substance use, phobias, and many others, negative thinking takes many forms, like:
- thinking in black and white
- ignoring the positive and focusing on the negative
In CBT, you’ll work with your therapist to identify the thinking patterns that cause your distress. This is an important step in managing overwhelming emotions and unhelpful behaviors.
Though many people think therapy is just chatting with a doctor, CBT is actually very structured and tailored to each person.
Over time, you’ll learn CBT techniques to acknowledge and challenge thoughts that get in your way.
CBT strategies might include:
- keeping track of your thoughts and reviewing them later
- confronting situations that create anxiety to learn coping mechanisms
- practicing problem-solving with your therapist
- role-playing interactions with others
By practicing CBT strategies like these with your therapist — and at home by yourself — you’ll develop useful skills like:
- gaining awareness of unhelpful thoughts and how they impact your emotional state
- getting a more logical understanding of other people’s actions
- challenging automatic assumptions
- accurately assessing reality
- coping with triggering or upsetting situations
- learning positive self-talk and how to boost confidence
- relaxation techniques
The idea is to apply the skills you learn in therapy to your daily life. It’s like exercising any muscle to make it stronger, except this time that muscle is your brain.
It requires both you and your therapist to be collaborative, committed, and communicative.
In the 1960s, psychiatrist Aaron Beck realized that the people he helped with depression often showed specific thinking patterns that didn’t serve them.
He explained emotional conditions using a cognitive model: Thoughts control how people view themselves, others, and their environment, which impacts their mood and behavior.
In other words, if you perceive everything around you to be bad, you’ll likely feel pretty bad, too.
The basic principle that underlies cognitive behavioral therapy is that most emotional and behavioral reactions are learned — and so they can be unlearned or changed.
Unlike many other forms of psychotherapy, CBT is mostly concerned with present feelings and events, not past trauma or life history. That’s not to say those topics won’t come up in therapy, but they’re not the central focus of CBT treatment.
Some goals in CBT include:
- forming new habits
- learning interpersonal skills
- developing constructive coping mechanisms
- reducing or managing stress and anxiety
- shifting from negative thinking to a more balanced outlook
- learning how to express feelings
How long does cognitive behavioral therapy take to work?
The time it takes to make progress toward these goals is different for everyone. Some people see results after only a few CBT sessions, while others require a few months to learn how to manage their symptoms.
You may start out with one session per week, and then gradually decrease the frequency. However, this will depend on both your and your therapist’s availability and accessibility.
Research in 2015 indicated that CBT is often just as or more effective in reducing symptoms than other types of therapy, especially when it comes to anxiety disorders.
That being said, medication does still perform better for some conditions, and many people find it most beneficial to combine CBT with medication.
The benefits of CBT are extensive. For example:
- It often leads to long-term results. Since the emphasis is on identifying unhelpful thinking patterns and building skills for everyday use, CBT’s positive effects can last long after treatment has stopped.
- It’s an effective alternative to medicine. For some people, medication simply doesn’t work for them. CBT offers another form of treatment using a completely different approach.
- The duration of treatment is pretty short. Unlike other kinds of talk therapy, CBT doesn’t have to go on for years. It can last anywhere around 5 to 20 sessions, though occasional follow-up sessions can be useful.
- CBT can take place one-on-one, in groups, or even on your own. Though the approach to CBT is structured, it’s flexible in terms of format. Some apps and workbooks even allow you to practice CBT techniques on your own.
- The skills you’ll learn can help beyond your original reason for treatment. The skills CBT often emphasizes, like problem-solving, personal interaction, and time management, can serve you in many aspects of your life.
Though CBT is generally a safe and effective treatment option, it has some potential drawbacks, too.
One 2018 study found therapists reported worsening symptoms in 9% of people in therapy. And during CBT, 27% experienced distress or negative well-being.
Still, it can help to keep in mind that this discomfort tends to be temporary and a normal part of some types of CBT.
The most significant drawback of CBT could be the reappearance of symptoms after therapy has ended. But it’s also not uncommon for this to happen. Your therapist may work with you to create a maintenance plan to keep symptoms at bay when you’re no longer having regular sessions.
Still, the overwhelming majority of research suggests the benefits of CBT outweigh the risks.
Besides the possibility of side effects, CBT does have some drawbacks to consider. For example:
- It’s a big commitment. Even though treatment may only last a few months, it takes commitment and persistence to get the results you want. You’ll likely need to practice the skills you’re learning often for them to stick.
- It may not be enough. For people with more complex or intense health concerns, CBT may not be the right approach — or it may simply not be enough to reduce symptoms by itself.
- It can be uncomfortable. Since part of CBT is addressing how distorted thinking makes you feel, therapy can temporarily stir up or worsen emotional symptoms. It can help to prepare yourself for some discomfort.
- It can be expensive. Depending on your insurance, where you live, and other factors, CBT with a professional might be out of reach due to its cost. Still, some therapists offer therapy with sliding scale fees, which means you pay what you can — it can help to look for therapists who offer this.
Before therapy even begins, your therapist will probably ask you to fill out a questionnaire used to assess your mental health and keep track of progress later on.
They’ll likely spend most of the first session asking questions and getting to know you and your thought processes so treatment can be customized for you.
Since CBT is a collaborative effort, it’s important to feel comfortable with and connected to your therapist. Even though it can be frustrating and time consuming, don’t be afraid to meet with multiple therapists until you find one that you’re happy with.
Once you’ve gone through all the basic questions, established your goals, and identified distorted patterns of thinking, your therapist can work with you to pick the right techniques to assess and adjust those thoughts.
Be prepared to get some homework, too. CBT often includes out-of-session practice like self-reflection tasks, behavioral exercises, and readings.
Although CBT usually takes place in-person, online options are also available and effective.
What is CBT used for?
Some of the mental health conditions most commonly treated with CBT include:
- generalized anxiety disorder
- bulimia nervosa and other eating disorders
- major depressive disorder
- substance use disorder
- bipolar disorder
- post-traumatic stress disorder (PTSD)
Physical conditions treated with CBT could include:
- irritable bowel syndrome (IBS)
- chronic fatigue syndrome
- chronic pain
Who’s most likely to benefit from CBT?
Research shows people of all ages, ethnicities, and genders can benefit from CBT.
But as mentioned before, some people may be more suited for CBT than others.
It’s most likely to help people who:
- have challenges they can identify and want to change
- have tried medication but not seen any or enough positive results
- are eager to improve their mental health and have time to fully commit
Cognitive behavioral therapy | PSYCHOLOGIES
On November 1, 2021, Aaron Temkin Beck, an American psychotherapist, professor of psychiatry, who went down in history as the creator of the cognitive-behavioral direction in psychotherapy, died.
"The key to understanding and solving psychological problems lies in the patient's mind," said the psychotherapist. His groundbreaking approach to working with depression, phobias and anxiety disorders has shown good results in therapy with clients and has become popular with professionals around the world.
What is it?
This method of psychotherapy appeals to consciousness and helps to get rid of stereotypes and preconceived ideas that deprive us of freedom of choice and push us to act according to a pattern.
The method allows, if necessary, to correct the unconscious, "automatic" conclusions of the patient. He perceives them as truth, but in reality they can greatly distort real events. These thoughts often become the source of painful emotions, inappropriate behavior, depression, anxiety disorders, and other illnesses.
Principle of action
Therapy is based on the joint work of the therapist and the patient. The therapist does not teach the patient how to think correctly, but together with him understands whether the habitual type of thinking helps him or hinders him. The key to success is the active participation of the patient, who will not only work in sessions, but also do homework.
If in the beginning the therapy focuses only on the symptoms and complaints of the patient, then gradually it begins to affect the unconscious areas of thinking - core beliefs, as well as childhood events that influenced their formation. The principle of feedback is important - the therapist constantly checks how the patient understands what is happening in therapy, and discusses possible errors with him.
Progress of work
The patient and the psychotherapist find out under what circumstances the problem manifests itself: how “automatic thoughts” arise and how they affect his ideas, experiences and behavior. In the first session, the therapist only listens carefully to the patient, and in the next they discuss in detail the patient's thoughts and behavior in numerous everyday situations: what does he think about when he wakes up? What about breakfast? The goal is to make a list of moments and situations that cause anxiety.
The therapist and patient then plan a program of work. It includes tasks to complete in places or circumstances that cause anxiety - take the elevator, eat dinner in a public place ... These exercises allow you to consolidate new skills and gradually change behavior. A person learns to be less rigid and categorical, to see different facets of a problem situation.
The therapist constantly asks questions and explains points that will help the patient understand the problem. Each session is different from the previous one, because each time the patient moves forward a little and gets used to living without the support of the therapist in accordance with new, more flexible views.
Instead of "reading" other people's thoughts, a person learns to distinguish his own, begins to behave differently, and as a result, his emotional state also changes. He calms down, feels more alive and free. He begins to be friends with himself and stops judging himself and other people.
When is it needed?
Cognitive therapy is effective in dealing with depression, panic attacks, social anxiety, obsessive-compulsive disorder and eating disorders. This method is also used to treat alcoholism, drug addiction and even schizophrenia (as a supportive method). At the same time, cognitive therapy is also suitable for dealing with low self-esteem, relationship difficulties, perfectionism, and procrastination.
It can be used both in individual work and in work with families. But it is not suitable for those patients who are not ready to take an active part in the work and expect the therapist to give advice or simply interpret what is happening.
How long should I have therapy? How much does it cost?
The number of meetings depends on the willingness of the client to work, the complexity of the problem and the conditions of his life. Each session lasts 50 minutes. The course of therapy is from 5-10 sessions 1-2 times a week. In some cases, therapy can last longer than six months.
What is CBT and how quickly does it help?
can sort everything out.
What is Cognitive Behavioral Therapy
In essence, Cognitive Behavioral Therapy (CBT) is a way to change the way you think about life and yourself, based on two important steps:
- ), where negative thoughts, experiences, habits come from. Assess how they affect your life. Find those logical errors, cognitive distortions that make you worry. Ask yourself, “Why do I choose suffering over joy?”
- Change behavior to eliminate negative experiences by focusing on positive ones.
Personal life problems, social anxiety, chronic stress, eating disorders, psychological problems that interfere with life - all of these can be managed with the help of cognitive behavioral therapy.
Keep in mind that CBT is not a magic pill. It will not save you from the existing objective problem. For example, if you suffer from the fact that your nose is too big, then it will remain the same. If you're going crazy over a divorce, your partner won't come running back with an apology. If you have a major anxiety disorder or clinical depression, psychotherapy is not a substitute for medication.
But CBT can teach you to be more accepting of problems or even turn them to your advantage. So, the same large nose can be a cause of suffering or become a highlight of appearance.
How Cognitive Behavioral Therapy Works
The basic idea of this type of psychotherapy is as follows. Your psychological state does not depend on the stressful situation as such, but on how you feel about it. The therapist will teach you to distinguish between different types of emotions, understand how your mind switches between them, and focus on the positive ones.
Here is a simple example: you are invited to a party. On this occasion, you may have such thoughts and feelings:
- “Sounds tempting! My friends will be there, and I will also be able to meet new interesting people. ” Experience: anticipatory, happy, excited.
- “Parties are still not my thing. Today, a new episode of my favorite series is coming out, I’d better stay at home, I don’t want to miss it. ” Experience: neutral.
- “I never know what to do or what to say at these events. They will make me make a toast again, I will make a fool of myself, and they will laugh at me again. Experience: anxious, negative.
Bottom line: the same event can lead to completely different emotions. Which one to choose is up to you. You must make the selection process conscious. Like in a store: you are offered emotions, they cost the same - which one will you take?
To help you feel like a rational "buyer of emotions", the therapist will do the following.
Will teach you to detect negative thoughts
That is, to catch what exactly you are thinking about when you start to feel anxious. For example, the thesis “I will be laughed at” is negative.
It will help to evaluate and challenge the negative
To evaluate means to ask questions: “Is the bad thing that scares me really going to happen? And if it does, will it really be catastrophic? Maybe it's not so scary?
Learn to replace negative thoughts with realistic ones
After you have identified and analyzed the disturbing thoughts, they will need to be replaced with more rational and realistic statements. For example: “Who will make me make a toast? I don’t drink at all and don’t plan to raise a glass.”
How quickly CBT can work
Understanding why a given situation makes you nervous can take time. And it will also be needed to teach your brain to choose the right ones from the “range” of emotions - calm and joyful.
To understand and change behavior, an average of 5 to 20 psychotherapy sessions are needed.
However, the duration of work with a psychotherapist is an individual matter. If your psychological problems are small, two or three meetings with a doctor may be enough. And someone will have to visit a specialist for years. It is impossible to predict the timing in advance. But, as experts note, on average, cognitive behavioral therapy leads to noticeable results faster than other types of intervention.
CBT has another bonus: meetings with a psychotherapist can be held online, and they will be no less effective than in person.