Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is a well-established and an effective type of therapy. This was developed by Aaron Beck as a result of his research on depression. It is a common form of talk therapy and is based on one’s thoughts, emotions and behaviors and how they influence each other. It totally focuses on present situation/ here and now of the client and not on the past experiences. Cognitive Behavioral Therapy provides various tools and techniques that the clients might need to solve their problems.

Cognitive Behavioral Therapy is an active, directive, present-centered, collaborative, problem-oriented, structured and empirical in nature. This therapy sees problems of clients as stemming from faulty thinking, incorrect inferences, and false perception of reality. It is an insight-focused therapy that involves recognizing and changing unrealistic and illogical thoughts and beliefs.

Therapist will teach changes that are required and must be implemented in life. For that purpose, therapist tries to understand the clients’ experiences and help them to examine validity of their automatic thoughts, understand relation between emotions, thoughts and behaviors and underlying beliefs.

Principles of Cognitive Behavioral Therapy

People maintain their core beliefs about themselves, their world and their future. Therapists help the clients in examining and restructuring their core beliefs by encouraging clients to gather evidence in support of their beliefs and bring required changes in their life. People with emotional difficulties tend to commit cognition errors that distort reality. These assumptions and misconceptions are known as cognitive errors:

1. Arbitrary Inference is making conclusions without any supporting evidence.

2. Mental Filtering is focusing on the negatives exclusively even when there are positive aspects also.

3. Polarization or All-or-nothing thinking is thinking about oneself in black or white and not in shades of gray and setting unrealistic standards for themselves.

4. Over-generalization includes people taking an isolated event and turning into a never ending loss.

5. Jumping to conclusions is a distortion in which people interpret a situation negatively without evidence and reach an irrational conclusion.

6. Catastrophising involves making worst ever assumptions in every scenario.

7. Personalization leads one to believe that they are responsible for events that they can’t control at all.

8. Fallacy of fairness refers to measuring behaviors on the scale of fairness. They make their own perception of what is fair and what is not and this causes stress when demands are not met fairly.

9. Global Labeling refers to judging and defining oneself or others based on an isolated event.

10. Always being right is a cognitive distortion in which one sees their opinions as facts of life.

How Cognitive Behavioral Therapy (CBT) works?

It is based on the rationale that the way people perceive and structure their experience influences that way they feel and behave. It has 3 assumptions:

• People communicate to themselves through introspection

• Client’s beliefs have highly personal meanings

• These meanings should be discovered by the client rather than being interpreted by the therapist

The cognitive distortions are identified and challenged to decrease their validity. Through a collaborative effort between the therapist and the client, clients learn the influence that the cognition has on their emotions and behaviors and on their life events as well. Clients start to engage in realistic thinking especially when they get caught in catastrophic thinking. The past may be brought up sometimes in the therapy sessions but this therapy majorly focuses on present problems of the client.

Cognitive therapists are concerned about the impact of such irrational, negative and illogical thinking on a person’s personality in general. These distortions go hand in hand with mental health conditions like personality disorders but they are not the only reason for them. Such pattern of thinking and drawing inferences is a part of personality which can cause unhappiness and dissatisfaction in lives that can be managed in Cognitive Behavioral Therapy.

Techniques in Cognitive Behavioral Therapy

The main aim in Cognitive Behavioral Therapy is to identify the connection between thoughts, emotions and behaviors and how they influence each other.

1. Cognitive Restructuring

It involves helping clients notice and changing their negative thinking patterns which are destructive and demeaning in nature and then explore ways to redirect them. Faulty and irrational thinking patterns are identified and challenged to reduce their frequency.

Unhelpful thoughts are deconstructed and rebuild in a healthy and balanced way. Several cognitive distortions are self-monitored by the client and then asked to question/challenge those assumptions by asking oneself like what evidence is there that it is true or the evidence is accurate? The, cost-benefit analysis is performed to decide a cognitive distortion should be maintained or not in the future. This lowers stress and anxiety levels and increase self-esteem and self-confidence.

2. Guided discovery

It is a process that is used in Cognitive Behavioral therapy to help the client reflect on the way they process any information. Therapist asks several questions to which clients have to answer and this opens up a range of alternative thinking for clients. The earlier perceived maladaptive thoughts and behaviors are changed when alternatives are discovered.

It helps clients learn different interpretations and perceptions of their problems which decrease the stress levels associated with the problem. Thus, the client not only focuses on the problem but also on the solutions.

3. Exposure therapy

It is designed to treat fears and any other negative emotions and behavior patterns. Clients are brought in safe and controlled conditions that has situation that contributes to their problems. Clients then are exposed to the fearful stimulus and are given relaxation simultaneously. This is done to reduce the fear and anxiety level of the client and develop their tolerance of anxiety-provoking situations.

Therapist works with the client to increase their motivation and willingness to do everything. Client is taught how to manage the distressing symptoms in the artificially created environment and then client applies the skills in day to day life.

4. Journaling

It is suggested to use in the Cognitive Behavioral therapy as it helps to keep a track on everything that is going on in life and differentiate between healthy and unhealthy behavior and thought. This can lead to exploring emotions associated with our behaviors and thoughts and learn to manage them in the therapy sessions.

Also, writing about something that gives anxiety reduces the chances of catastrophizing it. Various thought-challenging activities and worksheets can be done in the journal which helps in coming out of the spiral of overthinking. For every negative statement, positive ones must be written in the journal to develop optimistic thinking and self-talk.

5. Cognitive Behavioral Modification

This technique was given by Donald Meichenbaum that focuses on changing the client’s self-talk or self-statements which affect a person’s behavior the same way as statements are made by another person. Clients before changing behavior, they have to notice how they think, feel and behave and its impact on others as well. They need to interrupt the existing nature of their behavior and then evaluate their behavior in various situations.

It includes self-instructional training that focuses on helping clients become aware of their self-talk and stories they tell about themselves. According to this technique, for clients it is easy to behave their way into a new way of thinking rather than to think their way into a new way of thinking. In the whole journey of the therapy, therapist teaches clients to make self-talk and self-statements according to the given instructions that gives them the ability to cope with any situation effectively.

It has three phases:

1. The first phase of Self-observation where clients observe their own behavior and associated thoughts and emotions.

2. In the second phase, they start a new internal dialogue which is rational and positive. They initiate a new behavioral chain completely opposite to earlier maladaptive behaviors.

3. In the third phase, clients learn new skills by interrupting the downward spiral of thinking, feeling and behaving and learning adapting ways of coping using the resources from therapy.

6. Stress inoculation training

In this technique, clients are given opportunities to cope up with mild stressful stimuli successfully so that they gradually develop tolerance for stronger stimuli. It is based on the assumption that clients can affect their ability to cope up with situations by modifying their beliefs and self-talk about the performance in stressful situations. It just includes therapist teaching clients specific coping skills that they require in their life.

It involves designing interventions and motivating clients for a change so that resistance and relapse can be managed well by them. It consists of giving information, cognitive restructuring, self-monitoring, self-instruction, self-reinforcement, relaxation training, problem solving, decision making and modifying environmental events. These skills can be used for any event be it present or future ones.

It has a three-stage model :

1. Conceptual-education phase

2. Skills acquisition phase

3. Application and follow through phase

Clients are exposed to an anxiety-provoking situation by role playing or imagery and anxiety levels are evaluated. Clients are made aware of the anxiety-provoking situation and help them to examine their thoughts by reevaluating self-talks. Then they learn about their cognitions and emotions in developing and maintaining stress by guided discovery.

Then the clients are given behavioral and cognitive coping skills and exposed to several behavioral interventions and make lifestyle changes. All the learning are transferred carefully to everyday life and outcomes are checked thoroughly and focus is also given to relapse prevention.

7. Role playing

This technique is helpful and an easy approach that engages clients of any age in the therapy. It is a supervised activity that promotes reflection and insight in clients about themselves. It is done in a safe and controlled environment that promotes self-awareness and various other skills like problem solving and emotional intelligence. It offers insight about how clients view their environment and function in it. Various roles are given to the clients to enact that give them more opportunities of understanding a situation from different perspectives.

This technique of role playing is effective for mental health problems like phobias, panic attacks, anxiety, stress, overthinking, obsessive-compulsive disorders and many others. During role playing, the client while enacting tries to understand what could be changed to make a situation better and then learn how that learning can be applied in the real life situation. After the role play ends, it is necessary to ask questions like:

• How did you feel in that role?

• What is your new insight?

• What changes you think are required?

Seek Professional Therapy Sessions at Medavas

If you are facing any issue in your life that is causing stress, anxiety and negative thoughts, the, Cognitive Behavioral Therapy is one of the best therapies. And at Medavas, various psychologists/therapists are available who are trained in Cognitive Behavioral Therapy and have experience in its practicality. They are knowledgeable, informative and experienced in their field.

The process of booking the appointment for session is a smooth process without any issues. So, if you want to have a session then you can go ahead and book the session quickly on our website Medavas. Sessions are available in the mode of chats, audio calls and video calls thus you can book your session according to your convenience.