How helpful is CBT?
CBT or cognitive behaviour therapy is an active, directive and time limited therapeutic approach used to treat people suffering from depression, anxiety, phobia etc. CBT is based on the principle that a person's feelings and behaviours are determined by the way she/he thinks about the world. These cognitions are based on assumptions (schema) developed from previous experiences. For instance if the person interprets his experiences in terms or whether she/he is competent and adequate, one of the schema could be "unless I do everything right, I am a failure".
A variety of cognitive and behavioural strategies are used in CBT.
Cognitive techniques are aimed to challenge negative thoughts and assumptions the person might have developed during the years. Techniques used include the following:
- To monitor the negative thoughts.
- To recognise the connection between thoughts, feelings and behaviours.
- To examine the evidence for/against the distorted thoughts.
- To explore more positive thoughts to these maladaptive cognitions.
- To learn to identify dysfunctional beliefs which led the person to distort his experiences.
Behavioural techniques are used not only to change behaviours but also to challenge cognitions related to specific behaviours. This might include:
- A weekly activity schedule in which the person can log in his daily activities.
- A mastery and pleasure schedule in which the person rates the activities listed in his log.
- A graded task assignment in which the person undertakes some tasks to reach a goal in which he considers difficult.
Key factors influencing the effective delivery of CBT include the following:
- Collaboration - is a way of being with clients based on an equal partnership, each bringing something to the relationship.
- Formulation - a unique map or hypothesis of presenting problems and situations
- Socratic questioning - is a style of questionings which aims to stimulate alternatives ideas.
- Homework - the client tries things out between sessions putting into practice what has been learned.
CBT compared to other modalities:
- CBT targets problems in the here and now with less time spent on experiences in early life.
- Cognitive therapists do not usually interpret unconscious motivations but bring thoughts and beliefs into the current focus of attention.
- It focuses on a shared model of understanding of the formulation and teaching of self evaluation.
Overall CBT has proved to be very effective to treat a range of mental health issues such as psychosis, anger, bipolar disorders, anxiety, pain. The application of CBT is happening in many others fields rather than mental health, such as public health, forensic psychology and consultancy.
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