Cognitive Behavioral Therapy

I am proud to be certified as a cognitive behavioral therapist. Cognitive-behavioral therapy (or CBT) is an evidenced-based psychotherapy approach that has been shown to be effective with a wide range of mental health problems, including depression, anxiety, obsessive compulsive disorder, insomnia, and even social difficulties.

In a nutshell, CBT is based on the idea that our emotions and resulting behavior stem primarily from our thoughts and interpretations of events, rather than directly from the events themselves.

As such, two people might encounter the same situation, such as a new acquaintance (let’s call her “Jane”) saying no to a dinner invitation; but they might have totally different emotional reactions and behavioral responses.

For example, Person A – we’ll call him “Albert” – might have the thought:

“This (the declined invitation) means that Jane doesn’t like me,” which lends support to his beliefs: “I always get rejected;” “No one likes me;” and “I am worthless.”

As a result, Albert might feel sad and dejected and respond by engaging in poor coping behaviors (e.g., social withdrawal, excessive drinking, or other compulsive behaviors) that will make it less likely that his mood is going to improve any time soon.

Meanwhile, in a similar situation, Person B – we’ll call him “Bill” – might respond to the declined invitation with the thought:

“Jane may not be interested in me romantically, but other people are,” which is consistent with the beliefs: “I am a likeable person;” “Other people enjoy my company;” and “This is an isolated incident that need not get me down.”

With this different frame of mind, while Bill might understandably feel disappointed, he is more likely to view the situation as just a minor setback and bounce back quickly. Rather than isolating himself from others and vegging out in front of the TV for the next few days, he might consider inviting someone else to join him for dinner or proactively look for other enjoyable and meaningful activities to engage in. And by taking action, he’ll have a greater chance of having positive things happen, which will, in turn, enhance his mood.

Although cognitive therapy is similar to other forms of psychotherapy in that it is talking-based, there are key differences:

Sessions are Collaborative

For one, the therapist – client relationship is interactive and collaborative, with the therapist actively asking questions throughout and providing structure for the session and the client helping to set the session agenda and providing important information about his or her experience.

Treatment is Goal-oriented

Further, cognitive therapy treatment is typically finite. Upon beginning their work together, therapist and client clarify goals for treatment and work toward achieving these specified goals, with the therapist regularly assessing progress.

Action planning for outside the session

Third, unlike with other types of therapy, CBT practitioners regularly incorporate “action-planning” as an integral part of treatment. Based on the assumption that the more opportunities people have to practice a new skill, the more quickly they’ll develop proficiency, each session, the cognitive therapist and client devise together relevant actions for the client to do outside of the treatment session. Such actions might involve therapeutic activities as far-ranging as reviewing written notes from the most recent session to engaging in a new behavior as an experiment see how others respond.

Treatment sessions and action planning both help to teach the client to identify, challenge, and change thoughts and beliefs that might be contributing to the client’s dysfunctional mood and/or behavior and help the client to develop more effective coping skills to improve their mood and functioning in daily life.