What is CBT?

By Gina McSheffrey-Emmons, PhD

When you think of therapy, what comes to mind? A common and often misperceived image of therapy is the client lying down on a couch talking about his/her problems with the therapist passively sitting in the background taking notes. Therapy can be more than just talking about one’s problems and can be more interactive. It can take on a variety of forms and look different depending on the training of the therapist. One form of therapy that is structured, goal-directed, and solution-focused is Cognitive Behavior Therapy (CBT). CBT addresses one’s present thoughts/feelings and involves the client and therapist working collaboratively together to help achieve change.

The premise behind CBT is that our thoughts, feelings, and behaviors are all connected. Through CBT, the therapist helps the client to recognize patterns of negative thinking, and works on modifying those thought patterns to ultimately change the client’s feelings and behaviors. During this type of therapy, one learns different ways to help evaluate his/her thoughts and behaviors through various exercises and activities in order to bring about positive outcomes. Often times, homework outside of therapy is necessary to help reinforce and practice learned skills.

CBT can be used to treat a variety of mental health disorders; however it is commonly used in the treatment of anxiety and depression. Based on research findings, anxiety and depression can best be treated with CBT, and can be more effective in combination with medication (depending on symptom severity). As there are many techniques used in CBT, only some of them are highlighted below:

  • Journaling:  the client records thoughts, feelings, and behaviors pertaining to situations encountered each day for a period of time. The data gathered from journaling will help the therapist and client to identify patterns of thinking and emotional responses to different situations.
  • Cognitive Restructuring:  with the help of the therapist, a client’s negative thoughts are identified and challenged. Ultimately, the client learns how to view a situation differently and from a more neutral, or even, positive perspective.
  • Exposure Therapy/Fear Hierarchy:  one way exposure therapy can be implemented is when the client creates a list of “fears,” which may consist of anxiety-provoking situations or objects and ranks them in the order of least to most challenging. The client is then exposed to each “fear,” gradually working up to the most difficult one. The idea behind this technique is that through exposure, one can conquer his/her fears.
  • Relaxation Techniques:  the client learns and practices different muscle relaxation, breathing, and mindfulness techniques. This helps to alleviate stress, physical tension, and creates a calm and more peaceful state of mind.

Through a collaborative relationship and the commitment of both the therapist and client in CBT, there is hope for those suffering from anxiety and depression. The purpose of CBT is to equip clients with problem-solving skills and techniques to feel better, so that they can keep using these tools in their daily lives even when therapy ends. With a little bit of work, individuals are able to learn how to change their negative thoughts so that these thoughts have less power over them.