Cognitive behavior therapy (CBT) is a form of psychological therapy that has been shown to be effective in the treatment of a variety of mental health disorders. CBT is based on the idea that our thoughts, feelings, and behaviors are all connected. By changing the way we think and act, we can change the way we feel. In this guide, we will explore what CBT is, how it works, and some of the benefits associated with it.
Cognitive behavior therapy was developed in the 1960s by Dr. Aaron Beck. At the time, Beck was working with patients who had depression and noticed that their negative thoughts were often fueling their symptoms. He began to experiment with different ways to help his patients change their thinking patterns, and eventually developed cognitive behavior therapy as we know it today.
Since then, CBT has become one of the most popular forms of psychological therapy, and has been shown to be effective in the treatment of a wide range of mental health disorders including depression, anxiety disorders, bipolar disorder, eating disorders, and addiction.
How effective is CBT?
When we ask “How effective is CBT?” we really mean: “What is it effective for?” and “effective compared to what?” We also need to consider “how often do these conditions get better by themselves?” One way that researchers address these questions is by conducting randomised controlled trials (RCTs), where different treatments are carefully and systematically compared to one another. The same process is used in medicine to test the safety and effectiveness of new drugs. Over the past few decades thousands of such studies have examined CBT, and researchers can now combine the results of these RCTs into ‘meta-analyses’ to show, in even more reliable ways, which treatments work.
The summary of these reviews is that for many conditions CBT is as effective or more effective than other genuine forms of therapy, and is typically better than ‘treatment as usual’ (which often includes medication or check-ups with doctors) or doing nothing.
How is CBT effective?
There are a number of reasons why CBT is so successful in treating mental illness. First, CBT helps individuals to identify and challenge their negative thoughts. This can be helpful in reducing symptoms of mental illness, as many people with mental health disorders tend to have negative thinking patterns that contribute to their symptoms. Second, CBT helps individuals to develop healthy coping skills. When faced with difficult emotions or stressful situations, individuals who have undergone CBT training know how to better deal with these challenges in a healthy way. Finally, CBT helps individuals to focus on the present moment. This can be helpful in reducing symptoms of anxiety and depression, which are often characterized by rumination on the past or worry about the future.
“In general, the evidence-base of CBT is very strong.”
The Royal College of Psychiatrists
What is focused on in CBT?
There are many different ways that human problems can be maintained. Some common maintaining factors that can keep our problems stuck are Biased attention, Avoidance, maladaptive cognitions, Self-criticism, and behavioral inhibition.
Cognitive Factors
Biased attention means that we focus on certain aspects of a problem and ignore others. This can be due to the way that we see the world (our cognitive biases) or because we are reacting emotionally to the problem. For example, if we are always worried about being attacked, we may focus on all the ‘dangerous’ things around us and completely ignore the fact that we are actually safe. This can lead to feelings of anxiety and fear.
Maladaptive cognitions are thoughts or beliefs that cause us distress but which we continue to believe anyway. These could be thoughts like ‘I’m not good enough’ or ‘I’m a failure’. These thoughts often cause us to feel unhappy or anxious and they can prevent us from living our lives in a satisfying way.
Self-criticism is another common maintaining factor. This is when we are very hard on ourselves and constantly criticize our own behaviour or achievements. This can make us feel unhappy and discouraged and it often prevents us from taking risks or trying new things.
Behavioral Factors
Avoidance is another common maintaining factor. This is when we try to avoid any thoughts, feelings or situations that make us uncomfortable. We might do this by distracting ourselves with activities or by pushing our problems down into our subconscious. However, avoidance does not solve our problems – in fact, it usually makes them worse.
Behavioral inhibition is when we stop ourselves from doing the things we want to do because we are afraid of making a mistake or being disliked by others. This can lead to feelings of frustration and helplessness as well as decreased happiness and satisfaction with life.
References
- Hoffman, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioural therapy: a review of meta-analyses. Cognitive Therapy Research, 36, 427-440.
- Watts, S. E., Turnell, A., Kladnitski, N., Newby, J. M., & Andrews, G. (2015). Treatment-as-usual (TAU) is anything but usual: A meta-analysis of CBT versus TAU for anxiety and depression. Journal of Affective Disorders, 175, 152-167.