Cognitive Behaviour Therapy (CBT)

INTRODUCTION

CBT is a psychotherapeutic approach that aims to solve problems concerning
dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic
procedure.
CBT combines the Cognitive Therapy developed by Aron Beck and Behaviour Therapy
techniques.
Thoughts cause Feelings and Behaviors
Emphasis placed on current behavior.

CBT is a collaborative effort between the therapist and the client.

Client role - define goals, express concerns, learn & implement learning
Therapist role - help client define goals, listen, teach, encourage.

Based on "rational thought." - Fact not assumptions.

CBT is structured and directive. Based on notion that maladaptive behaviors are the
result of skill deficits.

Homework is a central feature of CBT.

Cognitive therapies do not appear to work as well with those who are cognitively
impaired.

DEFINITION

Focused form of psychotherapy based on a model suggesting that
psychiatric/psychological disorders involve dysfunctional thinking

The way an individual feels and behaves in influenced by the way s/he structures his
experiences.

Modifying dysfunctional thinking provides improvements in symptoms and modifying
dysfunctional beliefs that underlie dysfunctional thinking leads to more durable
improvement

INDICATIONS

Cognitive therapy was originally developed for use in the treatment of depression.
Personality disoders
Seasonal affective disorders
Generalized anxiety disorders
obsessive-compulsive disorders
Mood disorders-depression

MAJOR CONCEPTS & PROCEDURE

The General Cognitive Model

The Cognitive Triad

Negative view of the self (e.g., Im unlovable, ineffective)

Negative view of the future (e.g., nothing will work out)

Negative view of the world (e.g., world is hostile)

Automatic Thoughts

Negative thoughts about yourself, your world, or your future

Examples of automatic thoughts

Catastrophizing - extreme consequences of events

All or nothing - seeing things in black and white - no grey areas

Emotional reasoning - if I feel it, it must be true

Self-defeating (irrational) beliefs as per Ellis

Ellis suggested that a small number of core beliefs underlie most unhelpful emotions and
behaviours. Core beliefs are underlying rules that guide how people react to the events
and circumstances in their lives. Here is a sample list of such of these:

I need love and approval from those around to me.

I must avoid disapproval from any source.

To be worthwhile as a person I must achieve success at whatever I do.

I can not allow myself to make mistakes.

People should always do the right thing. When they behave obnoxiously, unfairlyor
selfishly, they must be blamed and punished.

Things must be the way I want them to be.

My unhappiness is caused by things that are outside my control so there is nothing I
can do to feel any better.

I must worry about things that could be dangerous, unpleasant or frightening
otherwise they might happen.

I must avoid lifes difficulties, unpleasantness, and responsibilities.

Everyone needs to depend on someone stronger than themselves.

Events in my past are the cause of my problems and they continue to influence my
feelings and behaviours now.

I should become upset when other people have problems, and feel unhappy when
theyre sad.

I shouldnt have to feel discomfort and pain.

Every problem should have an ideal solution.

Helplessness

I am inadequate, ineffective, incompetent, cant cope

I am powerless, out of control, trapped

I am vulnerable, likely to be hurt, weak, needy

I am inferior, a failure, a lower, not good enough, defective, dont measure up.

Hopelessness

I am unlikable, unwanted, will be rejected or abandoned, always be alone

I am undesirable, unattractive, ugly, boring, have nothing to offer

I am different, defective, not good enough to be loved by other, a nerd

The Cognitive Model



The Basic Goals of CBT

To challenge the thoughts about a particular situation by identifying the cognitive traps

To help the patient to identify less threatening alternatives

To test out these alternatives in the real world

To challenge the assumptions that lead to the automatic thoughts

The Basic Tenets of CBT

Cognitive specificity

Socratic dialogue

Collaborative empiricism

Conclusion

Cognitive behavioral therapy (CBT) is an established treatment for a number of
psychiatric disorders.
The CBTs are the best-studied psychological treatments of major depressive,
panic, generalized anxiety, and obsessive-compulsive disorders. (Friedman, Thase &
Wright, 2008)
The CBTs have become one of the standard psychosocial treatment approaches for
mental disorders.
References

Kaplan HI, Sadock BJ. Synopsis of Psychiatry , Behavioral Sciences/ Clinical Psychiatry. 9th
ed. Hong Kong :William and Wilkinson Publishers ;1998.

Friedman ES, Thase ME, Wright JH. Cognitive and behavioral therapies, in Psychiatry,
Third Edition. Edited by Allan Tasman, Jerald Kay, Jeffrey A. Lieberman, Michael B. First
and Mario Maj. John Wiley & Sons, Ltd, 2008.

Sims, A. Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed).
Elsevier, 2002.