What is Cognitive Behavioural Therapy (CBT)?therapist speaking with patient

Cognitive behavioural therapy (CBT) is an evidence-based therapy, meaning that research findings support its usefulness in improving mental health. Pioneered by Aaron Beck in the 1960s, CBT is regarded as a collaborative process between the counsellor and client with a brief, goal-oriented approach. Through this therapy, you will develop awareness of how your thoughts, feelings, and behaviours are interconnected, and then use that information to begin challenging old thinking habits and behaviours3. Overall, CBT teaches you to understand and challenge your thoughts that may be keeping you stuck, as well as to make changes to behavioural patterns that may be unhelpful.

CBT is distinct from other types of therapy in that it encourages you to become your own therapist. The therapist provides guidance along the way, as you learn skills to take home with you once the formal therapy is completed; you will be fully equipped to tackle any obstacle that life throws at you! By understanding the basics of CBT, you can get the most out of your therapy sessions, apply what you have learned to daily challenges, and change your life by changing the ways that you think.

How Does CBT target your thinking patterns?

We all have our own ways of looking at the world and interpreting the things that happen to us.  If your perspective tends to be overly focused on the negative, or you’re overly hard on yourself, you are likely to experience emotions such as sadness, anxiety, or frustration. The way we interpret situations in daily life influences how we feel and behave.

Do you find yourself jumping to the worst-case scenario in any given situation? Taking things personally that may not be all that personal after all? Do you assume an isolated incident, like failing a test, is representative of you or your skills at all times? These tendencies are a few of many examples of thinking traps. Thinking traps are automatic, and usually unhelpful, thinking patterns that can generate negative emotions like sadness, frustration, and anxiety2. Being mindful of your negative thought patterns and how therapists work to combat them will help you better understand yourself and your behaviours.

Thinking traps often stem from negative core beliefs or schemas—deeply held beliefs about ourselves, others, and the world1. Examples of negative core beliefs include “I am unlovable”, “the world is unfair”, or “I’ll never amount to anything”. These beliefs or schemas develop based on past experiences, like adverse events during childhood, and become the foundation for how we interact with the world1. CBT therapists help you work to identify and modify unhelpful core beliefs while considering all the information available, rather than exclusively focusing on information that supports original core beliefs.

CBT provides methods for changing the unhelpful thinking patterns that may contribute to more anxiety and stress in the long-term. The therapist guides you to expand your thinking to reveal underlying beliefs or alternative perspectives1. By answering questions and reflecting on your thoughts and behaviours, you will begin to reflect on the way you look at the world1. You are then provided with guidance on how to evaluate your thinking patterns on your own, including looking for evidence that both supports and opposes unhelpful thoughts so that you may draw more balanced conclusions about a given situation.

How Does CBT target your behavioural patterns?

Changing behaviour is also an important aspect of CBT.  By making changes in typical behavioural responses, you also likely to gather new information and come to new insights.  For instance, through behavioural experiments, you may write down a belief or prediction, intentionally collect information about the prediction, and record whether or not the prediction proved true1. This is intended to allow you to determine whether there is actually a need to change the original belief to one that is more neutral or helpful.1 Furthermore, when we feel negative emotions, we often default to unhelpful coping strategies to deal with these feelings. Some common behaviours that we might engage in when we are feeling negative emotions are:cbt model chart

 

  • Avoidance
  • Procrastination
  • Excessive checking
  • Reassurance seeking
  • Distraction
  • Cancelling plans/withdrawing
  • Excessive googling

 

Although these actions may give us a temporary sense of relief or control, they actually contribute to the ongoing maintenance of negative emotions. For example, imagine an individual who is scared of dogs. They might be tempted to avoid dogs by crossing the street when they see a dog, avoiding visiting friends who have dogs, and changing the channel when a dog comes on the TV. Although these behaviours will likely make them feel better in those moments by alleviating their anxiety, by avoiding the feared situation they ultimately contribute to the maintenance of anxiety and their fear of dogs will persist. In CBT we work on identifying unhelpful behaviours and making changes to these in order to disrupt the cycle of negative emotions.

Summary of some key CBT concepts:

  1. CBT relies on a strong therapist-client relationship – working collaboratively you’re your therapist will be important.
  2. CBT aims to teach new ways to understand thoughts, feelings, behaviours, and situations. The goal is to increase awareness of possible underlying biases and challenge ourselves to view situations in a more balanced way and act accordingly.
  3. CBT is a skills-based treatment approach, so practice assignments outside of therapy will be essential.
  4. CBT encourages the client to become their own therapist (through a lot of coaching of course!)
  5. CBT focuses on the here and now (i.e. the problems that come up in daily life) instead of dwelling on the past.

sad indifferent happy facesOverall, understanding the basics of CBT can help you grasp and appreciate your CBT sessions. This knowledge is essential to uncovering your own core beliefs and challenging the ways you think. Integrating these basic principles of CBT into daily life can help you face new challenges that arise. We recommend connecting with your therapist to see if CBT is right for you!

 

References

  1. Fenn, K., & Byrne, M. (2013). The key principles of cognitive behavioural therapy. InnovAiT: Education and Inspiration for General Practice, 6(9), 579–585. https://doi.org/10.1177/1755738012471029
  2. Yurica, C., & DiTomasso, R. (2005). Cognitive distortions. Encyclopedia of Cognitive Behavior Therapy, 117–122. https://doi.org/10.1007/0-306-48581-8_36
  3. CBT explained: An overview and summary of CBT. PositivePsychology.com. (2022). Retrieved June 1, 2022, from https://positivepsychology.com/cbt/