In the 20th century, the leading scientific approach in psychotherapy was behavioral. Proponents of this approach believed that human behavior consists of reflexes and reactions to external stimuli. Psychiatrist Aaron Beck developed this theory further by discovering that not just the environment but also a person's way of thinking influences their behavior and emotions. This assumption laid the foundation for cognitive-behavioral therapy (CBT), which focuses on changing the client's thinking patterns.
Our thinking patterns often cause our negative emotions and thoughts. They make us fixate on problems, feel anxious and worried, and sometimes experience depression.
CBT identifies such negative thinking stereotypes in clients and gradually frees them from these patterns, replacing them with positive and constructive ones. This approach helps patients critically reassess their perception of reality and their behavior within it.
While early CBT approaches focused on behavior, later ones emphasized cognitive processes and patients' deep-seated beliefs. Today, the cognitive-behavioral approach highlights spirituality and meanings that are important to the client. The new school of CBT helps clients accept, become aware of, and take responsibility for their emotions.
A cognitive-behavioral therapist observes the patient's reactions to life events, analyzing how and why they respond in certain ways.
The CBT Approach
Human behavior includes many unconscious, automatic actions such as rubbing your eyes, brushing your teeth in the morning, or going to the bathroom. By using familiar behavioral patterns, the brain forms habits and conserves energy. Our brain can also form patterns of thinking and emotions, programming how we react to the world and overcome problems.
As children, we receive these directives from our environment, adopting them from our parents, school, and surroundings. Not all of them may be beneficial, but they become deeply ingrained in our minds and continue to influence our behavior unconsciously even now. Thus, a person's thinking can be like a bad habit, difficult to break and requiring more conscious actions.
A cognitive-behavioral therapist draws the client's attention to their reactions, helping identify how their problems are structured and what thoughts lead to their emergence. The specialist works with the beliefs that cause the person to act inefficiently and destructively. Effective thinking is conscious thinking that leads a person to their goals and improves their quality of life.
CBT psychotherapy pays less attention to dialogue and more to solving the patient's specific problems and tasks. Clear formulation of requests, whether it's an anxiety disorder, phobias, or depression, is key to successful therapy.
Unconscious behavior rarely leads to the desired result. We become accustomed to how we think and react: some might habitually get angry at a partner if plans are changed at the last minute, while others might feel sad and withdraw into themselves.
Such emotional conclusions often arise automatically, instantly, and unconsciously. In CBT, they are called "automatic thoughts."
How Automatic Thoughts Differ from Regular Thoughts
Automatic thoughts are difficult to track or articulate; they are like lightning that strikes instantly and leaves an emotional imprint. For example, a client might feel sadness without understanding where it came from.
They exist beyond our conscious control and can be obsessive, negatively impacting our lives.
Often, they originate from our deep-seated beliefs formed in childhood or adolescence. "I am beautiful/ugly," "I find it hard/easy to make friends" are examples of positive and negative directives that might have been imposed on a person.
Automatic thoughts can paralyze you: you are in a kind of funhouse mirror that constantly distorts your reality and influences your actions. During cognitive-behavioral therapy, the specialist can help you recognize and track these patterns of automatic thinking, as well as replace harmful beliefs with more useful and reality-appropriate ones.
CBT therapists also believe that a patient's mental state is determined not by the stressful situation itself but by how they react to it. Whether a client faces life's challenges with calm and confidence or sinks into depressive and anxious states.
The main task of CBT therapy is to lead the client to a clearer understanding of their emotions and to form new, beneficial thinking patterns. This way, they can develop psychological flexibility and handle future problems independently, not just the initial request.
Cognitive-Behavioral Therapy: CBT Techniques and Treatment
To achieve the desired results for the patient, three main strategies from the cognitive therapy of Aaron Beck, the founder of the CBT approach, are used. Through collaborative empiricism, Socratic dialogue, and guided discovery, CBT therapy is particularly effective in addressing psychological issues.
Collaborative Empiricism
- The client takes an active role in the psychotherapeutic process, asking questions and showing interest.
- The psychotherapist is their co-author and guide, facilitating the patient's progress.
- The therapist does not teach the client how to think correctly but helps them explore themselves.
Socratic Dialogue
- In the form of a Socratic dialogue, the psychotherapist asks questions to the patient.
- Such questions lead to a reassessment of beliefs and help the client resolve their issues.
- In the process of seeking answers, the psychologist may only highlight contradictions in the patient's thoughts, but the client draws conclusions independently.
Guided Discovery
- The CBT therapist does not have a ready-made answer to lead the client to; the client formulates discoveries on their own.
- During therapy, the client notices their own cognitive distortions.
- The therapist provides a safe space for the patient to make these discoveries and integrate them into their experience.
Initially, the specialist helps to identify the problem and set the goals of the sessions. During cognitive-behavioral therapy, specific techniques are then selected to achieve these goals.
Examples of CBT Techniques
What to Expect from CBT Sessions
CBT is a goal-oriented process focused on quickly resolving the client's issues. To address the concern that brought the patient to therapy and solidify the results, it may take 5 to 20 sessions, typically conducted once or twice a week.
In the first session, the client and therapist get acquainted and formulate complaints into a request. The psychotherapist analyzes the client's problem, explains it from a CBT perspective, and determines effective techniques for its resolution. Between sessions, the patient receives tasks such as practicing breathing exercises or keeping a diary of thoughts that arise during the day. This helps the client acquire new skills for self-regulation and self-awareness.
CBT Approach Principles
CBT is based on several principles that better explain the therapy process:
- Cognitive Principle: Cognitive psychology is based on the belief that a client's thoughts directly influence their behavior. Their perception of the problem determines their subsequent actions.
- Behavioral Principle: Thoughts influence behavior, and behavior, in turn, reinforces the way of thinking. This is like a cycle, where the client continuously fuels the existing problem.
- Principle of Collaboration: The client is an active participant in the therapeutic process. They complete tasks and initiate discussions about their issues.
- Planning Principle: The CBT therapist sets specific tasks and therapy goals, creates a plan, and analyzes the results.
- Empirical Principle: The psychotherapist tests how effective CBT methods are for the patient in practice and adjusts the course of therapy if necessary.
- Here and Now Principle: CBT focuses on the specific current problem rather than analyzing the client's entire inner life.
Who Can Benefit from Cognitive-Behavioral Therapy?
If a client comes with a problem related to thoughts and behavior, cognitive-behavioral therapy can help address it. The CBT approach in psychology works with a wide range of issues, from self-esteem problems and interaction with others to crises and career issues. The key is to clearly formulate the request, and the CBT therapist will help achieve the desired result.
This approach is also effective for treating the following psycho-emotional disorders:
Anxiety disorders and panic attacks
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)
Neurotic disorders (neuroses)
A CBT therapist can collaborate with a psychiatrist in cases where additional medication therapy and diagnostics are needed.
Advantages of CBT Compared to Other Methods
CBT therapy has several advantages compared to other psychotherapy approaches:
Effective
Cognitive-behavioral therapy is a field with the most proven effectiveness. It is empirical, highly regarded by the scientific community, and incorporates knowledge from psychiatry, neurobiology, and pedagogy.
Short-term
Other psychotherapy approaches, such as Gestalt therapy or psychoanalysis, can last for years. Cognitive-behavioral therapy achieves stable and long-term results in 5-20 sessions.
Structured
This approach is based on clear methods, strategies, and techniques for working with patients. Each session has a structure and plan adapted to each client individually.
Goal-oriented
This therapy is aimed at identifying the problem and effectively achieving the result. The psychotherapist does not delve into the client's introspection; they set goals together and improve the client's quality of life.
As a result of CBT therapy, individuals learn to think more rationally and objectively, handle difficulties more easily, and find ways to solve them. The client develops psychological flexibility and resilience and acquires new skills to maintain their mental health.
