Cognitive Behaviour Therapy
Cognitive Behaviour Therapy (CBT) is an evidence-based approach to therapy that is based on scientific research into how people learn, and how our physiology and social structures work.
CBT encourages people to explore their thoughts, feelings and behaviour, and helps them to analyse their own patterns of behaviour and thinking, and understand how certain behaviours or thinking styles may affect the way they feel.
Once individuals understand their own emotional patterns, they can look at specific strategies to help them to act or think in ways that improve their wellbeing, and help them to lead a more fulfilling life.
Physiotherapy for the Mind
CBT is a bit like physiotherapy for the mind; during sessions, the individual will begin to understand the problem, and may learn specific strategies to help with their difficulties.
But, one session per week is usually not enough to address the difficulties – it’s not enough just to learn about the stretches and exercises. If an individual wants to reduce their pain and become more flexible, they will also need to practice the exercises each day between sessions. Only then will they begin to see changes, or places where they need to modify the exercises.
It is only with a lot of practice between sessions, that the individual can take the skills and understanding that they develop and use them in their everyday life. Eventually they will be able to live more comfortably by using those skills without needing to keep going to sessions.
CBT: an Evolving Therapy
CBT is soundly grounded in evidence-based practice, and evolves as research is conducted that informs which parts of the therapy are most effective, or adds to the therapeutic toolkit of CBT therapists. It relies on a solid understanding of physiology, learning theory, and social, developmental and evolutionary psychology.
Because CBT is grounded in scientific theory and research, it is a dynamic and evolving therapy, and is compatible with other evidence-based theories or approaches.
For example, contemporary CBT is informed by recent research into the benefits of mindfulness, a skill that people can develop to help them to focus on the present moment, and stop ruminating about the past or worrying about the future.
Mindfulness has been shown to offer many benefits, including better pain tolerance, greater satisfaction in life, improved physical health, and lower relapse-rates after therapy for depression. For this reason, it has been adopted into recent therapies, including mindfulness-based CBT, Acceptance and Commitment Therapy and Compassion Focused Therapy.
Although CBT is reputed to work exclusively on present symptoms and future outcomes, this is not actually accurate. CBT relies on understanding how behaviour is learned and shaped through experience, whether that was through watching others and imitating them, or through a person’s own history of success and failure.
When a therapist is meeting someone and considering CBT as a potential therapy, their interview will include an understanding of the individual’s temperament and biological predispositions, and their learning and relationship history in order to explain how that individual came to have a particular difficulty. The individual’s goals, values and plans for the future will also be assessed.
A CBT therapist is an active participant in the therapeutic relationship, providing unconditional positive regard to the client, and encouraging the client during the difficult process of change. The CBT therapist acts as a kind of mentor, providing empathy and comfort, and teaching boundaries and lessons about life and relationships, to help a client to develop more healthy ways of relating in relationships.
CBT is a time-limited and structured approach. The individual is typically given an estimated number of sessions once the assessment is complete, and therapy will end once those sessions are completed, barring exceptional circumstances. During the sessions, a structure will be followed in which the assessment is shared and negotiated, and a plan is generated to work on specific techniques or skills. The plan is explicit, negotiated, and continuously evaluated in a collaboration between the therapist and the person receiving therapy.
Beck, JS (2011). Cognitive Behaviour Therapy: Basics and Beyond (Second Edition). New York: Guildford Press.
Beck, JS (2004). CBT for Challenging Problems (Second Edition). New York: Guildford Press.
Hayes SC, and Smith, S (2005). Get Out of your Mind and into Your Life. New Harbinger Publications.