Cognitive Behavioural Therapy
What is Cognitive Behavioural Therapy?
Cognitive Behavioural Therapy (CBT) is a researched based method that helps you change how you feel by helping you change how you think and act/react. What you say to yourself impacts how you feel because automatic thoughts are often out of our awareness and are often negative. Negative thoughts breed more negative thoughts. CBT helps you to:
- Change your thoughts, beliefs, and assumptions. This is the cognitive, or thinking, part of CBT.
- Take actions that are likely to have good results. This is the behaviour, or action, part of CBT.
Cognitive Behaviour Therapy is:
- Results-oriented: Goals are defined, a plan is set out to accomplish those goals, and progress is monitored.
- Short-term: Depending on the nature of the problem and how hard you work at the therapy determines how quickly goals are achieved.
- Self-help oriented: CBT focuses on helping you learn ways to manage your life better.
What issues can CBT help with?
- anxiety
- depression
- eating disorders
- obsessive-compulsive disorder
- panic attacks
- phobias
- problems with relationships, family, work, and school
- self-esteem
How does CBT work?
In therapy, you learn to pay attention to the automatic thoughts and you begin to look at whether some of your thoughts may be distorted in terms of how you filter information. For example, if you do not trust others, you might have thoughts like, “Everyone is out to get me.” These thoughts may be “distorted” when they are not based on what is really true at the present moment.
Therapy helps teach you how to look at the evidence for and against these automatic thoughts so you can determine whether these thoughts are distorted. In the above example, the evidence for is that you might say, “I have 3 best friends.” You then learn to replace these thoughts with healthier or more helpful thoughts in order to change how you feel about the situation, others people, and about yourself. For instance, the new though may be “I can trust my best friends and I will allow other people to earn my trust with their actions.” You will also learn new skills, such as taking part in activities that you have avoided, decreasing bad habits, learning new people skills, and improving how you manage stress.
What does the research say about CBT?
In meta-analyses, CBT has been shown to significantly improve multiple mental health issues including: depression,1 anxiety,2 insomnia,3 and hypochondriasis.4 CBT appears to be the treatment of choice for primary depression that is not a result from a traumatic experience. The Clinical Practice Guidelines’ recommendation for mild to moderate depression is “psychological treatment specifically focused on depression”5 for 6 to 8 sessions. Combination of antidepressants and CBT should be considered for severe depression and for recurring depression, as both treatments together have significantly greater effect size than either treatment alone.5 The Clinical Practice Guidelines recommends that for the treatment of anxiety, patients should receive CBT therapy to resolve and maintain treatment gains over the long term for anxiety6 and that medication, concurrently with therapy, is recommended in severe cases of anxiety.
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References
- Dobson KS. A Meta-Analysis of the efficacy of Cognitive Therapy for depression Journal of Consulting and Clinical Psychology 1989;57(3):414-419.
- Hofmann SG. Smits JA. Cognitive-Behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo controlled trials. Journal of Clinical Psychiatry 2008;69(4):621–632.
- Seyffert M. Lagisetty P. Landgraf J. Chopra V. Pfeiffer PN. Conte ML. Rogers MAM. (2016). Internet-delivered Cognitive Behavioral Therapy to treat insomnia: A systematic review and meta-analysis. PLoS ONE;11(2):e0149139.
- Olatunji BO. Kauffman BY. Meltzer S. Davis ML. Smits JAJ. Powers MB. Cognitive-Behavioral therapy for hypochondriasis/health anxiety: A meta-analysis of treatment outcome and moderators. Behavior Research and Therapy 2014;58:65-74.
- National Collaborating Centre for Mental Health. Depression: Management of depression in primary and secondary care. National Institute for Clinical Excellence 2004; http://www.scamfyc.org/documentos/depresion%20NICE.pdf
- Swinson Antony MM. Bleau P. Chokka P. Craven M. Fallu A. Katzman M. Kjernisted K. Lanius R. Manassis K. McIntosh D. Plamondon J. Rabheru K. Ameringen MV. Walker JR. Clinical practice guidelines: Management of anxiety disorders. The Canadian Journal of Psychiatry2006;51(2):1S-93S.