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Cognitive-Behavioral Theory (CBT)

What is CBT

While seeing things in a negative light may contribute to worry, anxiety, and depression, CBT is not about putting on rose-colored glasses and ignoring the things that bring us down. Instead we often need to think more realistically, rather than simply positively. When we are depressed or anxious, we may be stuck in patterns of unrealistic and inaccurate thinking which, in CBT, are called thinking errors. The article 10 Thinking Errors That Will Crush Your Mental Strengthlink opens in new window, in Psychology Today, explains and gives examples of thinking errors. Read the article and then review the Cognitive Behavioral Toolslink opens in new window video (26:30) that explains in detail CBT strategies that can be used to help you correct thinking errors that lead to stress and anxiety. In your post, Come up with examples (other than those used in the article) for 5 of the 10 common thinking errors. You can use hypothetical examples or ones from your own life. (For instance, “An example of black and white thinking is when I when I tell myself that if I don’t clean the house perfectly,

I’m a terrible housekeeper.”) Then, using what you learned about cognitive behavioral strategies, create alternative thoughts/self-talk that would be more helpful than the thinking error examples you have provided. (For example, “Instead, I could tell myself that I’m working full time and going to school so keeping the house perfectly clean is not my first priority right now, but I’m doing a pretty good job managing.”) Describe another CBT strategy that you learned from watching the video. How might it be helpful to you or someone you know who struggles with thinking errors? Explain whether or not you think that cognitive strategies are an effective way to reduce stress. What arguments might be used against cognitive strategies? Additional resource is attached.

Cognitive-behavioral therapy (CBT), originally simply called cognitive therapy, is a type of psychotherapy developed by a psychiatrist named Aaron T. Beck in the 1960s.  The basis of this treatment is the cognitive model, which is the idea that dysfunctional thinking—faulty and irrational thoughts and beliefs about the self, others, or the world—negatively affect emotions and behaviors and, thereby, lead to psychological disturbances like depression and anxiety. 

disc showing continuous loop: feelings to thoughts to behaviors to feelings, etc.For example, if Jim were feeling depressed and then he learned that he didn’t get a promotion at work, an automatic thought might pop into his head: “I’m terrible at everything I do.” Jim’s thought might then lead him to feel sad (an emotion) and isolate himself at home (a behavior).  But if Jim took a closer look at his automatic thought that he is terrible at everything, he might realize that he had overgeneralized a thought about not being successful in something at work to being terrible at everything.

Principles of CBT

Realistically, failing to get one promotion does not equate to being terrible in all aspects of one’s life. If Jim were to notice that his thinking is faulty and unrealistic and were able to introduce another thought like, “I’m disappointed that I didn’t get that promotion,” the intensity of his sadness and his desire to isolate himself might be lessened.  A therapist could help Jim look deeper at the beliefs that underlie his thoughts.  The fact that Jim automatically had an overgeneralizing negative thought about being terrible at everything suggests that he may not believe himself to be very competent.

CBT was initially developed as a treatment for depression but has been expanded to apply to a range of difficulties and disorders including different types of anxiety disorders, eating disorders, substance abuse, and medical conditions with psychological components.  Therapy sessions are typically quite structured (rather than free-flowing and open-ended) and the course of treatment is short compared with other types of psychotherapy. A significant number of studies have supported the effectiveness of CBT treatments, making it an evidence-based therapy for many mental health problems.

According to Judith Beck (2011), a psychologist and daughter of CBT creator Aaron Beck, in successful CBT, the therapist will work collaboratively with the patient to do the following:

-develop a constantly-evolving understanding of the patient’s problems in terms of the patient’s current thinking, problematic behaviors, precipitating factors that led up to current problems, and enduring cognitive patterns that may keep the patient stuck;

-form a relationship based in trust, known as a therapeutic alliance;

-set specific goals and focus on problem-solving;

-educate the patient in CBT strategies, enabling the patient to become her own therapist;

-structure sessions with specific activities appropriate to the patient’s needs and stage of treatment, to maximize efficiency and effectiveness;

-teach patients to identify, evaluate, and respond to their dysfunctional thoughts and beliefs

-use a variety of techniques to change a patient’s thinking, mood, and behavior.

-Once a successful course of treatment is complete, a patient has developed new, more effective cognitive patterns and better ways of coping with difficulties and is experiencing less emotional distress.  The patient has also learned CBT skills that will help prevent a relapse in the future.  However, should a difficulty arise and the patient need more support, she would be encouraged to come back to the therapist for “booster” sessions or for an additional round of treatment if needed.

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