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Cognitive Behaviour Therapy: The Therapy Everybody's Talking About

Updated: Nov 6, 2020

Cognitive behaviour therapy, or CBT, is a short-term talking treatment that has a highly practical approach to problem-solving. CBT aims to change patterns of thinking or behaviour that are behind people's difficulties, and so change the way they feel.

What Is Cognitive Behaviour Therapy?

Cognitive behaviour therapy (CBT) describes a number of therapies that all have a similar approach to solving problems - these can range from sleeping difficulties or relationship problems, to drug and alcohol abuse or anxiety and depression. CBT works by changing people's attitudes and their behaviour. The therapies focus on the thoughts, images, beliefs and attitudes that we hold (our cognitive processes) and how this relates to the way we behave, as a way of dealing with emotional problems.

An important advantage of CBT is that it tends to be short, taking three to six months for most emotional problems. Clients attend a session a week, each session lasting either 50 minutes or an hour. During this time, the client and therapist are working together to understand what the problems are and to develop a new strategy for tackling them. CBT introduces them to a set of principles that they can apply whenever they need to, and which will stand them in good stead throughout their lives.

CBT is a form of psychotherapy which combines cognitive and behavioural therapy. Cognitive therapy looks at how our thoughts can create our feelings and mood. Behavioural therapy pays close attention to the relationship between our problems, our behaviour and our thoughts. CBT may focus on what is going on in the present rather than the past, but often the therapy will also look at how thinking patterns may have begun in early childhood and the impact patterns of thinking may have on how we interpret the world as adults.

What's the History of CBT?

In the 1960s, a US psychiatrist and psychotherapist called Aaron T. Beck observed that, during his analytical sessions, his patients tended to have an 'internal dialogue' going on in their minds, almost as if they were talking to themselves. But they would only report a fraction of this kind of thinking to him.

For example, in a therapy session the client might be thinking to him- or herself: 'He (the therapist) hasn't said much today. I wonder if he's annoyed with me?' These thoughts might make the client feel slightly anxious or perhaps annoyed. He or she could then respond to this thought with a further thought: 'He's probably tired, or perhaps I haven't been talking about the most important things'. The second thought might change how the client was feeling.

Beck realized that the link between thoughts and feelings was very important. He invented the term 'automatic thoughts' to describe emotion-filled or 'hot' thoughts that might pop up in the mind. Beck found that people weren't always fully aware of such thoughts but could learn to identify and report them. If a person was feeling upset in some way, the thoughts were usually negative and neither realistic nor helpful. Beck found that identifying these thoughts was the key to the client understanding and overcoming his or her difficulties.

Beck called it cognitive therapy because of the importance it places on thinking. It's now known as CBT because the therapy incorporated behavioural techniques as well. The balance between the cognitive and the behavioural elements varies among the different therapies of this type, but all come under the general term 'cognitive behaviour therapy'. CBT has since undergone scientific trials in many places by different teams and has been applied to a wide variety of problems.

What Are the Main Principles of CBT?

Briers (2009) highlights five main principles underlying CBT which must be understood in order for this approach to be effective. These key principles include the following: recognizing that another point of view always exists, events are not responsible for our feelings, everyone's unique experiences shape their beliefs, feelings impact behaviour and everyone is a scientist at heart.

Principle one recognizes that the manner or style of thinking impacts upon the way events or the world is viewed.

Principle two is a crucial one as it is easy to think if x happens then one will feel y, for example if one loses one's wallet this will make them feel angry. CBT teaches us to take responsibility for our feelings and that it is the way we interpret events that impacts our mood/emotions as opposed to the event itself.

The third principle explains that beliefs we hold about our self, other people and the world in general arise from our personal experiences while principle four recognizes that if one thinks depressive thoughts, they are more likely to act in the same way causing more negative thoughts.

The fifth principle is central to the way CBT is used to challenge the way one thinks and behaves through observing, testing, and experimenting.

*Artwork by Alejandra Salgado

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