Overview of Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy, or CBT for short, is a type of therapy that has been extensively researched and shown to be effective for treating a number of psychological problems, such as anxiety, depression, obsessive-compulsive disorder (OCD), phobias, post-traumatic stress disorder (PTSD), and insomnia.

Treatment with CBT tends to be short-term—lasting several months or as quickly as the client improves and feels well enough to use the acquired skills outside of the therapy sessions. The therapist essentially works with the client to become his or her own therapist. The therapist provides the client with information about his or her diagnosis or problem and how to treat it, which is referred to as psychoeducation. The overall goals of treatment are for the client to better understand how his or her problems have developed and are maintained, decrease symptoms or distress, and learn new skills to better cope with the problems.

CBT is intended to be collaborative between the client and therapist. It’s where both the client and therapist become active participants in the process. For example, the therapist and client may engage in a role-play exercise to help the client practice an assertive way of responding to others in her life. Homework is often assigned between sessions. But it’s not the kind of homework that involves writing a lengthy report and getting graded by your therapist. CBT homework is a task that is mutually agreed upon by the therapist and client. It could be, for example, that the client is expected to practice the newly taught relaxation exercise two times for the next week. These tasks or homework between sessions help the client cement the skills taught in the session and enhance the effectiveness of therapy. And more importantly, the reason for having to practice the skills outside of the session is for the client to feel better beyond the confines of the therapist’s office.

Let’s examine the principles of CBT better. CBT emphasizes the interaction between thoughts (or cognitions), emotions, and behaviors. Think of a triangle with each point representing one of the three components: thoughts, emotions, and behaviors. Each of these components influences the other. Unhelpful patterns of thinking or behaving are said to result in psychological problems. Therefore, CBT targets thoughts and behaviors since that’s easier than simply changing one’s emotions. For instance, therapy with a client who has anxiety about being in social situations might involve helping that client understand that anxiety is an unpleasant feeling but it is not harmful, and that avoidance of social situations in order to avoid feeling anxious will only maintain the anxiety. Therapy would then involve behavioral experiments to help the client tolerate and cope with the anxiety better. As such, improvements in one’s thinking and behavioral patterns often lead to an improvement in one’s feelings or to a decrease in distress.