Where is the Silver Lining?: Cognitive-behavioral Therapy

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What is Cognitive behavior therapy?

Cognitive behavior therapy is one of the few forms of psychotherapy that has been scientifically tested and found to be effective in hundreds of clinical trials for many different disorders. In contrast to other forms of psychotherapy, cognitive therapy is usually more focused on the present, more time-limited, and more problem-solving oriented. In addition, patients learn specific skills that they can use for the rest of their lives. These skills involve identifying distorted thinking, modifying beliefs, relating to others in different ways, and changing behaviors.

Who is the Founder of Cognitive Behavioral Therapy?

Albert Ellis (1913-2007)

American psychologist who in 1955 developed Rational Emotive Behavior Therapy (REBT). He held M.A. and Ph.D. degrees in clinical psychology from Columbia University and American Board of Professional Psychology (ABPP). He also founded and was the President of the New York City-based Albert Ellis Institute for decades.^[1] He is generally considered to be one of the originators of the cognitive revolutionary paradigm shift in psychotherapy and the founder of cognitive-behavioral therapies.

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CBT Techniques

Cognitive Behavioral Therapists use a wide variety of techniques to help patients change their cognitions, behavior, mood, and physiology. Techniques may be cognitive, behavioral, environmental, biological, supportive, interpersonal, or experiential. Therapists select techniques based on their ongoing conceptualization of the patient and his or her problems and their specific goals for the session. They continually ask themselves, “How can I help this patient feel better by the end of the session and how can I help the patient have a better week?” These questions also guide clinicians in planning strategy.

What are the Goals of Behavior Therapy?

The focus and method of cognitive behavioral therapy sets it apart from other, more traditional therapies:

· CBT is based on two specific tasks: cognitive restructuring, in which the therapist and patient work together to change thinking patterns, and behavioral activation -- in which patients learn to overcome obstacles to participating in enjoyable activities. CBT focuses on the immediate present: what and how a person thinks more than why a person thinks that way.

· CBT focuses on specific problems. In individual or group sessions, problem behaviors and problem thinking are identified, prioritized, and specifically addressed.

· CBT is goal oriented. Patients working with their therapists are asked to define goals for each session as well as longer-term goals. Longer-term goals may take several weeks or months to achieve. Some goals may even be targeted for completion after the sessions come to an end.

· The approach of CBT is educational. The therapist uses structured learning experiences that teach patients to monitor and write down their negative thoughts and mental images. The goal is to recognize how those ideas affect their mood, behavior, and physical condition. Therapists also teach important coping skills, such as problem solving and scheduling pleasurable experiences.

· CBT patients are expected to take an active role in their learning, in the session and between sessions. They are given homework assignments at each session -- some of them graded in the beginning -- and the assignment tasks are reviewed at the start of the next session.

· CBT employs multiple strategies, including Socratic questioning, role playing, imagery, guided discovery, and behavioral experiments.

· CBT is time limited. Typically, treatment with CBT lasts 14 to 16 weeks.

Who Can Benefit From CBT?

Anyone with mild or moderate depression can potentially benefit from cognitive behavioral therapy, even without taking medication. A number of studies have shown CBT to be at least as effective as antidepressants in treating mild and moderate depression. Studies also show that a combination of antidepressants and CBT can be effective in treating major depression.