Cognitive behavioral therapy, or CBT, is one of the most widely used and research-backed methods of psychotherapy. First developed in the 1960s, decades of research have shown that CBT is effective for a range of problems, including addiction, depression, anxiety, eating disorders, post-traumatic stress disorder, and more.
CBT targets both our thinking and our actions. It looks to adjust harmful thought patterns that influence how we feel and act. And it works to change unhelpful behaviors tied to those distorted thinking habits.
How Effective is CBT?
CBT is considered the gold standard of psychotherapy by many in the field. A 2018 paper titled Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy (1) argues that the wealth of empirical evidence and high success rates supports CBT meeting the criteria for being the premier treatment in psychiatry.
An expansive body of over 2,000 studies (2) has shown the efficacy of CBT for a wide range of mental health conditions and psychological issues.
CBT remains one of the most widely used and thoroughly researched therapies, with decades of data supporting its effectiveness for issues ranging from addiction and substance use disorder to eating disorders to trauma.
Benefits of Cognitive Behavioral Therapy
There are several features that make CBT such a popular treatment option. CBT has distinct advantages over other therapeutic approaches that make it efficient, practical, and accessible for many.
Medication May Not Be Necessary with CBT
First, CBT has been shown to be at least as effective as medication for non-psychotic disorders such as depression and anxiety. It is also helpful for psychotic conditions such as schizophrenia, but only in addition to medication. It’s best to avoid medication whenever possible.
Even if expense is not an issue, medications only work for as long as you take them, and there are almost always side effects to which people are sensitive in varying degrees. Some people are just going to need medication no matter what, but if you can get similar results from talk therapy without medication, that’s definitely an advantage.
Builds Lasting Coping Skill Fast
Second, CBT tends to have a limited run. Instead of weekly or daily therapy sessions, as with psychoanalysis–that go on indefinitely, CBT typically lasts about eight to 10 weeks. This is because the goal of CBT is to help you act as your own therapist by teaching you new skills. The focused, short-term structure provides practical tools and coping skills that you can continue applying on your own after therapy ends.
Flexible in Treating Diverse Conditions
Third, CBT is flexible, and its basic framework can be used to treat many conditions. It is the basis for other effective forms of therapy, including acceptance and commitment therapy, or ACT, and dialectical behavioral therapy, or DBT, which has proven to be effective in treating personality disorders and other issues. We’ll talk more about these other types of therapy shortly.
Specifically, CBT has demonstrated efficacy in treating:
- Anxiety disorders
- Post-traumatic stress disorder (PTSD)
- Depression
- Eating disorders
- Substance abuse
Pragmatic, Goal-Directed Approach
Finally, CBT is specific and oriented towards results. There’s none of the deep family history or dream interpretation of psychoanalysis. It focuses more on immediate problems and their solutions. The therapy itself gives you hands-on practice using new strategies, with practical homework assignments to try out between sessions. Instead of rehashing the past, CBT helps you build skills to better handle life and feel better day-to-day.
How Does Cognitive Behavioral Therapy Work?
So, how exactly does CBT work? CBT is based on the simple insight that thoughts create emotions. Many of our negative emotions and behaviors are created by distorted or maladaptive thinking patterns. We often learn these patterns at a young age, from our parents, or as a result of some trauma.
As we grow up, our situation changes, but the old thought patterns persist and make us miserable. CBT aims to replace these maladaptive thought patterns with more useful ones.
Exactly what these patterns are depends on the individual. It’s the job of a skilled therapist to help you identify what kinds of thoughts are causing you so much trouble. There are around 14 common cognitive distortions, but most people specialize in a few.
For example, perfectionists tend to catastrophize, believing that it would be awful to make any kind of mistake, and they tend to split, believing that any effort they make will turn out completely good or completely terrible. As a result, they tend to suffer from intense anxiety, feel hopeless when things never turn out perfectly, and end up avoiding new challenges altogether.
A CBT therapist will help you identify your own cognitive distortions and show you ways to combat them. For example, they might ask a perfectionist client about a situation when they felt especially anxious or depressed.
Then, they might discuss what they were thinking while experiencing those feelings. Once those thoughts have been recognized, the therapist will help them identify productive ways to reframe those thoughts. The process of transforming distorted, negative thinking into rational, positive thinking is called cognitive restructuring.
The next step is to start replacing those maladaptive thoughts with more realistic thoughts. So if the patient’s thought is, “I can’t do this new thing perfectly, so I shouldn’t do it at all,” their new, more realistic thought might be, “I can’t do this perfectly, but this particular task only has to be good enough, and I can do that,” or “I can’t do this perfectly, but with practice, I will be able to do it well.”
Both thoughts are more realistic and promote action over rumination.
Of course, it’s easy to admit a belief is not totally rational and commit to changing it when you’re sitting comfortably in a therapist’s office. It’s much different when you’re living your life and something stressful happens. Then, your best intentions to replace maladaptive thinking patterns with healthier, rational thinking patterns may instantly evaporate.
Making the change takes practice, which is why CBT therapists typically assign homework. This is sometimes in the form of worksheets, but is often in the form of journaling.
Practical Application and Homework in CBT
A typical CBT homework assignment might be to write down a situation from your day when you felt especially anxious. Then, write down your belief about what happened and the specific emotions you experienced as a result of that belief. Then, you would write down a belief to replace the one that caused you to feel anxious.
So, if your belief was, “It will be a disaster if I mess this up,” your more rational replacement might be, “I really would like to get this right, but if something goes wrong, I can probably find a way to fix it.”
This might seem pointless to do after the fact, but it’s a way of practicing a new way of thinking. Eventually, you’ll learn to spot faulty beliefs when they arise, and you will be able to counter them automatically.
Tips for Getting the Best Out of CBT Therapy
Getting the most out of CBT requires effort both in and out of therapy sessions. Here are some tips to maximize the effectiveness of your CBT treatment plan.
Open Up to Your Therapist
Letting down your guard with your therapist and trusting in them is the first step towards successful CBT therapy. If you can’t share openly, without censorship, the challenges you are facing, your therapist won’t be able to fully understand the thoughts and emotions they need to help you address. It also might be that you find some of the CBT concepts or assignments confusing. If this is the case, ask questions your therapist will be happy to clarify and point you in the right direction.
Come Prepared to Each Session
Come to your therapy session organized with observations, questions, and ready examples of any challenges that you’ve faced. By doing this, you can get the most out of your limited session time rather than waste time trying to remember relevant details on the spot.
Apply What You Learn
CBT takes a proactive, action-oriented approach – you must put in the work for it to pay off. Simply showing up and passively receiving info during sessions accomplishes little. Actively applying skills and strategies covered outside each appointment is what cements learning. Behaviors and thought patterns engrained over a lifetime don’t transform through osmosis or wishing alone.
The more diligently you implement the coping strategies you’ve learned, the more CBT delivers lasting dividends.
Have Realistic Expectations About Progress
That being said, don’t expect sudden, sweeping transformations in long-established thought patterns. Restructuring entrenched cognition is a gradual process that will require sustained effort. Remain patient and keep expectations reasonable.
Celebrate the Small Wins
Celebrate those small, cumulative gains, and you’ll avoid discouragement. Give yourself positive reinforcement to keep going and recognize the progress you’re making. Identify and pat yourself on the back for incremental improvements – like catching and challenging an automatic negative thought. Continual motivation hinges on praising the slight, steady steps forward.
Types of Cognitive Behavior Therapy
While traditional cognitive behavioral therapy is the most well-known and popular, other offshoot models have emerged. They retain the general framework of identifying and adjusting distorted thoughts and self-defeating behaviors but incorporate unique strategies that combine well with CBT.
Acceptance and Commitment Therapy (ACT)
ACT is about accepting negative thoughts and feelings rather than struggling with them. The goal is, despite the challenges faced, to commit to a values-driven life. You strive to embrace unpleasant internal experiences as part of being human while still choosing to act in alignment with your core values.
Dialectical Behavior Therapy (DBT)
DBT combines CBT with mindfulness techniques and was developed to treat borderline personality disorder. You can learn more about our DBT residential treatment in Thailand here.
Exposure Therapy
This approach incrementally exposes clients to a fear trigger in a safe, controlled way. This gradually deconditions the learned association between the stimulus and fear response.
Mindfulness-Based Cognitive Therapy (MBCT)
MBCT integrates mindfulness practices like meditation with CBT methods. It also shares principles with traditional CBT, but there are some differences between CBT and MBCT to consider when choosing treatment approaches.
Rational Emotive Behavior Therapy
Originated by Albert Ellis in the 1950s before CBT, REBT identifies irrational beliefs that fuel dysfunctional emotions and replace them with healthier rational mindsets. REBT differs from CBT in some of its core principles, for instance, pursuing unconditional self-acceptance.
Final Thoughts
CBT is not a panacea, but it is effective for a broad range of problems. It’s a standard method of treatment for therapists and treatment centers everywhere for good reason. Its methods are backed by research, and it’s flexible enough that its methods can constantly be refined to be more effective.
Whether you’re struggling with addiction, mental illness, or both, working with a skilled CBT therapist to learn more effective ways of thinking is a rock-solid foundation on which to build your recovery.
Contact us today if you’re struggling with addiction or mental illness. The Dawn Medical Rehab and Wellness Center can help. We are one of Thailand’s most respected addiction treatment and wellness centers. We use cutting-edge treatment modalities to provide personalized care to treat addiction, depression, anxiety, bipolar disorder, personality disorders, PTSD, and executive burnout.
FAQs
Q: Are there any risks involved with Cognitive Behavioral Therapy?
A: While the CBT process can feel mentally and emotionally challenging at times, there are no medical or physical risks involved with undergoing the therapy.
Q: How soon will I start to notice changes from CBT treatment?
A: CBT progress tends to occur gradually rather than overnight. Most people note small differences in thinking patterns or behavior within the first few weeks of active treatment. The new neural pathways being built need time to reinforce through ongoing practice.
Q: Does CBT only work for certain personality types?
A: The main principles – identifying distorted thoughts and making behavioral changes, can work regardless of personal attributes. However, a skilled CBT therapist will personalize the treatment and adjust the approach based on the issues they are dealing with.