What Everyone Should Know About Cognitive Behavior Therapy (CBT)

Recently a friend of mine's teenage daughter was going through a difficult time. They were desperate to find a therapy style that would work to support her needs, and spent a great deal of time researching different therapeutic approaches. They wound up finding a CBT therapist, and after weeks of intensive therapy, their daughter is doing well. Her mom attributes it to cognitive behavior therapy and said it was such a game-changer that I should look into becoming CBT certified myself.

So what is cognitive behavior therapy? And who is it good for?

Healthline.com describes it as: "Cognitive behavioral therapy (CBT) is a treatment approach that helps you recognize negative or unhelpful thought and behavior patterns. CBT aims to help you identify and explore the ways your emotions and thoughts can affect your actions."

Once you notice these patterns, you can begin learning how to change your behaviors and develop new coping strategies. CBT addresses the here and now, and focuses less on the past.

The key is that there is no one-size-fits-all approach. For some conditions in some people, other forms of psychotherapy are equally or even more effective.

The core idea: Your thoughts, emotions, and actions are connected. The way you think and feel about something affects what you do. But these thought and behavior patterns can be changed.

According to the American Psychological Association (APA):

• Psychological issues are partly based on unhelpful ways of thinking
• Psychological issues are partly based on learned patterns of behavior
• Those living with these issues can improve with better coping mechanisms and management

Typical CBT treatment often involves:

• Recognizing how inaccurate thinking can worsen problems
• Learning new problem-solving skills
• Gaining confidence and a better understanding of your self-worth
• Learning how to face fears and challenges
• Using role play and calming techniques when faced with challenging situations

The goal is to replace unhelpful or self-defeating thoughts with more encouraging and realistic ones. For example, "I'll never have a lasting relationship" might become, "None of my previous relationships have lasted very long. Reconsidering what I really need from a partner could help me find someone I'll be compatible with long term."

• SMART goals — Specific, Measurable, Achievable, Realistic, and Time-limited
• Guided discovery and questioning — Your therapist helps you challenge assumptions and consider different viewpoints
• Journaling — Writing down negative beliefs that come up during the week and the positive ones you can replace them with
• Self-talk — Replacing negative or critical self-talk with compassionate, constructive self-talk
• Cognitive restructuring — Looking at cognitive distortions (black-and-white thinking, catastrophizing, jumping to conclusions) and beginning to unravel them
• Thought recording — Recording thoughts and feelings in a specific situation, then developing more realistic thoughts based on evidence
• Positive activities — Scheduling a rewarding activity each day to increase overall positivity
• Situation exposure — Slowly exposing yourself to distressing situations until they lead to fewer negative feelings

Homework is another important part of CBT. Just as school assignments helped you practice skills you learned in class, therapy assignments help you become more familiar with the skills you're developing.

CBT can be used to treat a wide range of diagnoses, including:

• Depression
• PTSD (Post-Traumatic Stress Disorder)
• Eating disorders
• OCD (Obsessive Compulsive Disorder)
• Bipolar disorder
• Substance abuse and misuse
• Gambling and other addictions
• Schizophrenia
• Irrational fears and phobias
• Anxiety disorders and panic disorders

It can also be effective in situations like:

• Grief or loss
• Relationship issues
• Chronic pain
• Divorce or breakups
• A serious health diagnosis
• Low self-esteem
• Insomnia
• General life stressors

At the initial session, the therapist will gather information and ask questions to help identify the situations your child (or you) needs help with. It might take a few sessions for the therapist to fully understand the situation and decide together what problems and goals to focus on.

Then the therapist will encourage talking about thoughts, emotions, and beliefs about these problems. Identifying negative or inaccurate thinking can help recognize patterns that may be contributing to the problem.

Finally, the therapist will encourage reshaping negative or inaccurate thinking by assessing whether the view of a situation is based on fact or reality. With practice, helpful thinking and behavior patterns will become a habit and won't take as much effort.

CBT can be used with clients who've experienced trauma, with clients also taking medications, with parents and children, and in both group and individual therapy settings.

I'm a firm believer that the relationship between the therapist and the client is critical. While you're trying to find a CBT therapist, it's important to find one that fits with who you are and what your goals are.

And if you are currently experiencing any kind of mental health distress, please pick up the phone and call for help. 988 is the National Suicide & Crisis Lifeline. You can also reach out to a trusted adult or go to the nearest hospital. You matter and you are important.

Interested in learning more about therapy options? Reach out to schedule a session — I'd love to help you find the right fit.