Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT)

What is Cognitive Behavioural Therapy (CBT)?

Cognitive Behavioural Therapy (CBT) is a structured, evidence-based approach to psychotherapy that addresses unhelpful thought and behavioural patterns. 

By examining the interplay between emotions, cognitions, and behaviours – CBT provides individuals with tools to identify and challenge these patterns. 

Once identified, the therapy offers structured interventions to modify behaviours and establish effective coping strategies.

Distinct from therapies that emphasise past events, CBT prioritises present-day challenges and solutions. 

It is important to note that while CBT has proven effective for a range of disorders, its suitability and efficacy are individual-dependent.

In this article, we will see how CBT works, what it can help with, and some self-help CBT techniques.

How Does CBT Work?

CBT operates on the notion that our thoughts, emotions, and behaviours are interconnected. 

One can influence emotions and actions by identifying and challenging negative thought patterns. 

Firstly, CBT recognises that maladaptive behaviours stem from unhelpful thought processes. By addressing these, one can rectify problematic behaviours. 

Secondly, CBT focuses on confronting and altering deep-seated core beliefs that may be detrimental. Recognising these beliefs is pivotal in reshaping one’s perspective.

During CBT sessions, trained therapists guide individuals through reflective exercises. By doing so, patients gain insights into their cognitive distortions. 

Through guided questioning, therapists online or in-person assist in reframing these distortions and encourage healthier responses to challenges.

Furthermore, CBT is time-limited, ensuring focused and efficient treatment. Therapists usually incorporate CBT with other therapeutic approaches or medications tailored to individual needs. 

Cognitive Behavioural Therapy Techniques

What are the 5 steps of CBT?

CBT uses a variety of proven techniques to help people overcome negative thought patterns. Below are the five steps commonly used in CBT:

Identifying Negative Thoughts

This is a method used to identify and understand negative thought patterns. These thoughts can subtly influence our feelings and actions, often without our awareness.

Recognising these thoughts is essential because they can shape our daily experiences and overall well-being.

Strategies to Identify Negative Thoughts:

  • Thought Diary: Maintain a daily record of your thoughts, especially when you feel down or anxious. Over time, you might see patterns of negative thinking.

  • Critical Reflection: When a negative thought appears, pause and ask yourself if it is based on factual evidence or just an assumption.
  • Mindfulness Techniques: Practices like meditation can help you become more aware of your thoughts as they occur.
  • Feedback: Discussing your thoughts with trusted individuals and loved ones can provide a fresh perspective, helping you identify thoughts you might have overlooked.

Cognitive Restructuring

Cognitive restructuring is a tool that can help reshape our unhelpful thought patterns. It effectively manages stress by replacing anxiety-inducing thoughts with balanced, stress-free, and more realistic ones.

Here is how it works:

  • Recognise a specific event or scenario causing stress.

  • Understand the thoughts and emotions emerging from that situation.

  • Separate what is factual from what is not.

  • Replace the initial thought with a more rational and balanced one.

  • Observe the change in your feelings.

Let us delve into a CBT example of cognitive restructuring:

Situation: My friends went on a vacation, and I was not invited.

Thoughts: They hate me. They think I am annoying. I will have no friends. 

Feelings: Sad. Lonely. Anxious. Annoyed.

Evidence supporting the thought: I do get really awkward and moody. 

Evidence against the thought: I received several invites to hang out with them before. My friends told me they enjoyed spending time with me before. 

Alternative/balanced thought: My friends like me, but they can have other friends and hang out without me whenever they want. That does not mean they hate me. 

Outcome: I feel more peaceful and relaxed even if I am not invited to hang out.

Setting SMART Goals

CBT often incorporates goal setting to help individuals achieve desired changes in their lives. One of the most effective techniques used in CBT for goal setting is the SMART framework. Let’s delve into how this works.

1) Specific: Instead of creating vague goals like “get fit”, CBT encourages you to be precise. For instance, “walk for 30 minutes every day” is a more defined objective.

2) Measurable: It is crucial to track your progress. Setting goals such as “read 20 pages of a book daily” allows you to monitor and measure your advancement easily.

3) Achievable: CBT emphasises setting realistic targets. While “winning the lottery” might sound appealing, it is not a practical goal. Instead, focus on attainable outcomes like “save 10% of my monthly salary”.

4) Relevant: Make sure your goals align with your broader objectives. If you aim to expand your social connections, a goal like “join a local club” would be more relevant than “learn to play the guitar”.

5) Timely: Timing is essential. If you plan to start a new exercise regimen, ensure it is a suitable period, considering factors like health, resources, and availability.

Incorporating the SMART framework into your goal-setting process, not only makes your objectives more straightforward, but also boosts your chances of achieving them. 

Remember, it is about setting yourself up for success (in personal and professional settings), one SMART goal at a time.

Problem-Solving

Cognitive behavioural therapy uses a structured approach to problem-solving. Here is a breakdown of its process:

Pinpointing the issue: Begin by articulating the problem. This might involve a series of probing questions or a collaborative discussion to ensure the issue is comprehensively understood.

Brainstorming solutions: This phase is all about creativity. Propose multiple solutions, ensuring each idea is tabled without immediate critique. It is essential to avoid dismissing any potential solutions immediately, as this can limit options.

Weighing pros and cons: Once you have listed possible solutions, it is time to assess each one. Think about the advantages and disadvantages of every choice, bringing back a discerning eye to determine the most viable alternatives.

Implementing: Choose the solution that seems most practical and effective. Put it into action, ensuring you give it a fair chance to make an impact.

Reviewing and Iterating: After a certain period, evaluate the effectiveness of the chosen solution. If it has not yielded the desired results, do not be disheartened. Revisit the brainstorming or assessment stages to identify an alternative approach.

By following this structured approach, CBT ensures that problems are tackled systematically, increasing the likelihood of finding practical solutions. 

Professional therapists will work with you through each step to ensure you make the most out of every technique. 

Self-Discovery

At its core, self-monitoring is about keen observation. It is the act of consistently tracking your thoughts, feelings, and behaviours in response to specific situations. 

This does not just involve a diary entry; it is a structured process that captures patterns and triggers.

A therapist or counsellor plays a crucial role in this journey. They will introduce you to tailored self-monitoring tools, such as charts or trackers, ensuring they align with your unique needs. 

These tools are not one-size-fits-all; they are customised to focus on what is relevant to you.

As you gather data, your therapist will help you analyse it. Together, you will identify patterns that might contribute to your challenges. 

For instance, if you consistently feel anxious before meetings, you might discover certain thoughts or beliefs fuelling that anxiety.

Your therapist will then guide you in developing strategies to challenge and change these patterns. By recognising and understanding your triggers, you are better equipped to manage or even prevent unwanted reactions.

With the right guidance through this CBT technique, you can transform insights into actionable change, leading to a more balanced and fulfilling life.

What Cognitive Behavioural Therapy Can Help With

Cognitive behavioural therapy is used globally to treat several mental health conditions and emotional issues. It is suitable for people of all ages, including children.

Professional counsellors use CBT to address:

When used with medication, CBT can also help treat bipolar disorder and schizophrenia.

CBT is also effective for non-psychological medical conditions like:

Additionally, CBT can assist with:

Benefits of Cognitive Behavioural Therapy

CBT is a well-established therapeutic approach grounded in the understanding that thoughts and feelings significantly influence behaviour. 

By addressing and modifying maladaptive thought patterns, CBT offers several distinct advantages:

  • CBT assists individuals in identifying and rectifying negative and often unfounded beliefs that adversely affect their emotions.

  • People who use CBT techniques observe improvements within five to 20 sessions, making CBT a time-effective treatment option.

  • CBT is suitable for addressing a wide range of maladaptive behaviours, from social anxiety disorder to obsessive-compulsive tendencies.

  • Frequently, CBT presents a more cost-effective alternative to other therapeutic modalities.

  • The efficacy of CBT remains consistent whether sessions are conducted face-to-face or online.

  • CBT can be an optimal choice for individuals who do not prefer medications.

Lastly, one of the most essential benefits of CBT is its capacity to equip individuals with long-term coping strategies beneficial for present and future challenges.

Self-Help CBT Techniques

Self-help CBT techniques can help you handle daily worries, think positively, find new solutions, and feel mentally stronger. 

Facing Your Fears

  • Reflect on your physical sensations when confronted by fear. For instance, if public transport induces panic, recognise symptoms like feeling shaky or overheated.

  • Recognise that our body’s “fight or flight” response, though protective in certain situations, can be exaggerated in others, such as using a lift. The key is not avoidance but gradual exposure.

  • List situations triggering your fear, rating them from 0 (least difficult) to 100 (most fearful). For example, boarding a bus alone might score 50, while with a friend, it can be 10.

  • Tackle the least intimidating situations first. If initially rated as 10, persist until your fear level drops to 5. Repeated exposure typically diminishes the fear intensity.

  • When facing fears, allow yourself to experience the anxiety without distractions. Avoid habitual coping mechanisms, such as phone usage. This process reinforces your capability to manage fear.

  • After reducing one fear by half, proceed to the next. While some situations might require more time, remember that each effort, irrespective of its magnitude, is a stride towards facing your fears.

Tackling Your Daily Tasks

If you have mental health issues like chronic depression, it can be quite hard to finish all your daily tasks. However, you can efficiently manage your to-do list with the right strategies.

Use reminders: Visual cues can be instrumental. Consider placing reminders in locations you visit frequently, such as a note on your fridge reminding you of the grocery shopping.

Try for 5: The ‘just 5 minutes’ technique is transformative. Commit to spending merely 5 minutes on a task. Set a timer, begin, and evaluate your feelings after the duration. Often, you will find the motivation to continue beyond the initial time frame.

Task swap: Balance is key. Therefore, alternate between tasks you favour and those you find challenging. By transitioning swiftly without pauses, the enthusiasm from pleasurable tasks can fuel your drive for the more demanding ones.

By integrating these techniques, you will find daily tasks more approachable and less overwhelming. 

Focusing on tackling your daily tasks can improve your sense of accomplishment! Remember, consistency is the foundation of progress.  

Prioritising Your Well-Being

When life presents challenges, these strategies serve as invaluable tools to navigate stress, anxiety, and low moods. Here is a concise guide:

Consistent practise: Familiarising yourself with CBT techniques and integrating them into your daily routine enhances their efficacy. Over time, they transform into habits.

Routine integration: Include mental well-being practices into your daily life. This proactive approach safeguards your mental health and equips you to handle adversities with greater ease.

Personalised plan: Combine the techniques you have acquired into a routine. This ensures a holistic approach to maintaining mental wellness.

Stay informed: Continuously update yourself with the latest CBT practises. Knowledge and awareness empower you to make informed decisions about your mental health.

Seek support: While self-help is vital, do not hesitate to reach out for a professional psychologist’s guidance when needed. A balanced approach often yields the best results.

Celebrate progress: Recognise and celebrate your growth. Every step towards better mental well-being deserves acknowledgement.

Choose to prioritise your mental health every single day; it is the foundation of overall well-being!

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Obsessive-Compulsive Disorder (OCD) | TYHO | Talk Your Heart Out