Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.
Cognitive behavioral therapy is used to treat a wide range of issues. It’s often the preferred type of psychotherapy because it can quickly help you identify and cope with specific challenges. It generally requires fewer sessions than other types of therapy and is done in a structured way.
CBT is a useful tool to address emotional challenges. For example, it may help you:
• Manage symptoms of mental illness
• Prevent a relapse of mental illness symptoms
• Treat a mental illness when medications aren’t a good option
• Learn techniques for coping with stressful life situations
• Identify ways to manage emotions
• Resolve relationship conflicts and learn better ways to communicate
• Cope with grief or loss
• Overcome emotional trauma related to abuse or violence
• Cope with a medical illness
• Manage chronic physical symptoms
Mental health disorders that may improve with CBT include:
• Anxiety disorders
• Sleep disorders
• Eating disorders
• Obsessive-compulsive disorder (OCD)
• Substance use disorders
• Bipolar disorders
• Sexual disorders
Your therapist will encourage you to talk about your thoughts and feelings and what’s troubling you. Don’t worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort.
CBT generally focuses on specific problems, using a goal-oriented approach. As you go through the therapy process, your therapist may ask you to do homework — activities, reading or practices that build on what you learn during your regular therapy sessions — and encourage you to apply what you’re learning in your daily life.
Steps in CBT
CBT typically includes these steps:
• Identify troubling situations or conditions in your life. These may include such issues as a medical condition, divorce, grief, anger or symptoms of a mental health disorder. You and your therapist may spend some time deciding what problems and goals you want to focus on.
• Become aware of your thoughts, emotions and beliefs about these problems. Once you’ve identified the problems to work on, your therapist will encourage you to share your thoughts about them. This may include observing what you tell yourself about an experience (self-talk), your interpretation of the meaning of a situation, and your beliefs about yourself, other people and events. Your therapist may suggest that you keep a journal of your thoughts.
• Identify negative or inaccurate thinking. To help you recognize patterns of thinking and behavior that may be contributing to your problem, your therapist may ask you to pay attention to your physical, emotional and behavioral responses in different situations.
• Reshape negative or inaccurate thinking. Your therapist will likely encourage you to ask yourself whether your view of a situation is based on fact or on an inaccurate perception of what’s going on. This step can be difficult. You may have long-standing ways of thinking about your life and yourself. With practice, helpful thinking and behavior patterns will become a habit and won’t take as much effort.
Length of therapy
CBT is generally considered short-term therapy — ranging from about five to 20 sessions. You and your therapist can discuss how many sessions may be right for you. Factors to consider include:
• Type of disorder or situation
• Severity of your symptoms
• How long you’ve had your symptoms or have been dealing with your situation
• How quickly you make progress
• How much stress you’re experiencing
• How much support you receive from family members and other people
Except in very specific circumstances, conversations with your therapist are confidential. However, a therapist may break confidentiality if there is an immediate threat to safety or when required by state or federal law to report concerns to authorities. These situations include:
• Threatening to immediately or soon (imminently) harm yourself or take your own life
• Threatening to imminently harm or take the life of another person
• Abusing a child or a vulnerable adult ― someone over age 18 who is hospitalized or made vulnerable by a disability
• Being unable to safely care for yourself
Getting the most out of CBT
CBT isn’t effective for everyone. But you can take steps to get the most out of your therapy and help make it a success.
• Approach therapy as a partnership. Therapy is most effective when you’re an active participant and share in decision-making. Make sure you and your therapist agree about the major issues and how to tackle them. Together, you can set goals and assess progress over time.
• Be open and honest. Success with therapy depends on your willingness to share your thoughts, feelings and experiences, and on being open to new insights and ways of doing things. If you’re reluctant to talk about certain things because of painful emotions, embarrassment or fears about your therapist’s reaction, let your therapist know about your reservations.
• Stick to your treatment plan. If you feel down or lack motivation, it may be tempting to skip therapy sessions. Doing so can disrupt your progress. Attend all sessions and give some thought to what you want to discuss.
• Don’t expect instant results. Working on emotional issues can be painful and often requires hard work. It’s not uncommon to feel worse during the initial part of therapy as you begin to confront past and current conflicts. You may need several sessions before you begin to see improvement.
• Do your homework between sessions. If your therapist asks you to read, keep a journal or do other activities outside of your regular therapy sessions, follow through. Doing these homework assignments will help you apply what you’ve learned in the therapy sessions.
• If therapy isn’t helping, talk to your therapist. If you don’t feel that you’re benefiting from CBT after several sessions, talk to your therapist about it. You and your therapist may decide to make some changes or try a different approach.
Source: The Mayo Clinic