Cognitive behavioral therapy (CBT) helps people change patterns of thinking and behavior that contribute to painful moods, interfere with daily functioning, and prevent them from achieving their life goals.
The treatment helps clients to identify thoughts and beliefs that are inaccurate or not adaptive to their life circumstances. Clients learn how to correct their thinking with more realistic and reasonable thoughts and attitudes which results in improvement of mood and functioning.
The behavioral dimension of CBT encourages clients to experiment with new behaviors designed to challenge unrealistic beliefs they have or to learn new behaviors which will help them achieve their goals.
CBT is an evidence-based psychotherapy. Over the past several decades there has been overwhelming international research evidence confirming CBT as the treatment of choice for a broad range of psychiatric disorders. Based on research findings, the therapy strategies are continuously being improved to maximize the help that we are able to provide.
Cognitive therapists teach their clients crucial mental health skills. Clients learn to self-correct their distorted thinking and engage in behaviors that help them achieve personal goals. They also learn important problem solving skills. The goal of treatment is for people to have many more choices in how to think and behave.
During treatment, we often recommend research based client treatment manuals as well as carefully selected self-help books that support the changes that clients are trying to make. When clients complete treatment, they have their own “reference library” as well as their notes from therapy sessions and their written self-help assignments. These materials help them to maintain the progress that they have made.
CBT is structured as a collaboration between therapist and client. The content of the sessions, e.g., which problems to address, the design of self-help assignments, and decisions to change treatment interventions if the client is not making sufficient progress are part of ongoing discussions between the therapist and client.
The cognitive therapist is expert in providing CBT and the client is expert in his/her own life experience and what does and does not work to get better. This partnership of the therapist and client is critical to achieving successful treatment outcomes.
Clients are asked to identify and challenge in writing inaccurate thinking and/or to perform a behavioral experiment to test out dysfunctional thinking or learn a new behavioral skill. In this way the therapeutic benefit is greatly enhanced during the week between therapy sessions.
There is abundant evidence that clients’ improvement during CBT treatment and decreased likelihood of relapse following treatment is directly related to how diligent they are in doing their self-help assignments. I offer people the analogy of trying to learn to play the piano and the only time the student actually plays is during the weekly lesson. CBT offers clients the opportunity to really take charge of their therapeutic progress.
The focus of treatment is clients’ problems in the present. Clients often find the CBT focus on relief of what is troubling them in the moment to be both refreshing and comforting.
There are some clients, however, for whom formative or traumatic life experiences have played a significant role in creating and maintaining their current problems. We can then provide CBT interventions that have been shown to have therapeutic impact on the damaging consequences of these unfortunate life experiences.
We use self-report symptom inventories as well as record keeping of improvement in mood, symptoms, and behaviors. These ongoing assessments keep us accountable as to what extent therapy is working.
The CBT therapist actively inquires if the sessions and the self-help assignments are helpful to the client. If not, the therapist will make adjustments and formulate a different CBT strategy. In cognitive behavioral therapy it is the therapist’s responsibility to tailor treatment interventions to each client’s needs in order to maximize the effectiveness of treatment.
Since CBT is a skill based treatment approach addressing specific target problems, the goal of treatment is to be relatively short term with definite treatment outcomes in mind.
Our objective is for our clients to learn the skills that we teach so that ideally upon completion of treatment they are capable of serving as their own self-corrective “therapist.”