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Cognitive Behavioural Therapy and underlying principles

Stress and a large number of psychological issues are troubling people all around the world. People use medications and various forms of psychological treatments to overcome these problems including PTSD, Depression, anxiety and several more. Cognitive Behavioural therapy (CBT) is a form of psychological treatment that has been found to be highly effective at treating mental illnesses. Several research studies show that CBT can significantly improve the quality and functioning of life.

Many studies have been carried out regarding the effectiveness of CBT which have shown it to be just as effective or more effective than the other psychological therapies and psychiatric medications. It is among the most widely researched areas in psychology. Moreover, CBT is a directive, time limited and structured approach. Both research and clinical practice have helped advance the area of Cognitive Behavioural therapy. There is a lot of scientific evidence to show that CBT is an effective approach and brings real change.

The focus of CBT is on how thoughts, emotions and behaviours are interrelated. It notes how bringing changes in one domain bring effects in the other. An example is if a person can regulate helpful thinking, he can better regulate his emotions.

Cognitive behavioural therapy: Thoughts, behaviours and feelings.

The cognitive model upon which CBT is based was developed by Beck in 1964. Cognitive model is the model of conceptualization of cognition. In 1976, Beck outlined three levels of cognition –

  • Core beliefs
  • Dysfunctional Assumptions.
  • Negative Automatic Thoughts (NATs)

Core beliefs are also called schemas. These are deeply held beliefs that people have about themselves, others and the world. They are learned during early life and influenced by childhood experiences.

Dysfunctional assumptions on the other hand are rigid rules or conditions people adapt. Since these are unrealistic, they can make it difficult for persons to adapt to a situation.

Negative Automatic Thoughts or NATs may get activated under certain conditions automatically. In depression, these thoughts are focused on low self esteem, negativity and a feeling of worthlessness. A feeling that one is going to fail when facing a task or situation is a NAT. In case of anxiety disorders, people grow nervous and grow NATs that make them overestimate risks and underestimate their capabilities.

The cognitive model is used as a framework in CBT to understand mental problems Psychologists place individual experiences of clients within a cognitive behavioural framework . This process is called formulation and helps build a picture of the person’s life experience and understand his difficulties. CBT uses mainly two types of techniques – Cognitive techniques and behavioural techniques.

CBT is different from the other forms of psychological treatments and based upon some core principles. Some of the main core principles are the following:

– Faulty or unhelpful ways of thinking can lead to psychological problems.

– Unhelpful behaviour patterns c an cause psychological problems.

– People affected by psychological problems can be taught  better ways of coping so that they are more effective in their lives. 

Cognitive Behavioural Therapy tries to change thinking patterns and uses strategies like :

–  identifying distorted thoughts and then evaluating them again in the light of reality.

– Understanding others’ behaviour and motivation better.

– Problem solving skills for better coping with difficult situations. 

– Growing a person’s confidence in his abilities.

Apart from trying to influence and change thinking processes, CBT also tries to influence and change behaviour patterns.

– It tries to help patients face their fears instead of running away.

– Role playing to help with potentially difficult interactions.

– Calming the mind and relaxing the body.

These are some key strategies but psychologists do not use  all of them simultaneously. They develop tailored strategies to help the patients. They talk to patients to develop  a treatment strategy according to the problem. In case of Cognitive Behavioural therapy, the focus is to help the patients solve their problems by letting them become their own therapists.

Patients develop coping skills through in-session and out session exercises. Out-session exercises are like homework exercises. It helps them change erratic thinking and problematic behaviour and reign in troubled emotions. Instead of trying to address the roots of the difficulty, the therapist work on the current situation. They may need some historical information but the focus is still on helping patients move ahead and cope more effectively. Apart from depression, CBT is also effective at the treatment of PTSD.

CBT has two major advantages :-

Enduring effect : Research has shown that the positive effects of CBT endure in the long term. The chances of relapse are higher among the patients having received anti depressant medication compared to those having received CBT.

Cost effectiveness : CBT may seem to be costly initially but in the longer term and based on overall results it is a more cost effective treatment than the medications.

Beck, A. T. (1976) Cognitive Therapy and the Emotional Disorders, New York: Penguin. 
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