Cognitive-Behavioral Therapy (CBT) is a commonly used, empirically sound (meaning well-researched and proven effective) form of mental health treatment. It is based on the work of psychologists Albert Ellis and Aaron Beck, who emphasized the need for attitude change in order to promote and maintain behavioral modification. CBT is essentially a hybrid of Cognitive Therapy and Behavior Therapy. The central premise of Behavior Therapy is that behavior is maintained by its consequences. The central tenet of the Cognitive approach is that our interpretation of other people’s behavior affects the way we respond to them. [i]
Often, when we go throughout our days in life, we are operating in autopilot mode – feeling emotions, thinking automatic thoughts, and reacting with behaviors based on them without being fully aware or tuned into the whole process of what’s going on. This can be very problematic for us if our thoughts, feelings and behaviors are particularly negative or destructive. One key tool in CBT which is helpful in understanding and changing this process, is the Cognitive Triangle. The Cognitive triangle is simply a diagram that depicts how our thoughts, emotions and behaviors are all interconnected with each other, and influence one another. Therefore, you can change, or at least influence, one by changing another. It doesn’t matter which one you start with (hence it being triangular in nature, rather than linear or even circular). For example, you can influence the way you feel about something, by changing behaviors or by changing your thoughts , whichever one is the easiest or makes the most sense for you to start with.
Two other key concepts in CBT are very helpful in promoting positive change in people’s lives: the concepts of Automatic Negative Thoughts (a term used interchangeably with the term Cognitive Distortions), and Unproductive Core Beliefs. Automatic Negative Thoughts are rooted in Unproductive Core Beliefs, and can be very powerful forces in affecting the way we see ourselves, others and the world, our expectations, our emotions and, of course, our behaviors. CBT is very helpful in aiding individuals to learn to recognize and change these distorted ways of thinking. CBT is also very helpful in teaching individuals concrete, effective strategies and skills for managing strong emotions, and practicing and implementing new patterns of behavior.
What populations and presenting problems is CBT used to treat?
CBT has been shown to be effective in treating a wide variety of mental health concerns, including, but not limited to: depression, anxiety disorders (including PTSD, phobias, and Obsessive-Compulsive Disorder), Bipolar Disorder, eating disorders, and substance use disorders. [ii]
What can clients expect this process to be like?
While working with a therapist using CBT, be prepared to be actively engaged in learning and working toward developing new skills and patterns of thinking and behaving. This therapeutic approach tends to be quite structured and goal-oriented, with the therapist taking a relatively active, sometimes directive, role. It often involves developing concrete plans and homework assignments aimed at implementing these plans and practicing skills and strategies outside of therapy. Psychoeducational handouts and worksheets may be provided, and workbooks (such as Mind Over Mood or The Anxiety and Phobia Workbook) may be used to enhance the therapeutic work throughout the course of treatment.
- NAMI Website: www.nami.org/NavigationMenu/Inform_Yourself/About_Treatments_and_Supports/Cognitive/Behavioral_Therapy1.htm
- The Beck Institute: www.beckinstitute.org
- Association for Behavioral and Cognitive Therapies (ABCT): www.abct.org
[i] Nichols, M and Schwartz, C. (2007). The Essentials of Family Therapy, Third Edition. Boston, MA:
Pearson Education, Inc.