Written by
Ridha Minna, MSc psychology
Psychologist
What Is Cognitive Behaviour Therapy?
Cognitive behaviour therapy(CBT) is a relatively short-term psychotherapy that focuses on the relationship between emotions, thoughts, and behaviours and how they affect one another. It helps people with psychological problems to identify and challenge the destructive thought patterns that negatively influence their emotions and behaviours, and guides them to restructure negative thoughts with more realistic and positive thoughts.
Even though CBT was developed as a treatment for depression, it is successful in treating a wide range of disorders including depression, anxiety, post-traumatic stress disorder, eating disorders, etc. Many studies found that CBT is far more effective than any other existing psychotherapies.
Why Cognitive Behaviour Therapy?
Learned patterns of faulty, destructive, and unhelpful thinking are the major source of many psychological problems. CBT helps people to challenge distortions in thinking (like overgeneralization and exaggerating negatives) by helping them to think more realistically and making a positive effect on emotion. This helps to relieve symptoms and lead a better life.
CBT emphasizes more on the current situation rather than the past or causal factors of illnesses. It helps to
- Manage symptoms
- Prevent relapse of illness
- Learn to cope with grief and stressful situations and
- Overcome the trauma and guilt from past life experiences
Cognitive Behaviour Therapy for Depression
Clinical depression is a relatively common psychological disorder characterised by persistent sadness, low mood, loss of interest in activities, etc. Cognitive behaviour therapy is considered most effective for both types of depression – major depressive disorder and dysthymic disorder.
Cognitive behavioural therapy for depression focuses on how a person’s thoughts and behaviours contribute to their depression. The therapist will help the client to learn ways to challenge negative preconceptions by setting goals together and giving ‘Home Works’.
Cognitive restructuring and challenging negative thoughts are part of CBT for depression and the therapy process continues for several sessions.
Cognitive Behaviour Therapy for Anxiety
Anxiety is an emotion of intense & excessive worry with feelings of tension about any anticipated threats in everyday life. As the body tries to fight the threat, somatic reactions like increased blood pressure, sweating, trembling, rapid heartbeat, etc. may appear. People with anxiety disorders show high levels of anxiety in specific situations and eventually avoid such situations.
It is important for the individual to be aware of their anxiety and as a first step, cognitive behaviour therapy educates the individual and helps him/her to understand and recognize whenever they feel anxious. The next step is to challenge the negative thoughts and replace them with a new positive belief. The therapist helps the individual to challenge those negative thoughts using examples from real-life experiences.
Psychoeducation helps the individual deal with anxiety-provoking situations more calmly.
Cognitive Behaviour Therapy for Generalized Anxiety Disorder
Generalized Anxiety Disorder is defined as the presence of uncontrollable worries and anxiety about a variety of topics, events, or activities. It is the persistent and excessive worry about everything that occurs, more often than not for at least 6 months. People with Generalized anxiety disorder have great difficulty controlling these worries.
In CBT, therapists help clients by raising awareness of their harmful thoughts and ideas, challenging them, and guiding them to more desirable ways of thinking.
CBT helps an individual who is experiencing extreme worry about a situation by recognising and calming the worry through a more constructive and peaceful way of thinking.
Cognitive Behaviour Therapy for Social Anxiety
Social anxiety, also called social phobia, is characterised by persistent severe anxiety in social settings, or even just thinking about the social settings. It is a typical problem that usually starts during the adolescence period. It is extremely disturbing and has a significant impact on life.
When there is a deficit in social skills, CBT helps individuals to learn and practice social skills. Therapy techniques include skills training and behavioural assignments to work at home.
Through continuous learning and practice of CBT techniques, the individual learns to become his/her own therapist. Cognitive behaviour therapy is an effective treatment method for social anxiety.
Cognitive Behaviour Therapy for Health Anxiety
Health anxiety is the persistent worry that one will contract a serious sickness or die from a serious illness, even though doctors have advised against this. Many people occasionally worry about their health, but health anxiety occurs when this fear becomes irrational, consumes a lot of time, and may adversely affect an individual’s functional, occupational and behavioural wellbeing.
Through cognitive restructuring, the individual gets the opportunity to take a closer look at the negative thought patterns which evoke anxiety. These patterns include overgeneralization, assuming the worst, giving too much importance to minor details, etc.
Cognitive Behaviour Therapy for Phobia
Phobia is an anxiety disorder in which the person feels irrational and develops excessive fear about a specific thing or situation. They may be overwhelmed by anxiety, dizziness, and other mental and physical symptoms related to fear even by mere thought about the situation. Specific phobia, social phobia, and agoraphobia are 3 types of phobias.
Phobias can be treated very easily when compared to other psychological disorders, and CBT is the best option with about an 80% success chance within 10 sessions.
CBT helps to unpair anxiety from feared situations through cognitive restructuring. The therapist helps the individual understand, challenge, and replace their negative thoughts with more realistic perceptions.
Exposure therapy and other behavioural techniques are used to reduce anxiety and prepare them to face their fears.
Cognitive Behaviour Therapy for Misophonia
Misophonia is the term used for aversion or dislike of sounds, particularly certain noises associated with eating and breathing, which is associated with negative emotional, physical and behavioural responses such as stress, muscle tension, and aggressive outbursts.
Cognitive behaviour therapy for misophonia-related suffering seeks to break the loop by assisting the person to examine and alter their negative cognitive processes. Techniques such as exposure to trigger sounds and response inhibition help in effectively managing the behaviour.
Cognitive Behaviour Therapy for Panic Disorder
Panic disorder is an anxiety disorder that leads to frequent, unexpected panic or dread episodes. Panic attacks are a symptom of panic disorder which is a sudden strong episode of intense fear and anxiety that triggers severe physical symptoms like increased heartbeat, fast breathing, and sweating. If someone has panic disorder, they may experience frequent, unplanned panic episodes and spend a lot of time living in continuous terror of another attack.
CBT guides people with panic disorder to learn how to control their symptoms. Even though having a panic attack is beyond a person’s control, they can successfully manage the symptoms with the help of proper CBT.
CBT uses problem-solving, relaxation methods, cognitive restructuring, and refocusing. Therapists teach coping mechanisms like breathing and relaxation techniques to help in the case of a panic attack.
Cognitive Behaviour Therapy for Chronic Pain
Chronic pain is severe, protracted pain in the body that has no apparent physical cause or that persists even after the physical reason has been treated. It can also produce despair, anxiety, and other symptoms that make it difficult for people to live normal lives. Although the cause of chronic pain is unknown, it is thought to be a psychological or neurological issue.
A combination of counselling, psychotherapy, and physical therapy is found to be effective in treating chronic pain.
CBT believes that individuals themselves create their experiences, not outside situations; so pain is also what we create in the brain. CBT helps the patient to change their view on pain. By changing negative thoughts and behaviours, patients can cope with pain better.
CBT helps to reduce stress related to pain and helps them learn better relaxation and coping skills. This eventually reduces pain and related symptoms including anxiety and depression.
Cognitive Behaviour Therapy for Obsessive Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is a chronic disorder characterised by uncontrollable, recurring thoughts (obsessions) and/or behaviours (compulsions). It triggers the person to repeat specific behaviour over and over. The obsession and compulsion may be related to any daily life activities or situations, thus making day-to-day life difficult for the patient and family members.
According to researchers, 75 – 80 % of OCD patients are significantly helped by CBT.
Exposure and Ritual Prevention is the most effective CBT technique for treating OCD. The patient is gradually exposed to objects, situations and thoughts which cause anxiety/obsession and is helped to reduce compulsive behaviours.
Cognitive Behaviour Therapy for Stress
Stress is a common phenomenon that occurs naturally. It involves complex relationships between mind, body, and environment and occurs as a result of physiological responses. Stress is not inherently bad, because everyone needs a certain optimal level of stress to remain alert and perform well.
CBT helps an individual to understand how particular thinking and behavioural trends may increase stress levels. It helps establish desirable thinking and behavioural patterns which equips the individual to identify stress-causing triggers and increases confidence and ability to deal with stressful situations more effectively.
Cognitive Behaviour Therapy for Post-Traumatic Stress Disorder (PTSD)
PTSD is a psychological disorder that happens in people who experienced or witnessed any traumatic events like natural disasters, accidents, violence, abuse, etc. They may have long-lasting, intense, disturbing feelings & emotions like fear, anger, thoughts, flashbacks, and nightmares related to their traumatic experience later in life. They may avoid situations that remind them of traumatic events.
Cognitive Behavioural Therapy for PTSD involves encouraging patients to evaluate their distorted thinking patterns.
Exposure to emotions, narratives and reminders that are associated with the trauma in a controlled environment helps to reduce avoidance and maladaptive association with trauma. Psychoeducation about trauma and relaxation techniques are also used as part of CBT.
Cognitive Behaviour Therapy for Postpartum Depression
Postpartum depression is a condition that begins 4 weeks after delivery, characterised by a complex combination of physical, emotional, and behavioural problems. During the pregnancy period, women may experience depression, anxiety, and stress symptoms. These conditions are collectively referred to as perinatal distress. These conditions in new moms become worsened by the demands for perfect parenting and intense parental standard.
The cognitive behaviour therapy technique helps people to explore their harmful thought processes and behaviour patterns. In CBT therapist helps to identify and replace such thoughts with more desirable ones.
Cognitive Behaviour Therapy for Personality Disorders
Personality disorders are characterised by a rigid and maladaptive pattern of thinking, behaving and acting. People having personality disorders often find it difficult to perceive and relate to people and situations. It may include 3 clusters with 10 types of disorders. Paranoid personality disorder, Schizoid personality disorder and Schizotypal personality disorder are included in cluster A and then Narcissistic personality disorder, Histrionic personality disorder, Antisocial personality disorder and Borderline personality disorder are included in cluster B. Dependent personality disorder, Obsessive-compulsive personality disorder and Avoidant personality disorder are included in cluster C.
CBT is an effective technique for treating personality disorders and it is based on the individual’s personality style being treated. The methods in CBT which are commonly used for personality disorders may include graded exposure to avoided situations, mindfulness training, restructuring of core beliefs, distress tolerance training, interpersonal skills training, emotion regulation training and experiential cognitive interventions.
Cognitive Behaviour Therapy for Somatic Symptom Disorder
Somatic symptom disorder is characterised by a persistent, severe lifelong history of various physical symptoms that are medically undiagnosed. The symptoms may include pain or fatigue that cause discomfort and inability. CBT facilitates long-lasting, clinically significant benefits.
Therapy focuses on stress management, activity regulation, emotional awareness, cognitive restructuring, and interpersonal communication. It helps the individual to identify and adapt to the beliefs and expectations about health and bodily symptoms. It also helps to learn how to cope with physical symptoms and the stress associated with them.
Cognitive Behaviour Therapy for Irritable Bowel Syndrome
Irritable bowel syndrome is a functional gastrointestinal disorder, which affects the digestive system as well as the large intestine. It alters how the muscle contracts and makes the digestive tract extremely sensitive. This causes constipation, diarrhoea, and stomach pain.
Cognitive behaviour therapy for Irritable Bowel Syndrome typically includes teaching the individual specific techniques for soothing the body, dealing with uncomfortable symptoms, and learning to confront challenging circumstances.
It focuses on addressing the cognitive and behavioural problems associated with IBS, and the techniques include exposure, stress management and mindfulness.
Cognitive Behaviour Therapy for Psychosis
In Psychosis, the individual becomes detached from reality. He/she could act in accordance with false beliefs they hold and also experience unreal sounds or images.
The primary step in cognitive behaviour therapy for psychosis is trying to understand what kinds of strange experiences a person is having and how long those experiences have been going on
The therapist guides the client to identify and reduce the distress associated with the symptoms of psychosis and helps him/her improve wellbeing. All of this is done while keeping in mind the person’s unique therapeutic goals.
Cognitive Behaviour Therapy for Schizophrenia
Schizophrenia is a psychotic disorder characterized by severe impairment in the perception of reality. The main symptoms of schizophrenia are hallucinations, delusions, disorganized thinking, disorganized speech & behaviour, unusual postures & movements, and negative symptoms like limited speech, social withdrawal, etc.
Although CBT alone is not effective for treating psychotic disorders like schizophrenia, CBT can be used along with medication to a large extent.
Cognitive behaviour therapy helps to reduce negative thoughts and cope with difficult situations that may otherwise worsen the condition. Most schizophrenic patients have comorbid conditions like depression, anxiety, post-traumatic stress disorder and substance use disorders. CBT can successfully be applied to treat such comorbid conditions. CBT helps as an agent of pharmacological treatment and helps to relieve symptoms and prevent relapses.
Cognitive Behaviour Therapy for Schizoaffective Disorder
Schizoaffective disorder is considered a mental health condition that is characterised by both mood disorder symptoms such as depression or mania, and schizophrenia symptoms like hallucinations or delusions. It is classified into – bipolar type and depressive type.
The fundamental goal of cognitive behaviour therapy is to assist a person with this disease to become more aware of erroneous thoughts and actions that may be causing symptoms and help develop more adaptive and sensible coping mechanisms.
Managing psychotic symptoms like delusions and hallucinations can also benefit from CBT.
Cognitive Behaviour Therapy for Alcohol Use Disorder
Alcohol use disorder is a condition when a person experiences an uncontrolled drive to consume alcohol. The terms “alcohol abuse,” “alcohol dependence,” “addiction,” and “alcoholism” are all used to describe conditions that are included in this category. Alcohol use disorder is regarded as a neurological condition and can range in severity from mild to severe. It is characterised by heavy or frequent alcohol use, even when it has negative effects like behavioural problems, physical injuries, emotional pain and discomfort.
Cognitive behavioural therapy helps to recognize the feelings and situations (also called ‘cues’ or ‘triggers’) which make one drink heavily. It changes the thought processes that lead to drinking and develops the skills to cope with the triggers.
In alcohol use disorder, CBT may be group therapy or individual therapy as per need.
Cognitive Behaviour Therapy for Substance Use Disorders
Substance use disorders are the continued use of psychoactive drugs despite their negative consequences. Alcoholism, marijuana usage, other substance addictions and abuse are included in this category. Substance abuse is the use of a substance that is damaging to the user or others around them. It depends on the type of substance, amount, or method of use. Substance dependence is a situation in which the person is compelled to reuse the drug because of the adaptive state developed through the consumption of psychoactive drugs that result in feelings of withdrawal. Drug addiction refers to a persistent and intense urge to use drugs despite the harm they cause.
CBT is widely used to treat substance use disorders along with other treatment methods including medication if needed.
Cognitive behaviour therapy helps to avoid false beliefs and insecurities that lead to addiction. Therapy aids in avoiding erroneous notions and fears that fuel addiction. By strengthening their self-control, CBT enables the individual to better cope with the triggers that lead to drug usage.
Additionally, comorbid problems including depression and stress are treated with CBT.
Cognitive Behaviour Therapy for Attention Deficit Hyperactive Disorder (ADHD)
Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that usually starts in childhood and often continues into adulthood. Children with ADHD have trouble paying attention and controlling impulsive behaviours.
CBT may not be effective against core problems of ADHD, but it is quite useful in regulating problems like procrastination, time management, etc. CBT guides the child to avoid negative thoughts about themselves and their condition and teaches strategies to fight comorbid depression, stress, and anxiety. CBT helps achieve self-control, enhances self-esteem, and improves the child’s behaviour.
Cognitive Behaviour Therapy for Oppositional Defiant Disorder (ODD)
The oppositional defiant disorder is a childhood disorder with persistent patterns of irritable mood, defiant behaviour and vindictiveness. Even if they may not have violent or aggressive behaviour, they will have a resentful attitude and tend to argue with authority figures including teachers and parents, also with peers and others. They like to blame others for their mistakes.
CBT as a treatment for ODD tries to replace defiance and irritable symptoms with calmness and positive thinking.
CBT identifies triggers of outbursts and helps the child to regulate emotions and use relaxation techniques. CBT equips the child with socially appropriate reactions to provoking situations.
Cognitive Behaviour Therapy for Stuttering
Stuttering, commonly referred to as stammering or childhood-onset fluency disorder, is a speech condition that often seriously impairs the natural flow and fluency of speech. The person who stutters is always aware of what they want to say yet finds it difficult to express it.
Cognitive behaviour therapy focuses on the biopsychosocial crises that stutterers encounter. The therapist exposes the individual to face the situation that triggers stuttering, like speaking in public, or in a simulated environment and examines the cognitive mistakes and the views of the observers. Based on this, the therapist slowly guides the individual to modify their self-focused behaviour over a series of CBT sessions.
Cognitive Behaviour Therapy for Procrastination
Procrastination is the practice of delaying or postponing things until the very last minute or after the due date. It is a failure in self-regulation characterized by an unreasonable delay in tasks though it may result in potentially negative consequences.
Techniques from cognitive behavioural therapy are designed to deal with these problems by altering thought processes, beliefs, and behavioural patterns. It teaches individuals to think objectively and realistically, which enables effective responses to difficult life circumstances. This raises the possibility that a person will get the right “dosage” of constructive thinking and behaviour.
Cognitive Behaviour Therapy for Grief
Grief is characterised by severe pain that accompanies loss. Grief is not just caused by the loss of a loved one, but it may also result from the serious illness of a family member, separation or a relationship breakup. It can affect the physical, emotional, spiritual, cognitive and behavioural aspects of an individual.
CBT channels individuals to change their negative thought patterns by learning to recognise them. This therapy is founded on the core idea that individual can reduce their symptoms and live more productive life by learning to manage their negative thoughts and behaviours.
Cognitive behaviour therapy for grief works by assisting the individual to become aware of unfavourable thought patterns and take actions to deal with the problematic thoughts, by learning to perceive the situation more clearly.
Cognitive Behaviour Therapy for Self-Esteem
Self-esteem is defined as how we see, value and perceive ourselves as well as our emotional states. It’s based on our overall opinion and how we feel about our strengths and weakness.
The goal of cognitive behaviour therapy treatment is to help the individual to understand how specific thoughts, behaviour, and emotional patterns keep them trapped in a cycle of low self-esteem. It teaches them how certain situations can trigger negative thought patterns and behaviours and how to prevent this from happening in the future.
CBT helps to find new ways of thinking and behaving that help to break free from feeling bad and develops the confidence that is required to feel good about ourselves.
Cognitive Behaviour Therapy for Anger Management
Anger is a negative emotional state with an increased predisposition towards thoughts of blame and aggressive behaviour. It is often triggered by frustration or interpersonal provocation.
In cognitive behaviour therapy, there is a broad range of questions and exercises that help an individual to understand the triggers which cause anger to become intense and lead to outbursts. Once the person gets insight regarding anger, provoking factors, and their root cause and consequence, the behavioural therapist can teach the techniques to control anger more effectively.
CBT for anger management may focus on replacing aggressive, undesirable behaviour with more adaptive and calm behaviour. Techniques commonly used for anger management may include deep breathing, muscle relaxation, cognitive restructuring, problem-solving, behavioural rehearsal, and assertive communication.
Cognitive Behaviour Therapy for Jealousy
Jealousy can be in any form. It may be between couples as usually seen or between colleagues or in any relationship or social situation. It basically stems from insecurity, suspicion of rejection, fear, anger or anxiety.
Cognitive behaviour therapy focuses on all the root causes of jealousy and guides the individual to alter the underlying negative thinking and emotional patterns to more positive thinking patterns.
Cognitive Behaviour Therapy for Driving Anxiety
Driving anxiety or Amaxophobia is the persistent fear of driving. It can cause serious distress and have a significant effect on a person’s daily living. Individuals with this condition may avoid being in a vehicle either as a passenger or as a driver.
Cognitive behaviour therapy focuses on facing the fearful situation by helping the individual to identify and alter the distorted thinking that causes irrational fear.
Cognitive Behaviour Therapy for Teens
The World Health Organization (WHO) defines teens as those individuals who are between 10 and 19 years of age. CBT has been found significantly beneficial to adolescents with a range of conditions, including but not limited to mood disorders, anxiety disorders, eating disorders, and problems with substance abuse.
Cognitive Behavioural Therapy for adolescents is a goal-oriented therapy that concentrates on looking at links between adolescents’ feelings, thoughts, and actions. It aims at altering their maladaptive habits and thought processes in order to avoid harmful effects on their mental health.
CBT helps teens to overcome negative thought patterns through cognitive restructuring. It equips them with effective coping skills to deal with distressing situations.
Cognitive Behaviour Therapy for Adults
The World Health Organization (WHO) defines an adult as someone older than 19 years old unless national legislation specifies an earlier age.
Cognitive behaviour therapy is an active process that focuses on current problems in a goal-oriented step-by-step method involving homework. Therapy aims at skill development for coping with difficult situations. Instead of blaming the situation, CBT helps patients to change their way of interpreting the situation to reduce distress.
Many studies found that CBT is effective against a variety of mental disorders like depression, anxiety, stress etc.
Summery
Cognitive behaviour therapy as the name suggests focuses on changing cognition and behaviour at the same time. CBT believes that our thoughts, emotions and behaviours are interconnected. It is our thoughts and ways of interpretation that play a major role in eliciting emotion and behaviour rather than the situation. CBT may not offer an instant cure to your problem but it can certainly give you the power to manage the situation most positively. Hope this content has helped you gain a brief insight into how cognitive behaviour therapy helps in dealing with varied psychological conditions.
References: https://prayatna.co.in/behavioral-therapy-everything-you-need/
Strategies for Dealing with Children’s Challenging Behaviours
