Cognitive Behavior Therapy

 Cognitive-Behavioral Therapy is the assumption that one’s beliefs, thoughts, ideals, and perceptual biases influence emotions and the intensity of those emotions affect the outcomes of the experiences we encounter. CBT is a form of psychotherapy that emphasizes the important role of thinking. How thinking influences in how we feel and what we then do in return. Aaron Beck, MD. Was the pioneering scientist who developed Cognitive Therapy. Beck states, “Memories of our experiences are stored and configured efficiently into structures called schemas. Schemas serve as filters for ongoing experience, allowing us to come to conclusions about events automatically. In Performance Coaching's leadership program we refere to this as "conditioning",  which leads to "scripts" that are acted upon automatically.

Dr. Beck outlines these factors in CBT with his clients:

• Automatic Thoughts - happen continuously throughout the day and it is our responsibility to improve upon the automatic thoughts that are contributing to eating disorders, depression, anger, etc.

• Conditional Beliefs (rules) - in cognitive therapy, an attempt is made to help you identify conditional rules and find more flexible healthy alternatives.

• Protective Behaviors - exposing oneself to behaviors which counter dysfunctional protective ones is a powerful part of cognitive therapy.

• Core Beliefs - Core beliefs are, in essence, our realities. These core beliefs play themselves out as scripts in our daily lives. Therefore, they are not as readily alterable as automatic thoughts (which are the products of core beliefs). In cognitive behavior therapy, the following techniques are used to help you identify and begin to improve and change core beliefs:

1. Thought monitoring and disputing - thought monitoring can be a good way to begin to understand core belief themes (by virtue of their frequency). As stated, altering automatic thoughts adds conflicting memories to the schema system which can alter core beliefs gradually in time.
2. Prescription of healthier, more flexible core beliefs - attempts are made to help you move away from certain behaviors and thinking which support dysfunctional core beliefs and toward healthier more balanced ones. Clients are encouraged to review evidence which supports healthier core beliefs frequently, and to also review evidence which supports dysfunctional core beliefs, disputing exaggerated or distorted “support.”
3. Experimenting healthier core beliefs - after a healthy substitute for a dysfunctional core belief is prescribed, it is important to plan “experiments” for ourselves, in which we enter situations “as if” the prescribed belief were true. These experiments can lead to outcomes that support the new belief, thus adding REAL conflicting memories to the system.
4. Reprocessing of old memories - cognitive therapy is not only useful in helping you dispute distortions in your every day life, but re-thinking old memories which have lead to dysfunctional core beliefs.  

The following information is found on the following web address provided by the National Association of Cognitive Behavioral Therapist (www.nacbt.com).  

Cognitive-behavioral therapy does not exist as a distinct therapeutic technique. The term "cognitive-behavioral therapy (CBT)" is a very general term for a classification of therapies with similarities.  There are several approaches to cognitive-behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy.

However, most cognitive-behavioral therapies have the following characteristics:

1. CBT is based on the Cognitive Model of Emotional Response.
    Cognitive-behavioral therapy is based on the idea that our thoughts
    cause our feelings and behaviors, not external things, like people, situations,
    and events.  The benefit of this fact is that we can change the way we think to
    feel / act better even if the situation does not change.

2. CBT is Briefer and Time-Limited.
    Cognitive-behavioral therapy is considered among the most rapid in terms of
    results obtained.  The average number of sessions clients receive (across all
    types of problems and approaches to CBT) is only 16.  Other forms of
    therapy,  like psychoanalysis, can take years.  What enables CBT to be briefer
    is its highly instructive nature and the fact that it makes use of homework
    assignments.  CBT is time-limited in that we help clients understand at the
    very beginning of the therapy process that there will be a point when the formal
    therapy will end.  The ending of the formal therapy is a decision made by the
    therapist and client.  Therefore, CBT is not an open-ended, never-ending
    process.

3. A sound therapeutic relationship is necessary for effective therapy, but
    not the focus.
    Some forms of therapy assume that the main reason people get better in
    therapy is because of the positive relationship between the therapist and
    client.  Cognitive-behavioral therapists believe it is important to have a good,
    trusting relationship, but that is not enough.  CBT therapists believe that the
    clients change because they learn how to think differently and they act on that
    learning.  Therefore, CBT therapists focus on teaching rational self-counseling
    skills.

4. CBT is a collaborative effort between the therapist and the client.
    Cognitive-behavioral therapists seek to learn what their clients want out of life
    (their goals) and then help their clients achieve those goals.  The therapist's
    role is to listen, teach, and encourage, while the client's roles is to express
    concerns, learn, and implement that learning.

5. CBT is based on aspects of stoic philosophy.
    Not all approaches to CBT emphasize stoicism.  Rational Emotive
    Behavior Therapy, Rational Behavior Therapy, and Rational Living
    Therapy emphasize aspects of stoicism.  Beck's Cognitive Therapy is not
    based on stoicism.   

    Cognitive-behavioral therapy does not tell people how they should feel.
    However, most people seeking therapy do not want to feel they way they have
    been feeling. The approaches that emphasize stoicism teach the benefits of
    feeling, at worst, calm when confronted with undesirable situations.  They also
    emphasize the fact that we have our undesirable situations whether we are
    upset about them or not.  If we are upset about our problems, we have two
    problems -- the problem, and our upset about it.  Most people want to have the
    fewest number of problems possible.  So when we learn how to more calmly
    accept a personal problem, not only do we feel better, but we usually put
    ourselves in a better position to make use of our intelligence, knowledge,
    energy, and resources to resolve the problem.

6. CBT uses the Socratic Method.
    Cognitive-behavioral therapists want to gain a very good understanding of
    their clients' concerns.  That's why they often ask questions.  They also
    encourage their clients to ask questions of themselves, like, "How do I
    really know that those people are laughing at me?"  "Could they be laughing
    about something else?"

7. CBT is structured and directive.
    Cognitive-behavioral therapists have a specific agenda for each session.
    Specific techniques / concepts are taught during each session.  CBT
    focuses on the client's goals.  We do not tell our clients what their goals
    "should" be, or what they "should" tolerate.  We are directive in the sense that
    we show our clients how to think and behave in ways to obtain what they
    want. Therefore, CBT therapists do not tell their clients what to do -- rather,
    they teach their clients how to do.

8. CBT is based on an educational model.
    CBT is based on the scientifically supported assumption that most emotional
    and behavioral reactions are learned.  Therefore, the goal of therapy is to
    help clients unlearn their unwanted reactions and to learn a new way of
    reacting. Therefore, CBT has nothing to do with "just talking".  People can "just talk" with anyone.

    The educational emphasis of CBT has an additional benefit as it leads to
    long term results.  When people understand how and why they are doing
    well, they know what to do to continue doing well.

9. CBT theory and techniques rely on the Inductive Method.
    A central aspect of Rational thinking is that it is based on fact. Often, we
    upset ourselves about things when, in fact, the situation isn't like we think it
    is.  If we knew that, we would not waste our time upsetting ourselves.

    Therefore, the inductive method encourages us to look at our thoughts as
    being hypotheses or guesses that can be questioned and tested.  If we find
    that our hypotheses are incorrect (because we have new information), then we
    can change our thinking to be in line with how the situation really is.

 10. Homework is a central feature of CBT.
      If when you attempted to learn your multiplication tables you spent only one
      hour per week studying them, you might still be wondering what 5 X 5
      equals.  You very likely spent a great deal of time at home studying your
      multiplication tables, maybe with flash cards.

      The same is the case with psychotherapy.  Goal achievement (if obtained)
      could take a very long time if all a person were only to think about the
      techniques and topics taught was for one hour per week.  That's why CBT
      therapists assign reading assignments and encourage their clients to
      practice the techniques learned.

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