COGNITIVE BEHAVIORAL THERAPY
Cognitive Behavioral Therapy
The evidence-based counseling practice I chose to research is cognitive behavioral therapy (CBT). It is a form of psychotherapy or “talk” therapy. It is a term for many different therapies that share common elements. Two of the earliest forms of this was Rational Emotive Behavior Therapy (REBT), developed by Albert Ellis in the 1950’s, and Cognitive Therapy (CT), developed by Aaron T. Beck, in the 1960’s.
Rational Emotive Behavior Therapy
Rational Emotive Behavior Therapy focuses on resolving emotional and behavioral problems. The goal of this is to change irrational beliefs to more rational ones. Albert Ellis proposed that each of us hold a unique set of assumptions about ourselves and the world that serve to guide us through life and determine our reactions to the various situations we encounter (McLeod S.A. 2015).
According to Ellis, “people can hold irrational assumptions about themselves or the world. Some of these common irrational assumptions are: The idea that one should be competent at everything, the idea that it is catastrophic when things are not the way you want them to be, the idea that people have no control over their happiness, the idea that you need someone stronger than yourself to be dependent on, the idea that your past history greatly influences your present life, and the idea that there is a perfect solution to human problems, and it’s a disaster if you don’t find it” (McLeod S.A. 2015).
There was an interesting exercise that Albert Ellis called the ABC Technique of Irrational Beliefs. There are 3 columns on a sheet, the first column is the Activating Event, the second is Belief and the third is Consequences. It helps analyze the process of which a person has developed irrational beliefs. The Activating event column is where the client writes down the event that led to some type of high emotional response or negative dysfunctional thinking. The Beliefs column is where the client writes down what negative thoughts occurred to them. The Consequences column is where the client writes down negative feelings and dysfunctional behavior that followed after the event.
The negative thoughts of the second column are used as a connecting bridge between the situation and the distressing feelings. Using this exercise, Ellis believed that “it is not the activating event that causes negative emotional and behavioral consequences, but that a person interprets these events unrealistically and develops an irrational belief system that helps cause the consequences” (McLeod S.A. 2015).
Aaron T. Beck’s approach, Cognitive Therapy, is similar to Albert Ellis’ but has been most widely used for depression. Cognitive therapy helps clients to recognize negative thoughts and errors in logic that can cause them to be depressed.
“Beck identified three mechanisms that he thought were responsible for depression, these are: The cognitive triad, Negative schemas, and errors in logic. The cognitive triad are three forms of negative thinking: negative thoughts about the self, the world and the future. As these three components interact, they interfere with normal cognitive processing, leading to impairments in perception, memory and problem solving” (McLeod S.A. 2015).
“Beck believed that depression prone individuals develop a negative self-schema, basically they possess a set of beliefs about themselves that are negative. He identified several illogical thinking processes, they can be self- defeating and cause great anxiety or depression for an individual:
Arbitrary interference- drawing conclusions without sufficient evidence or without any evidence at all.
Selective abstraction- focusing on a single aspect of a situation and ignoring others.
Magnification- exaggerating the importance of undesirable events.
Minimization- it’s kind of like the opposite of magnification so underplaying the significance of an event.
Overgeneralization- drawing broad negative conclusions based on a single insignificant event.
Personalization- attributing the negative feelings of others to yourself” (McLeod S.A. 2015).
Cognitive Behavioral Therapy helps you to become aware of inaccurate or negative thinking, so you can view challenging situations more clearly and respond to them in a more effective way. It can be a helpful tool in treating mental health disorders or for anyone who needs help to learn how manage stressful life situations. It is a common and preferred type of psychotherapy because it can help you quickly identify and cope with specific challenges.
Cognitive Behavioral Therapy Uses
“It is useful with: Addressing emotional challenges, managing symptoms of a mental illness, prevention of a relapse of mental illness symptoms, coping with a medical illness,
treating a mental illness when medications aren’t a good option, identifying ways to manage emotions, resolving relationship conflicts, and teaching ways to communicate more effectively” (Cognitive Behavioral Therapy 2017).
I chose to research this approach because it seems like it can be very effective method and it is used to address several issues or concerns. It is a method of helping people address their negative thinking and the behaviors that stem from it and help them develop healthy coping skills if they are going through something stressful or traumatic. What I like about it is that it can be used to treat multiple disorders and problems that people may face throughout life. It is the most widely used evidence-based practice for mental health. It is based on a combination of basic principles from behavioral and cognitive psychology.
There are many different types of cognitive behavioral therapy, some of these are: Brief cognitive behavioral therapy which is used if there is a limited amount of time, cognitive emotional behavioral therapy which combines some aspects of cognitive behavioral therapy and dialectical behavioral therapy and it works to improve understanding and tolerance of emotions. This can be used as a pretreatment for long-term therapy. There is also structured cognitive behavioral therapy which works to bring a client to a specific result in a certain amount of time, stress inoculation training, this works to help clients better cope with stress or anxiety after stressful events, it is interesting because it involves a three phase process that helps clients learn to use skills they already have to better adapt to their current stressors (Cognitive Behavioral Therapy 2018).
Effectiveness of CBT
I also looked up how effective cognitive behavioral therapy is or can be and came across a mix of reviews. Some research suggests that it has shown to be very effective and most effective when combined with medications. Other research showed that even though it has become a more common model of therapy, the effectiveness of it has declined over the last few years.
“In a 2014 eight- week clinical study, conducted by Sweden’s Lund University, it was concluded that cognitive behavioral therapy was no more effective than mindfulness-based therapy for those suffering from depression and anxiety” (Lyford 2016).
In another study conducted by psychologist Tom Johnsen and Oddgeir Friborg, they concluded that “the effects of cognitive behavioral therapy have declined linearly and steadily since the introduction, as measured by patients’ self-reports, clinician’s ratings, and rates of remission. According to Johnsen, just seeing a decrease in symptoms doesn’t translate into greater wellbeing” (Lyford 2016). “In 2012, Sweden’s National Board of Health and Welfare, concluded after a two-year trial period, that cognitive behavioral therapy had no noticeable advantage over alternative therapies and that increasing numbers of clients were dropping out of treatment after finding it ineffective” (Lyford 2016).
There are mixed reviews about this approach, it has been shown to be more effective in treating some mental disorders than other approaches while other approaches seemed to be more effective for others. “There is still a clear need for high quality studies examining the efficacy of CBT. Many of the meta-analytic studies included studies with small sample sizes or inadequate control groups and except for children and elderly populations, no meta-analytic studies of CBT have been reported on subgroups such as ethnic minorities and low-income samples (Steven G. Hofmann 2012).
This surprised me because while learning about this approach, it seemed like it could be useful and after learning about some of the studies about it, it seems like it is effective but maybe not more than other approaches and it depends on what kind of problem the person is going through, different approaches could be more effective for different situations. There is also a lot of information about it and there are many approaches or methods that are based off of cognitive behavioral therapy and to me that is so interesting because it seems like a flexible approach that focuses on working on people’s negative thought processes or illogical thought processes and helping them develop healthier thought processes which can help change some of the behaviors a person has or wants to change.
BIBLIOGRAPHY Cognitive Behavioral Therapy . (2017, December). Retrieved from mayoclinic.org: https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610
Cognitive Behavioral Therapy. (2018, May). Retrieved from Wikipedia: https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy
Lyford, C. (2016, January ). Is Cognitive Behavioral Therapy as Effective as Clinicians Believe? Retrieved from psychotherpaynetworker.org: https://www.psychotherapynetworker.org/blog/details/705/is-cognitive-behavioral-therapy-as-effective-as-clinicians
S.A., M. (2015). Cognitive Behavioral Therapy. Retrieved from Simplypsychology: https://www.simplypsychology.org/cognitive-therapy.html
Steven G. Hofmann, A. F. (2012, July ). The Efficacy of Cognitive Behavioral Therapy: A review of meta-analyses . Retrieved from NIH.gov: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/