Cognitive therapy (CBT)

Cognitive therapy or cognitive behavior therapy

Cognitive/behavioral therapists help patients to change some of the patient's habitual modes of thinking about herself, her situation, and her future, change the negative styles of thinking and behaving often associated with depression.

Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. It involves recognising distorted thinking and learning to replace it with more realistic substitute ideas. Its practitioners hold that the cause of many (though not all) depressions are irrational thoughts. Cognitive therapy is often used in conjunction with mood stabilizing medications to treat bipolar disorder.

According to the U.S-based National Association of Cognitive-Behavioral Therapists:

"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."

Cognitive behavior therapy combines two very effective kinds of psychotherapy - cognitive therapy and behavior therapy.

Behavior therapy helps you weaken the connections between troublesome situations and your habitual reactions to them. Reactions such as fear, depression or rage, and self-defeating or self-damaging behavior. It also teaches you how to calm your mind and body, so you can feel better, think more clearly, and make better decisions.

Cognitive therapy teaches you how certain thinking patterns are causing your symptoms - by giving you a distorted picture of what's going on in your life, and making you feel anxious, depressed or angry for no good reason, or provoking you into ill-chosen actions. Cognitive behavior therapy* combines two very effective kinds of psychotherapy - cognitive therapy and behavior therapy.

"Behavioral" therapists help patients learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression.

Cognitive Therapy (CBT) for Depression

The first step in cognitive therapy is to learn to recognise cognitive distortions . At first you feel like your whole mind is a hypertext document and every thought you click on reveals some cognitive distortion. In cognitive therapy, depression is broken down into its symptom categories so that the tangible aspects can be identified.

Cognitive Factors in Depression

• Self-evaluation
• Identification of Skill Deficits
• Evaluation of Life Experiences
• Self-talk
• Automatic thoughts
• Irrational Ideas and Beliefs
• Overgeneralizing or Catastrophizing
• Cognitive Distortions
• Pessimistic Thinking

Negative thinking in depression can result from biological sources (i.e., endogenous depression), modeling from parents, or other sources. The depressed person experiences negative thoughts as being beyond their control. The cognitive therapist provides techniques to give the client a greater degree of control over negative thinking by correcting "cognitive distortions" or thinking errors that abet them in a process called cognitive restructuring.

Negative thoughts in depression are generally about one of three areas - negative view of self, negative view of the world, and negative view of the future. These comprise the cognitive triad.

Therapeutic Approach of Cognitive or Cognitive Behavioural Therapy

A major technique in cognitive therapy is the four column technique. It consists of a four step process. The first three steps analyze the process by which a person has become depressed or distressed. The first column records the objective situation. In the second column, the client writes down the negative thoughts which occurred to them. The third column is for the negative feelings and dysfunctional behaviors which ensued. The negative thoughts of the second column are seen as a connecting bridge between the situation and the distressing feelings. Finally, the fourth column is used for challenging the negative thoughts on the basis of evidence from the client's experience.

Cognitive therapy aims to help the client to become aware of thought distortions which are causing psychological distress, and of behavioural patterns which are reinforcing it, and to correct them. The objective is not to correct every distortion in a client's entire outlook - and after all, virtually everyone distorts reality in many ways - just those which may be at the root of distress. The therapist will make every effort to understand experiences from the client's point of view, and the client and therapist will work collaboratively with an empirical spirit, like scientists, exploring the client's thoughts, assumptions and inferences. The therapist helps the client learn to test these by checking them against reality and against other assumptions.

Throughout this process of learning, exploring and testing, the client acquires coping strategies as well as improved skills of awareness, introspection and evaluation. This enables them to manaage the process on their own in the future, reducing their reliance on the therapist and reducing the likelihood of experiencing a relapse.

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Site last updated: March 4, 2008

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