What is CBT?

What is Cognitive-Behavioral Therapy (CBT)?

CBT is a form of psychotherapy that emphasizes the importance of how we think (cognitions) on how we feel (emotions) and what we do (behaviors). Cognitive-behavioral therapists believe that when our brains are healthy, it is our thinking that causes us to feel and act the way we do. Therefore, if we are experiencing unwanted feelings and behaviors, it is important to identify the thinking that is causing the feelings / behaviors and to learn how to replace this thinking with thoughts that lead to more desirable reactions. 

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:

Cognitive-behavioral therapy is based on the scientific fact that our thoughts cause our feels and behaviors, not external things, like people, situations, and events. The benefit of this position is that we can change the way we think to feel / act better even if the situation has not changed.

Cognitive-behavioral therapy is considered among the “fastest” in terms of results obtained. For instance, the average number of sessions clients receive (across all types of problems) in my practice is only 16. Other forms of therapy, like psychoanalysis, can take years. What enables CBT to be briefer is its highly instructional nature and the fact that it makes use of homework assignments.

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 the relationship is not enough. CBT therapists believe that the client changes when they learn to think differently; therefore, CBT therapists focus on teaching rational self-counseling skills.

Cognitive-behavioral therapists seek to learn what their clients want out of life (goals) and then help their clients achieve those goals. The therapist’s role is to listen, educate, and encourage, while the client’s role is to speak, learn, and implement what he or she learns.

Cognitive-behavioral therapy does not tell people how to feel. However, most people seeking therapy do not want to feel the way they do. CBT teaches the benefits of feeling, at worst, calm when confronted with undesirable situations. It also emphasizes 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 sane people want to have the fewest number of problems possible.

Cognitive-behavioral therapists want to gain a very good understanding of their client’s concerns. That’s why they often ask questions. This process is sometimes known as guided discovery. 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?”

Cognitive-behavioral therapists have a specific agenda for each session. Specific techniques / concepts are taught during each session. CBT focuses on helping clients achieve the goals they have set collaboratively with their therapist. CBT is directive in that respect. However, CBT therapists do not tell their clients what to do – rather, they teach their clients how to do.

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. While CBT therapists do not present themselves as “know-it-alls,” the assumption is that if clients knew what the therapist had to teach them, the clients would not have the emotional / behavioral problems they are experiencing.

Therefore, CBT has nothing to do with “just talking.” People can “just talk” with anyone.

The educational emphasis of CBT has an additional benefit – it leads to long-term results. When people understand how and why they are doing well, they can continue doing what they are doing to make themselves well.  Viewed this way, it can be seen that CBT is also a self-help therapy.

A central aspect of Rational thinking is that it is based on fact, not simply our assumptions made. Often, we upset ourselves about things when, in fact, the situation isn’t like we thought it was. Had we known that, we would not have wasted our time upsetting ourselves.

Therefore, the inductive method encourages us to look at our thoughts as being hypotheses 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.

There are over 25 very common mental mistakes that people make that cause them to not have the facts straight.

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 flashcards.

The same is the case with psychotherapy. Goal achievement (if obtained) could take a very long time if all a person thought about were the techniques and topics taught for only 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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