When it comes to figuring out the type of therapy best suited for your needs, you may find yourself in murky waters when trying to decipher different therapeutic styles. Each post in this series serves as a primer on a major therapeutic approach to guide you in the right direction. It is important to note that many clinicians identify as integrative rather than adhering to a single school of thought, though there are some that stick to one orientation over others. Even within one school of thought, however, the individual therapist inevitably brings their own unique style to the work, so nothing here is cut and dry. Additionally, on the whole, research has shown support for success with all major schools of thought! So even if you feel unsure about what style is suited for you, with a good therapy relationship you should be positioned for success.
Cognitive-Behavioral Therapy (CBT) is a widely utilized therapeutic orientation and has grown tremendously over the last few decades. Aaron Beck, MD is considered the father of modern CBT and its structured, scientific, and organized approach to problem-solving. CBT involves an emphasis on education to improve self-awareness and develop coping strategies for achieving behavioral change and more positive feelings. CBT tends to focus not on HOW your struggles came to be, but more exclusively on understanding how these struggles manifest and what you can do to change -- it is heavily goal-oriented. Many clinicians integrate CBT with other therapeutic approaches, as it is a great framework for short-term symptom reduction within the context of a deeper insight-oriented therapy.
CBT techniques focus on the links among thoughts, feelings, and behavior; at its core, CBT hones in on irrational, negative, and distorted thinking patterns (see: "thinking traps"), which connect to low mood and unhelpful behavioral patterns. The therapist first works with the client to identify unhelpful thinking patterns that support low mood and maladaptive behaviors. Next, the clinician provides a model of ways to effectively challenge and alter those cognitive patterns to achieve reduction of anxiety, depression, or other mental health struggles. Importantly, clients are encouraged to adapt and continue using CBT strategies to help maintain their well-being even after the therapy is finished.
In CBT, structure is important both within therapy sessions as well as during the days between in the form of homework assignments. A typical session of CBT involves completing an objective questionnaire to assess the client's mood, setting an agenda to determine what issues will be discussed, review of prior session, joint problem-solving and discussion of agenda topics, followed by a review of how the session went. CBT ranges from as few as 6 weekly appointments up to 20 depending on need, with follow up booster sessions after the course of therapy is complete. CBT has been found to be effective with many presenting problems, and it is especially well-suited (and researched backed) for anxiety disorders, somatoform disorders (psychological problems manifesting in physical symptoms), bulimia, anger problems, and general stress (Hofmann et al., 2012).
If you are looking for quick symptom reduction, coping skill development, and a straightforward, structured therapy approach, CBT is an excellent option for your treatment. If you like the principles of CBT but also want a deeper, insight-oriented approach, keep an eye out for clinicians who integrate CBT with other forms of therapy, such as psychodynamic, interpersonal, and existential. CBT is quite user-friendly; if you are experiencing more mild to moderate symptoms or can't access a CBT therapist, you can find a number of self-help books based in CBT principles that may offer you some relief (see resource list).
What are your thoughts about CBT? Share any questions or comments below!
Some other resources to learn more about CBT:
More About CBT
Socratic Questioning in CBT
Self-Help CBT Book List
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. http://doi.org/10.1007/s10608-012-9476-1
Dr. Bethany Detwiler is a psychologist practicing in Allentown, PA. She specializes in mood and relationship struggles. She also is an adjunct professor of counseling at Lehigh University.