What constitutes cognitive behavioral therapy?

Cognitive behavioral therapy is a psychotherapeutic approach that aims to teach a person new skills on how to solve problems related to dysfunctional emotions, behaviors, and cognitions through a systematic and goal-oriented approach. This title is used in many ways to differentiate behavioral therapy, cognitive therapy, and therapy that is based on cognitive and behavioral therapies. There is empirical evidence showing that cognitive behavioral therapy is quite effective in treating various conditions, including personality, anxiety, mood, eating, substance abuse, and psychotic disorders. Treatment is often manual, as specific psychological commands are treated with short, direct, time-limited treatments based on specific techniques.

Cognitive behavioral therapy can be used both with individuals and in groups. The techniques are often adapted for self-help sessions as well. It is up to each individual clinician or researcher whether he/she is more cognitively oriented, more behaviorally oriented, or a combination of both, as all three methods are used today. Cognitive behavioral therapy was born from a combination of behavioral therapy and cognitive therapy. These two therapies have many differences, but found common ground by focusing on the “here and now” and symptom relief.

Evaluation of cognitive behavioral therapy has led many to believe that it is more effective than psychodynamic treatments and other methods. The UK advocates the use of cognitive behavioral therapy over other methods for many mental health difficulties, including post-traumatic stress disorder, obsessive-compulsive disorder, bulimia nervosa, clinical depression, and the neurological condition chronic fatigue syndrome /myalgic encephalomyelitis. The forerunners of cognitive behavioral therapy draw their roots from various ancient philosophical traditions, especially Stoicism. The modern roots of CBT can be traced back to the development of behavioral therapy in the 1920s, the development of cognitive therapy in the 1960s, and the subsequent merger of the two therapies. The first behavioral therapeutic approaches were published in 1924 by Mary Cover Jones, whose work dealt with the unlearning of fears in children.

Early behavioral approaches worked well with many of the neurotic disorders, but not so well with depression. Behavioral therapy was also losing popularity due to the “cognitive revolution.” This eventually led to Aaron T. Beck founding cognitive therapy in the 1960s. The first form of cognitive behavioral therapy was developed by Arnold A. Lazarus during the period between the late 1950s and the 1970s. During the 1980s and 1990s, cognitive and behavioral therapies were combined thanks to the work done by David M. Clark in the United Kingdom and David H. Barlow in the United States. Cognitive behavioral therapy includes the following systems: cognitive therapy, rational emotive behavioral therapy, and multimodal therapy. One of the biggest challenges is defining exactly what cognitive behavioral therapy is. The particular therapeutic techniques vary within the different approaches to CBT depending on the type of problem being treated, but the techniques generally focus on the following:

• Keep a journal of significant events and associated feelings, thoughts, and behaviors.
• Question and test cognitions, evaluations, assumptions, and beliefs that may be unrealistic and unhelpful.
• Gradually facing activities that may have been avoided.
• Try new ways of behaving and reacting.

Additionally, distraction, mindfulness, and relaxation techniques are also commonly used in cognitive behavioral therapy. Mood-stabilizing medications are also often combined with therapies to treat conditions such as bipolar disorder. NICE guidelines within the British NHS recognize the application of cognitive behavioral therapy in the treatment of schizophrenia in combination with medication and therapy. Cognitive behavioral therapy typically takes time for patients to implement effectively into their lives. It usually takes a concentrated effort for them to replace a dysfunctional cognitive-affective-behavioral process or habit with a more reasonable and adaptive one, even as they recognize when and where their mental processes fail. Cognitive behavioral therapy is applied to many different situations, including the following conditions:

• Anxiety disorders (obsessive-compulsive disorder, social phobia or social anxiety, generalized anxiety disorder)
• Mood disorders (clinical depression, major depressive disorder, psychiatric symptoms)
• Insomnia (including being more effective than the drug Zopiclone)
• Serious mental disorders (schizophrenia, bipolar disorder, major depression)
• Children and adolescents (major depressive disorder, anxiety disorders, symptoms of trauma, and post-traumatic stress disorder)
• Stuttering (to help them overcome anxiety, avoidance behaviors, and negative thoughts about themselves)

Cognitive behavioral therapy involves teaching a person new skills to overcome dysfunctional emotions, behaviors, and cognitions through a systematic, goal-oriented approach. There is empirical evidence showing that cognitive behavioral therapy is effective in treating many conditions, including obsessive-compulsive disorder, generalized anxiety disorder, major depressive disorder, schizophrenia, anxiety, and negative thoughts about oneself) . With the great amount of success demonstrated by the use of this therapy, it is one of the most important tools that researchers and therapists have to treat mental disorders today.