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An Introduction to Cognitive Behavioural Therapy (CBT)

by Anne Ueberbach
Assistant Director/Counsellor

CBT is known for its effectiveness in treating a wide range of psychological disorders (such as Depression, Anxiety, Post-Traumatic Stress Disorder (PTSD) and Eating Disorders), chronic pain, addiction, stress management, low self-esteem and relationship issues. CBT offers practical tools and strategies to help individuals overcome challenges, breaking free from negative thought patterns and leading fulfilling lives.

What is CBT

CBT is a widely used form of psychotherapy that focuses on identifying and changing negative or harmful thought patterns that can influence behaviours and emotions. It is a structured, time-limited therapy that is typically goal-oriented and problem-focused. CBT's strength lies in its ability to provide individuals with tools to modify their thoughts and behaviours, leading to improved mental health and well-being. It empowers individuals to become their own therapists, with skills that can be applied to current problems and future challenges.

The cognitive model of CBT posits that our perceptions of events determine our emotional responses. According to this model, individuals develop core beliefs and automatic thoughts based on their past experiences, upbringing, and societal influences. These cognitive distortions (also known as unhelpful thinking styles), such as black-and-white thinking, catastrophizing, and overgeneralization, can contribute to the development and maintenance of psychological problems.

Key Principles of CBT

CBT is based on several core principles that guide the therapeutic process. These include:

  • Psychological problems are based on unhelpful thinking styles

  • Psychological problems are based on learned patterns of unhelpful behaviours

  • People struggling with psychological problems can learn helpful coping mechanisms to relieve their symptoms and becoming more effective in their lives.

  • The primary focus is on the present moment

Therapeutic Techniques used in CBT

CBT encompasses a diverse array of therapeutic techniques designed to address unhelpful or irrational cognitive and behavioural patterns. Your therapist will apply the appropriate technique(s) based on your personal circumstances and needs. Commonly used strategies include:

For Cognitive Patterns

  • Cognitive Restructuring - This technique involves identifying and challenging negative or irrational thoughts that contribute to emotional distress. Through guided questioning and evidence-based reasoning, individuals learn to reframe their thinking and adopt more balanced and constructive perspectives.

  • Journaling – Journaling about one’s moods and thoughts is a great technique to identify thought patterns and emotional tendencies. Journals may also be used to keep track of the time of the mood/thought, source of origin / stressor, intensity and reaction.

  • Confidence Building – Empowering clients through learning to develop a greater sense of confidence in one’s own abilities. 

For Behavioural Patterns

  • Role Play -  Role play can be used to prepare clients for potentially difficult or problematic interactions with others. It can also be used to demonstrate a more helpful or more rational behavioural response in specific social settings.

  • Exposure Therapy - Exposure therapy is a behavioural technique used to treat anxiety disorders by gradually exposing individuals to feared situations or stimuli in a controlled manner. Through repeated exposure and habituation, individuals learn to tolerate and eventually overcome their fears, leading to a reduction in anxiety symptoms.

  • Activity Scheduling - Activity scheduling involves structuring one's daily routine to incorporate enjoyable and meaningful activities. By scheduling pleasurable activities and setting achievable goals, individuals can combat feelings of lethargy and apathy often associated with depression and other mood disorders.

  • Relaxation Techniques: CBT often incorporates relaxation techniques, such as relaxed deep breathing, progressive muscle relaxation, and mindfulness meditation to reduce stress.

CBT also often involves assigning clients homework. Homework is strategically created by the therapist to correct and lessen the client's psychopathology. The purpose of these exercises is to allow the patients to practice and reinforce the skills learned in therapy sessions in real life.

Where can CBT be Applied?

CBT has demonstrated efficacy in treating a wide range of psychological disorders, both as a standalone treatment and in conjunction with other therapeutic modalities. Some of the common mental health conditions treated with CBT include:

Depression
CBT has been proven to be highly effective in treating depression by addressing negative thought patterns, increasing activity levels, and fostering problem-solving skills. Research has shown that CBT is as effective as antidepressant medication in reducing depressive symptoms and preventing relapse.

Anxiety Disorders
By challenging catastrophic thinking and gradually confronting feared situations, individuals can learn to manage anxiety and regain a sense of control.

Obsessive-Compulsive Disorder (OCD)
Exposure and response prevention (ERP) is highly effective in treating OCD by helping individuals confront and resist compulsive behaviours. Through repeated exposure to obsessional triggers and prevention of compulsive rituals, individuals can reduce the frequency and intensity of obsessions and compulsions.

Post-Traumatic Stress Disorder (PTSD)
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) are effective in treating PTSD by processing traumatic memories and reducing associated symptoms such as flashbacks, nightmares, and hypervigilance.

Substance Use Disorders
CBT is widely used in the treatment of substance use disorders, helping individuals identify triggers, develop coping skills, and prevent relapse. Through techniques such as motivational interviewing and relapse prevention, individuals can achieve and maintain sobriety.