Cognitive Behavioural Therapy (CBT) is the current culmination of several other therapies, in particular:
• Cognitive therapy – focusing on a client’s thoughts and how they feel on the inside
• Behavioural therapy – focusing on how a client acts and reacts to certain situations
The philosophy behind CBT is that the client’s problem is not the problem itself; the client’s problem is actually their attitude towards the problem.
The theory states that our behaviours are the product of our thought patterns, how we respond to our feelings and physical bodily sensations, in relation to the situation we are in, and that these aspects all interact with each other, in both good and bad ways.
For example, negative thoughts can trigger a negative emotional response, which could then create unpleasant physical sensations in the body and make the person feel ill, which then reinforces the negative thoughts which continue to go around and around in their head, and the cycle continues, and may well get worse. The key to CBT being successful is the belief that thoughts are not facts, bodily reactions can be interpreted several different ways, emotions do not have to be acted upon, behaviours can be changed wilfully, and thus the cycle that reinforces itself with negativity can be broken.
The therapeutic goals of CBT are essentially for the client and counsellor to work out which cognitive distortions are causing the client the most problems, and then working out together how the client can change those behaviours. The relationship between counsellor and client is thus collaborative, but more like that of a teacher and student than other therapies. The counsellor teaches the client various techniques, which include things such as journaling, mindfulness and thought exercises, with the aim to restructure cognitive distortions. Another commonly used technique is to do “homework” experiments out in the real world, which are tailored to the individual client and designed to challenge skewed core beliefs.
CBT is very much rooted in the present, with an eye towards the future, and progress is often measured numerically with questionnaires over the course of therapy. This makes improvements in mood easy to spot. A client’s past may well be brought up, but it is not necessarily examined thoroughly for the causes or explanations of their unwanted behaviour.
