What is Cognitive Behavioral Therapy?

As society becomes more open about mental health and therapy, you may have heard the term “CBT.”  Cognitive behavioral therapy, or CBT for short, is an approach to counseling that is used by many counselors – but what does it actually mean? To put it simply, CBT is based on the idea that the way that we feel and behave is determined not by our circumstances or situations, but by how we think about our circumstances and situations. To better understand this, let’s look at an example. Let’s say you’re walking down the hallway at work and a coworker who is usually friendly with you passes by without even acknowledging you. One way to think about this situation might be, “How dare they not even acknowledge my existence! They are so rude!” As a result, you might feel angry, then choose to ignore your coworker and refuse to talk to them. Another way to think about this situation might be, “Oh no, I must have done something wrong to offend them. This is all my fault!” As a result, you might feel rejected or embarrassed, then either go and profusely apologize to your coworker or hide in shame from them. A third way to think about this situation might be, “That’s odd. They must have a lot on their mind today. I should check on them and make sure they’re doing ok.” As a result, you might feel concerned but calm, then reach out to your coworker and give them an opportunity to share what’s on their mind. Same situation, three different outcomes. The only difference is the thought or belief about the situation. CBT is especially popular in counseling because it is one of the most evidence-based approaches, meaning that there is a lot of research and evidence out there showing that it’s an effective way to reduce symptoms and suffering. When used effectively, it can even alleviate symptoms fairly quickly compared with other therapeutic approaches. Many people also appreciate the empowerment that CBT offers through psychoeducation, meaning that clients learn the information, awareness, and skills that they need to be able to use this approach on their own, even outside of therapy.

What is CBT Helpful With?

CBT has been shown to be effective with a wide variety of concerns,  including:
  • Anxiety
  • Stress
  • Depression
  • Trauma
  • Anger
  • Chronic Pain/Illness
  • Work and School Problems
  • Marriage and Family Issues
  • And much more!

So How Does CBT Work?

The first step is becoming aware of our “automatic thoughts,” or the first thoughts that come into our minds when something happens. Often these thoughts are irrational, negative, or simply unhelpful such as only focusing on the negatives, expecting the worst, jumping to conclusions, or all-or-nothing thinking. From here, there are a few approaches we can use, depending on the thoughts and the situation. The first and most simple option is to simply ask ourselves, “Is this really the best way to see this situation or is there another perspective?” The goal is to open our minds to perspectives that might be more rational, more realistic, more positive, and/or less distressing than our original automatic thought. This does not mean simply looking for a sugar-coated feel-good explanation, but one that is also grounded in reality. A second option is to put our thoughts on trial. Imagine the courtroom scene in one of those popular true crime shows. First, the witnesses describe as factually and truthfully as possible what actually happened. In CBT, this means recalling the who, what, when, where, and how of the situation, being as honest and unbiased as you can. Second, any external circumstances are considered. In CBT, this means taking a step back and looking at anything else outside of you that could have influenced or contributed to what happened. Third, the prosecution and defense present their evidence. In CBT, this means looking for the actual evidence that either supports or refutes your irrational, negative, or unhelpful thought. Finally, the jury reviews all the evidence and decides whether to support the prosecution or the defense. In CBT, this means gathering up all the information you’ve collected and deciding whether to believe your irrational, negative thought about what happened, or to believe a more realistic, often more positive, one. A few other questions we can ask ourselves are:
  • “Is my thought based on actual facts or just my feelings?”
  • “Am I looking at all the facts or only what supports my initial thought?”
  • “Could I be misinterpreting anything or making any assumptions?”
  • “Could I be exaggerating anything? Is my thought likely to happen or is it the worst case scenario that is not actually likely to happen?”
  • “How would someone else see or interpret this situation?”
As is often the case, all of this is easier said than done. However, there is hope that with regular intentional practice, you actually can change your thoughts, thereby changing your feelings and behaviors. In the same way that you can’t wake up one day and run a marathon without any physical practice, you can’t wake up one day and start thinking more positively and realistically without any cognitive practice. It will take regular training, but it’s  possible! To help learn this process and gain help in becoming more aware of your thoughts, contact us today! – By Angie Masinde, LLPC, ATR-P