Cognitive behavioral therapy is an approach used by psychotherapists to influence a patient’s behaviors and emotions. The key to the approach is in its procedure which must be systematic. It has been used successfully to treat a variety of disorders including eating disorders, substance abuse, anxiety and personality disorders. It can be used in individual or group therapy sessions and the approach can also be geared towards self help therapy.
Cognitive behavioral therapy is a combination of traditional behavioral therapy and cognitive therapy. They are combined into a treatment that is focused on symptom removal. The effectiveness of the treatment can clearly be judged based on its results. The more it is used, the more it has become recommended. It is now used as the number one treatment technique for post traumatic stress disorder, obsessive compulsive disorder, depression and bulimia.
Cognitive behavioral therapy first began to be used between 1960 and 1970. It was a gradual process of merging behavioral therapy techniques and cognitive therapy techniques. Behavioral therapy had been around since the 1920’s, but cognitive therapy was not introduced until the 1960’s. Almost immediately the benefits of combining it with behavioral therapy techniques were realized. Ivan Pavlov, with his dogs who salivated at the ringing of the dinner bell, was among the most famous of the behavioral research pioneers. Other leaders in the field included John Watson and Clark Hull.
Instead of focusing on analyzing the problem like Freud and the psychoanalysts, cognitive behavioral therapy focused on eliminating the symptoms. The idea being that if you eliminate the symptoms, you have eliminated the problem. This more direct approach was seen as more effective at getting to the problem at hand and helping patients to make progress more quickly.
As a more radical aggressive treatment, behavioral techniques dealt better with more radical problems. The more obvious and clear cut the symptoms were, the easier it was to target them and devise treatments to eliminate them. Behavioral therapy was not as successful initially with more ambiguous problems such as depression. This realm was better served with cognitive therapy techniques.
In many academic settings, the two therapy techniques were used side by side to compare and contrast the results. It was not long before the advantages of combining the two techniques became clear as a way of taking advantage of the strengths of each. David Barlow’s work on panic disorder treatments provided the first concrete example of the success of the combined strategies.
Cognitive behavioral therapy is difficult to define in a succinct definition because it covers such a broad range of topics and techniques. It is really an umbrella definition for individual treatments that are specifically tailored to the problems of a specific patient. So the problem dictates the specifics of the treatment, but there are some common themes and techniques. These include having the patient keep a diary of important events and record the feelings and behaviors they had in association with each event. This tool is then used as a basis to analyze and test the patient’s ability to evaluate the situation and develop an appropriate emotional response. Negative emotions and behaviors are identified as well as the evaluations and beliefs that lead to them. An effort is then made to counter these beliefs and evaluations to show that the resulting behaviors are wrong. Negative behaviors are eliminated and the patient is taught a better way to view and react to the situation.
Part of the therapy also includes teaching the patient ways to distract themselves or change their focus from something that is upsetting or a situation that is generating negative behavior. They learn to focus on something else instead of the negative stimulus, thus eliminating the negative behavior that it would lead to. The problem is essentially nipped in the bud. For serious psychological disorders like bipolar disorder or schizophrenia, mood stabilizing medications are often prescribed to use in conjunction with these techniques. The medications give the patient enough of a calming effect to give them the opportunity to examine the situation and make the healthy choice whereas before they could not even pause for rational thought.
Cognitive behavioral therapy has been proven effective for a variety of problems, but it is still a process, not a miracle cure. It takes time to teach patients to understand situations and identify the triggers of their negative behaviors. Once this step is mastered, it still takes a lot of effort to overcome their first instincts and instead stop and make the right choices. First they learn what they should do, and then they must practice until they can do it.
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