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September 5, 2011 | by  | in Features |
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CBT: Teaching Old Cogs New Tricks

Cognitive behaviour therapy is based on the idea that people will progress better in therapy if they change their beliefs and responses to their environment.

It has a large number of variants, but the generalised term is CBT or CT (Cognitive Therapy). This article focuses on this umbrella concept as a whole rather than any one specific variant.

The focus of CBT is on the client’s beliefs, and how they apply those beliefs to events in their life. Essentially, the therapist aims to ensure the client’s actions and beliefs are optimally healthy—the person does not engage in ‘dysfunctional’ thinking. Dysfunctional thinking occurs when the beliefs you hold about the world distort reality, are unsupported by the evidence available to you or cause you to harm yourself/others, or feel distressed and immobilised. Dysfunctional thinking in general is seen to occur as a reaction to events in one’s life, as a part of the ABC model (see insert).

During therapy, which is generally given a static timeframe of 3-12 months, the therapist and client will work together in an attempt to change the client’s beliefs, in the view that those beliefs are the mitigating factor in the client’s problems. The therapist will give the client ‘homework’ and much of the therapy will in fact be self-directed—the client will attempt to address the situations in which they have trouble as they occur, outside of therapy, with the mental/emotional tools given by the therapist.

CBT has similar rates of success as with other forms of therapy. It does not seem to reduce the risk of relapse in psychiatric disorders, such as schizophrenia or bipolar disorder. What it does seem, from an outsiders’ perspective, to be useful for is for relatively minor personality problems which may cause anxiety or depression.

It interests me that the perspective of most of those who practise CBT compared to those who practise other forms of therapy, CBT has a unique perspective by focussing on beliefs. Surely other forms of therapy also examine the beliefs underlying events, and discuss how and why the clients acted in a given situation. As a result of the popularity of, and diversion of psychiatric funding into CBT, it has attracted some criticism as there is little data suggesting it is more effective than other forms of therapy. Indeed, there is arguably little data suggesting any one form of therapy is more effective than others, but rather going to therapy is more effective than not going to therapy! Most studies examining CBT compare CBT to taking psychiatric drugs for treatment, and in those cases CBT often will resolve the issue, and much faster than the drugs, when it comes to mood or anxiety disorders. So, while CBT may not be leagues ahead of other forms of therapy, it is still an effective form of therapy.

All in all, CBT does seem to be a very direct method of dealing with personal problems, if those problems are based on one’s beliefs. Because it involves very seemingly cold interpretations of how and why the client acts the way they do, coupled with treating the client’s life as a lesson they can give homework for, it may well be too direct for many people.

The ABC model of Cognitive
Behaviour Therapy

A: Activating event: A friend passed me in the street without acknowledging me
B: Beliefs about A: He’s ignoring me. He doesn’t like me
I am unacceptable as a friend, so must be worthless as a person
For me to be happy and feel worthwhile, people must like me
C: Consequence: Emotionally hurt and depressed. Behaviour changes to avoid people generally
‘A’ does not cause ‘C,’ but triggers off ‘B’ which in turn causes ‘C.’ ‘C’ may also then become the ‘A’ of another ABC model (e.g. the person may infer, from their avoidance of people, that they are weak (‘B’) and put themselves down (‘C’). CBT is heavily focused on intercepting beliefs at point B to affect point C

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  1. Hi!!!!!

    I fully agree with this post. This is my favorite post that i read today.

    Thanks

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