Cognitive Behavior Therapy (CBT)

Cognitive-behavioral therapy, or CBT, is an evidence-based form of talk therapy. CBT’s central focus is on changing negative patterns of thinking and behaving. CBT is centered on the idea that thoughts are connected to feelings, and feelings are connected to behaviors. Thus, negative thought patterns can lead to difficult emotions, which can drive negative behaviors. CBT aims to help individuals improve their overall mental health through increasing their ability to identify, challenge, and change their negative patterns.

CBT is commonly used in individual therapy sessions, yet it can also be adapted to fit group therapy settings. Sessions are typically 50 to 60 minutes and held on a weekly basis. Cognitive behavioral therapy tends to be short term – typically 12 to 20 sessions, although length of treatment can vary depending on the individual.

A CBT therapist works with clients to help increase awareness of negative thought patterns and unhealthy behaviors. Once clients can better identify their patterns, they work with the therapist to develop tools and skills to change them. While there are many approaches to challenging and changing negative thought/behavior patterns, one of the central methods inherent to CBT is homework. Homework can help clients continue to make progress in between sessions, as well as solidify and practice skills in "real world" settings. Homework frequently assigned in CBT include:

• Thought records
• Relaxation techniques
• Behavioral activation
• Mood charting

Cognitive-behavioral therapy is often used to treat panic attacks. CBT aims to help individuals who suffer from panic attacks by teaching them ways to better identify the thought patterns and/or beliefs that contribute to the symptoms of panic. Because panic attacks also manifest physically (i.e. – elevated heart rate, tightness in chest, dizziness), CBT skills include ways to manage and reduce these symptoms. These skills, such as progressive muscle relaxation or deep breathing techniques can be applied in a group or individual setting.

Just as CBT is effective in treating symptoms of panic, it is also frequently used to treat anxiety. In fact, it is one of the most widely used approaches in the treatment of anxiety disorders, including Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), and phobia specific anxieties. Studies have shown cognitive-behavioral therapy is as effective as medication for the treatment of anxiety disorders. Furthermore, some research indicates the benefits of CBT for anxiety are long-lasting, with fewer relapses than treatment with medication alone.

Although cognitive-behavioral therapy is most widely used for anxiety and panic disorders, it can be effective in treating a wide-range of mental health disorders including:

• Depressive Disorders
• Post-Traumatic Stress Disorder (PTSD)
• Insomnia and Other Sleep Disorders
• Substance Abuse and Addiction
• Eating Disorders

CBT is also often used in combination with other treatment modalities, especially when co-occurring disorders are present.

While CBT is widely used and found effective in treating a range of mental health disorders, it, like any treatment, may not be the best approach for everyone. Cognitive-behavioral therapy is typically not the first line of treatment for clients struggling with:

• Severe mental illnesses (i.e – schizophrenia or bipolar disorder)
• Dementia or other cognitive disorders (as these disorders impact a person’s ability to engage in therapy)
• Some personality disorders (where individuals have extreme rigidity in their way of thinking and thus may be unable to utilize thought-challenging tools)
• Certain developmental disorders (such as autism)

Although CBT may not be the most useful intervention for these conditions, it may prove helpful as an adjunctive treatment for some. As always, it is important to consult with a mental health professional to determine a best course of treatment.

If you think you could benefit from cognitive-behavioral therapy, it is important to find a qualified clinician to ensure effective treatment. There are various ways to begin the search for a CBT therapist including:

1. Check with your primary care physician – ask for a recommendation or referral
2. Check with your insurance provider – most insurance providers have directories of mental health providers and their specialties and can be searched by location and other criteria.
3. Look for a CBT certified therapist through professional organizations such as:
   • The International Association for Cognitive Psychotherapy
   • The Academy of Cognitive Therapy
   • The British Association for Behavioural and Cognitive Psychotherapies

When looking for a qualified CBT therapist, it can be helpful to schedule an initial consultation with more than one professional. Just because a therapist is qualified, does not necessarily mean they will be a “good fit” for you. Getting the chance to meet with a couple of different therapists can provide you the opportunity to determine who you feel most comfortable with. It might also be advantageous to ask the therapist about their experience in the field, what their success rate is in treatment similar conditions, and what to expect from treatment with them.

Finding the right therapist can be a process that takes some time. Thankfully there are many qualified CBT therapists out there. So, if the first one or two don't seem like a good match, do not get discouraged, and continue the search for a CBT therapist.