Cognitive Behavioral Therapy (CBT) is a merger of Cognitive Psychotherapy, based on theories of our thoughts and our information processing and behavioral therapy, based on learning theory. Currently, CBT also includes other treatment methods, and is considered to be an umbrella term. Examples of new features within CBT are the mindfulness concept, which has its roots in Eastern meditation.
In behavioral therapies, behaviors are not just the things we do, but also bodily reactions and thought processes.
According to the theory of learning, all the behaviors have been learned sometime. Changing them becomes a matter of learning about, or learning something new.
Learning can be done in several different ways. If at any time we have been scared, it may have caused us to couple a certain thing with an unpleasant feeling. It is called “classical condition”.
But a fear can also arise because we are looking for someone else, such as a parent’s behavior. It is called “model learning”.
Finally, our behaviors are also governed by the consequences they receive, which is called “operant condition”.
If a behavior has a positive consequence, chances are it is good to repeat it. This can lead us to be helpful and courteous, but also to avoid what we are afraid because short-term avoidance leads to the positive consequence of getting rid of our fear and anxiety.
Cognitive Behavioral Therapy (CBT): How does it happen?
A cognitive behavioral therapy always begins with a thorough behavioral analysis with learning theory as a starting point.
One analyzes what is the problematic behavior, what it triggers and the consequences it causes. In other words: what behavior the behavior fills. Only then can you see what you need to do in order for a new learning to come about.
The CBT includes some teaching. The therapists are always clear how the treatment will look and why you use a certain method. This means that the client acquires general knowledge, but also increased awareness of his own, mental and bodily mechanisms
A central treatment course is exposure. This means that you are gradually exposed to what is difficult, in manageable steps, so long as the fear or anxiety is diminishing. Because it is believed that the anxiety will rise to unbearable heights never happens, then a learning is going on.
Other common methods within CBT are behavior activation, role play, behavioral experiments and relaxation exercises.
Example of Cognitive Behavioral Therapy (CBT)
A teenage boy is seeking a panic attack therapy. The behavioral analysis reveals that the panic attacks often come to school after drinking about 5 cups of coffee, which he himself associates with the panic attacks.
The first action will therefore be to limit coffee drinking. The therapists tell about the mechanisms behind a panic attack: that it is a strong boost to the autonomic nervous system with palpitation, hyperventilation and other unpleasant, but completely harmless, bodily reactions as a result.
The boy is surprised but relieved, because he has believed he has been close to death at the attacks. He may also be exposed to the bodily sensations that he has experienced as scary during the attacks, under controlled forms.
Together with the therapist he does exercises that lead to dizziness, he hyperventiles and breathes through straws to get a sense of breathlessness.
At the evaluation, it appears that the boy had his last panic attack just before the second therapy session, and he no longer worries about panic.
Common questions about Cognitive Behavioral Therapy (CBT)
How long is the treatment going?
For treatment of, for example, anxiety disorder, 15-20 sessions are common. Simpler problems, such as phobia, often require significantly fewer sessions, while more profound treatments in, for example, personality disorders may last for some or a few years.
How often do you meet?
The most common thing is that you meet once a week during the active treatment phase.
How is the treatment going on?
In CBT, we work mainly with what is currently and here. The working method is structured, action oriented and clear, for example regarding focus and goals. The client gets home assignments and learns methods that he can benefit from in future problems. The treatment is not based solely on conversations, but also on practical exercises.
What is the role of the therapist?
The therapists structure the work and play an active role.
To change thought and behavior patterns in order to better deal with emotional problems.