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All About Cognitive Behavioural Therapy (CBT)

Updated: Nov 16

What is Cognitive Behavioural Therapy?

Developed by Aaron Beck in 1964, cognitive behavioral therapy (CBT) is an evidence-based psychotherapy that is practical, structured, focused on your presenting concern(s), and goal-oriented. Beck developed CBT on the cognitive model of mental illness, which hypothesizes that an individual's emotions and behaviors are affected by their cognitions. That is, it is not an event in and of itself that will determine how you may feel, but how you perceive the situation. CBT will provide you with skills and strategies for becoming and staying healthy emotionally and mentally. It enables you to identify, analyze, and change your thought patterns, attitudes, and beliefs that you find unhelpful. The emphasis in CBT is not on the past but on the present, and how to help you develop the skills to deal effectively with difficulties you are facing, allowing you to live a fulfilling life.


Core Principles of Cognitive Behavioral Therapy

CBT has several core principles:

  1. Unhelpful or problematic thinking patterns can negatively impact your mental health

  2. Learned patterns of unhelpful behavior can negatively impact your mental health

  3. At times, some of your core beliefs, including beliefs about yourself and the world around you, may negatively impact your mental health

  4. If you find yourself struggling with your mental health, there are coping skills you can learn that can improve your emotional, mental, and physical health


Cognition in Cognitive Behavioural Therapy

Your thoughts, feelings, and behaviors can be viewed as points of a triangle - when one part of the triangle is functioning in an unhelpful manner, it will affect the other two parts of your triangle.


The theory behind CBT is that your thoughts affect your emotions and your behaviors. Within CBT, there are three levels of thinking, conscious thoughts, automatic thoughts, and schemas. Your conscious thoughts are ones you are aware of, and your automatic thoughts quickly run through your mind, so fast that you may not be aware of them. Schemas are your core beliefs and stories that you have developed about yourself and the world around you and are influenced by your life experiences.


How Does Cognitive Behavioral Therapy Work?

CBT will enable you to identify, analyze, and adapt your thoughts, attitudes, and beliefs that are negatively impacting your mental health. CBT provides you with strategies to change your thought patterns, such as recording thoughts and feelings you had about a difficult event or situation you experienced, reflecting on how much evidence your thoughts have, and then through your reflection, reframing your thoughts in a more realistic manner. For example, say some of your coworkers go out to lunch and don’t invite you. One of your automatic thoughts might be “none of my coworkers like me”. After going through the thought record process, where you look at how not being invited made you feel, what it made you think about yourself, and what evidence you have for and against your coworkers not liking you, you may end up reframing the thought to be something such as “My coworkers may have had a separate meeting I did not need to be a part of, which is why I was not invited to lunch. I know they appreciate me because I have been invited to other lunches with them, and one of them told me yesterday that they enjoy working with me”. Through practicing exercises such as thought records over time, you will come to recognize thought patterns that are contributing to your mental health symptoms, and how to reframe them in a way that enables you to cope with difficult situations, grows your confidence and self-esteem, and reduce emotional distress.

CBT also has strategies to help you change behaviors, such as learning to face your fears, using role-plays to practice dealing with situations such as conflict management, and skills to help you relax, such as meditation. Through giving you different tools and strategies, CBT will empower you to become your own therapist, in which you are able to utilize practical and effective coping skills, recognize and adapt unhelpful thought patterns, and change your emotions and behaviors.


Who Would Find Cognitive Behavioural Therapy Helpful?

CBT is evidence-based, with decades of research proving its efficacy. It has proven to be effective in treating a number of mental health concerns, most notably anxiety and depression, but also bipolar disorder, eating disorders, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder (PTSD), schizophrenia, psychosis, specific phobias, substance use disorders, insomnia, and grief. Additionally, CBT helps you to cope with and process regular life challenges such as conflict in relationships, employment challenges, and stress. Interestingly, it is also beneficial in treating chronic illnesses such as irritable bowel syndrome (IBS), fibromyalgia, and chronic fatigue syndrome by giving you tools to cope with your symptoms.


Sources

Cognitive Behavioral Therapy (CBT). (2022). Cognitive Behavioral Therapy (CBT). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt

Cognitive behavioural therapy. (2022). Cognitive behavioural therapy. CMHA. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cognitive-behavioural-therapy

Fenn, K., & Byrne, M. (2013). The key principles of cognitive behavioural therapy. InnovAiT, 6(9), 579-585. https://journals.sagepub.com/doi/full/10.1177/1755738012471029

https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Overview - Cognitive behavioural therapy. (2019). Overview - Cognitive behavioural therapy. NHS. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

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