Cognitive-Behavioral Therapy (CBT)
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Cognitive-Behavioral Therapy (CBT)

(Rational Emotive Therapy; Rational Behavior Therapy; Rational Living Therapy; Dialectic Behavior Therapy; Schema Focused Therapy)

En Español (Spanish Version)

Definition

Cognitive-behavioral therapy (CBT) is a form of talk therapy. This means that you discuss your thoughts, feelings, and behaviors with a mental health professional. CBT focuses on how the way you think affects the way you feel and act.

For example, a situation may be perceived in a positive way by one person, enhancing his/her well-being, but may be perceived in a negative way by another person, contributing to feelings of sadness or anxiety . Your therapist helps you identify negative thoughts and evaluates how realistic these thoughts are. Then, he or she teaches you to “unlearn” negative thought patterns and “learn” new, helpful ones.

CBT is a problem-solving approach. While you cannot control other people or situations, you can control the way you perceive and react to a particular situation. CBT teaches you the skills to change your thinking and manage your reactions to stressful people and situations.

Reasons for Procedure

Cognitive-behavioral therapy is used to treat many health concerns. These include:

Managing Mental Health Concerns

Brain Man Face

Many mental health concerns are caused by a combination of physiological and emotional triggers. CBT can help patients cope by decreasing the effects of emotional triggers.

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Risk Factors for Complications During the Procedure

CBT may not be appropriate for people with certain conditions:

  • Those who are psychotic
  • Those with untreated or uncontrolled bipolar disorder
  • Those who lack stable living arrangements
  • Those with a variety of unstable health problems

What to Expect

Prior to Procedure

There is no specific preparation for CBT. You may be asked to fill out a questionnaire about your feelings.

Description of the Procedure

You may receive CBT in one-on-one therapy sessions or in a group format.

CBT can be divided into two parts: functional analysis and skills training .

In functional analysis, you and your therapist identify stressful situations. You also determine the thoughts that lead to or worsen these situations. These thoughts are then analyzed to see if they are realistic and appropriate. For example, your therapist may point out negative thought patterns, such as “I can’t handle this” or "people are laughing at me.”

Next, through skills training, your therapist guides you to reduce unhealthy ways of thinking, and to learn healthier ways. Instead of thinking “I can’t handle this,” you will learn to draw on your strengths: “I’ve handled difficult situations before, so I can handle this one.”

You’ll also learn to ask more questions about yourself before making a conclusion. For example, “Could those people be laughing at something other than me?” The goal is to replace irrational thought patterns with more appropriate and rational ones.

Skills training takes a lot of practice, which is often given as “homework.” You might practice deep-breathing exercises or role-play how to act in certain social situations. A person dealing with substance abuse might practice ways to decline an alcoholic drink.

Homework is vital to the success of CBT. You must practice new, rational responses until they replace your previous, unhealthy responses. Homework also allows you to try new skills and give feedback to your therapist on which works best for you.

After Procedure

You may be given homework between sessions. You’ll need to practice the strategies you and your therapist have discussed.

How Long Will It Take?

The length of an individual session is usually 50-100 minutes. Group sessions may last longer. Treatment sessions may occur 1-2 times per week for 12-16 weeks. This is a general guideline and depending on your situation, treatment may be longer or shorter.

Keep in mind it may take several tries to unlearn poor habits and to learn healthier ones.

Possible Complications

There are no known complications to CBT for patients.

Average Hospital Stay

CBT is usually done on an outpatient basis. This may be in a therapist’s office or in a community health center.

Post-therapy Care

Some therapists advise that you return for a check-up about 3, 6, and 12 months after therapy has ended. In addition, you may call your therapist whenever the need arises.

Outcome

The goal of CBT is to change your thought process and unhealthy thought patterns to allow healthy and realistic responses to difficult situations. Many patients notice an improvement in their symptoms within 3-4 weeks of beginning CBT and doing their “homework.”

Call Your Doctor If Any of the Following Occurs

If the thoughts, feelings, or other difficulties that led you to seek therapy are returning or worsening, call your doctor. If you have thoughts of hurting yourself or others, call your doctor or 911 immediately.

RESOURCES:

American Psychological Association
http://www.apa.org

The Beck Institute for Cognitive Therapy and Research
http://www.beckinstitute.org

National Association of Cognitive—Behavioral Therapists
http://www.nacbt.org/index.htm

CANADIAN RESOURCES:

BC Health Guide, British Columbia Ministry of Health
http://www.bchealthguide.org

Canadian Psychiatric Association
http://www.cpa-apc.org

References:

About cognitive therapy. The Beck Institute for Cognitive Therapy and Research website. Available at: http://www.beckinstitute.org/Library/InfoManage/Guide.asp?FolderID=200&SessionID={C2B865B0-C678-401C-B776-47F352D4CFC9}. Accessed June 10, 2007.

About cognitive therapy. The Beck Institute for Cognitive Therapy and Research website. Available at: http://www.beckinstitute.org/InfoID/220/RedirectPath/Add1/FolderID/237/SessionID/{F703BF2C-4363-4997-B964-170D984B48F8}/InfoGroup/Main/InfoType/Article/PageVars/Library/InfoManage/Zoom.htm . Accessed November 30, 2005.

Bush JW. The CBT website. Available at: http://www.cognitivetherapy.com/index.html . Accessed November 29, 2005.

Butler AC, Chapman JE, Forman EM, et al. The empirical status of cognitive-behavioral therapy: a review of meta-analyses [abstract]. Clin Psychol Rev . 2005.

A cognitive-behavioral approach: treating cocaine addiction. National Institute on Drug Abuse website. Available at: http://www.nida.nih.gov/TXManuals/CBT/CBT1.html . Accessed November 22, 2005.

Cognitive-behavioral therapy. National Association of Cognitive-Behavioral Therapists website. Available at: http://www.nacbt.org/whatiscbt.htm . Accessed November 22, 2005.

Morris N, Raabe B. Some legal implications of CBT stress counselling in the workplace. British Journal of Guidance & Counselling . 2002 Feb;30(1):55-62.



Last reviewed May 2008 by Ryan Estevez, MD, PhD, MPH

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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