What is cognitive Behavior therapy?

Theory and empirical evidence

Cognitive behavior therapy is based on the principal that thoughts, or cognitions, influence mood and behavior.  For example, if someone thinks “I’m a failure”, he/she may feel depressed.  If an individual thinks “Something terrible will happen to me”, he/she may feel anxious.  A primary goal of the therapy is to teach clients to think logically and accurately.  However, cognitive behavior therapy is not just about changing thoughts.  The client is also taught a variety of concrete skills for modifying behaviors, situations, and emotions.  Using these tools leads to symptom reduction relatively quickly.  The client develops a repertoire of techniques he/she can utilize even long after therapy has ended. 

Cognitive behavior therapy has demonstrated efficacy in hundreds of research trials.  It is  successful with a broad range of disorders such as anxiety, depression, eating disorders, and coping with medical illnesses.  It has proven to be helpful for children, adults, in group settings, and for individual clients. 

Techniques

Cognitive behavior therapists view themselves as teachers.  They want the client to develop expertise in the strategies.  Clients practice these tools between sessions in order to master them.  These techniques generally fit into the following domains:

  1. Cognitive – strategies here include identifying and modifying thoughts, developing coping statements and plans, and using imagery

  2. Behavioral – examples include problem solving, exposure hierarchies, skills training, and role plays

  3. Emotion focused – techniques include mindfulness, relaxation training, and distraction

Structure of the session

In cognitive behavior therapy the therapist and client focus on current life challenges and have specific goals.  Consequently, treatment is usually short-term. 

A structured session helps keep the focus on symptom reduction and skill acquisition.  In a typical cognitive behavior therapy session, the therapist and client:

  1. set an agenda to use the meeting time efficiently

  2. check in on symptoms to monitor progress

  3. review therapy homework and assign new tasks to strengthen skill development

  4. get feedback to ensure the client is satisfied and so the therapist can make necessary adjustments if needed