In clinical psychology there are various intervention methods to treat psychological problems and increase people’s well-being.
In this Psychology-Online article we will talk about Cognitive-behavioral therapy: what it is and what techniques it uses, we will explain what it consists of, what it is for, how it is applied, who should apply it and we will summarize the most used cognitive-behavioral psychological techniques in general and specifically to treat depression and anxiety. We will also see the differences between cognitive therapy, behavioral therapy and cognitive behavioral therapy.
What is cognitive-behavioral therapy
The cognitive-behavioral current is a set of theories and techniques that establish a psychotherapeutic system. Therefore, cognitive behavioral therapy is a form of psychotherapy.
Cognitive behavioral therapy (CBT) is based on the relationship between thoughts, emotions, physical sensations and behaviors. All of these areas are interconnected and influence each other. By example: you find yourself in the situation of having failed an exam. You can think:
- “I failed because I am stupid. I will never pass”
- “I failed an exam. I’ll have to try harder next time.”
- After thought 1 will surely come an emotion of sadness, frustration and resignation. Such thinking and emotions will lead to a state of demotivation and reluctance. From that state, The action, surely, will be not to study. As a consequence, it is likely that the situation will repeat itself again. On the other hand, after thought 2 an emotion of certain sadness but acceptance and hope may come. Such thinking and emotions will lead to a state of motivation and willingness to make an effort. This state pushes the action of studying, consequently, the probability of passing the next exam will be greater.
Other example It may be that of a person who believes he or she is incapable of running 10 kilometers. The behavior may be not doing it or it may be trying. If you try and succeed, the change in behavior will have an impact on your thinking.
With the previous examples we can see that, in the same situation, thinking, emotional state and behavior are different and influence each other.
The cognitive behavioral therapy intervenes at a cognitive level, that is, in the thoughtsand also in behavior, that is, in actions that are carried out. It consists of changing the way of thinking, replacing thoughts based on irrational beliefs and cognitive distortions with more objective and adaptive thoughts. As well as transforming less useful behaviors into beneficial behaviors. Cognitive-behavioral therapy focuses on the present and the immediate future, it does not usually delve into the past.
The use of cognitive-behavioral psychotherapy has grown greatly as a therapeutic system in the practice of psychology and psychiatry. Currently, cognitive-behavioral interventions They are widely accepted and their effectiveness has been recognized by empirical studies and by authors such as Albert Ellis and Aroon Beck. His procedures and techniques have been investigated with rigorous experimental methods, therefore It is a scientific therapy. Its scientific basis does not ensure absolute success, but it guarantees its effectiveness in general.
What is cognitive-behavioral therapy for?
First of all, it is a form of psychological intervention, but it can be applied in many areas and for different problems. Cognitive behavioral therapy has been shown to be helpful in treating the following psychological disorders:
- Anxiety disorders
- Depressive disorders
- Affective disorders
- Phobias
- Eating disorder
- Obsessive compulsive disorder
- Post-traumatic stress disorder
- Substance use disorders
- Sleep disorders
- Sexual disorders
In addition, it is also useful for people without a mental health diagnosis, as it helps to better manage the stressful life situationssuch as:
- Life crises
- couple problems
- emotional upset
- School or work difficulties
- Lack of social skills
How is cognitive behavioral therapy applied?
In the context of clinical psychology, cognitive-behavioral therapy should be conducted by an accredited professional, with the corresponding degree and certification. Therapy can be done individually or in a group. Regarding the duration of the therapy, it is not considered a long therapy, quite the opposite. The average number of sessions can range from Approximately 15 and 20 sessions, lasting between 30 and 60 minutes that can be weekly or biweekly. It is recommended that the sessions be weekly at the beginning to be spaced out later. On the other hand, the therapy must be applied in a physical space prepared for it and totally confidential.
Both the mode of application, the duration and the effectiveness will depend on many factors, including the complexity of the problem presented by the patient, the involvement of the patient and the collaboration received from those around them.
Differences between cognitive behavioral therapy with cognitive therapy and behavioral therapy
Cognitive-behavioral therapy includes parts of cognitive therapy and parts of behavioral therapy. The main difference between the two is the starting theoretical approach, whether it is cognition or behavior. Meanwhile, the cognitive-behavioral approach is based on the relationship between cognition and behavior. In fact, its fundamental principle is that cognitive, affective and behavioral aspects are related and that a change in one of the parts will affect the others.
Cognitive therapy
Cognitive therapy starts from an intrapsychic point of view and is focused on cognition. It is based on the premise that the explanation of behavior is found in cognitive processes and thoughts. Cognitive therapy intervenes in thoughtsidentifying and replacing distorted thoughts and beliefs with other more flexible, adaptive and functional interpretations.
behavioral therapy
In behavioral therapy, the explanation of the behavior that a person presents is based on the environment, on the influence of the environment. Therefore, behavioral therapy techniques focus on modify behaviors maladaptive behaviors and learn new, more functional behaviors, thus causing a change in emotions and thoughts.
Cognitive-behavioral therapy techniques
Cognitive-behavioral therapy techniques are those that have been scientifically proven to be most effective in clinical psychology. These techniques focus on modifying thoughts and behaviors by learning new, more adaptive ways of thinking and acting. The techniques of cognitive-behavioral therapy focus on the present, although their objective is acquisition of habits and skills that provide greater well-being and quality of life and that last over time.
Below are explained some of the cognitive-behavioral techniques most important and used:
Rational Emotive Behavioral Therapy (REBT)
Rational emotive behavioral therapy is based on the premise that emotional discomfort is due to the person’s interpretation of a situation and not the situation itself. The objective of rational emotive behavioral therapy is for the person to achieve a change in thinking patterns to change the way they interpret situations. That is, it begins to evaluate situations with conclusions based on fact and not on subjective assumptions. The REBT follows the following scheme:
- A. Real situation or event.
- B. Interpretation of the situation: thoughts, beliefs, conceptions, conclusions, etc.
- C. The emotions that arise from the interpretation of the situation. If the interpretation is negative, surely the emotions are unpleasant.
- D. Question the validity of the interpretation of the situation through discussion of irrational thoughts.
- AND. Favorable change in emotions after becoming aware of irrational cognitions.
Cognitive restructuring
Cognitive restructuring is a cognitive therapy technique that consists of modifying thought patterns:
- Understand what cognitive distortions arethat is, negative and irrational thoughts that affect mood and behavior.
- Be aware of thoughts: learn to identify one’s own cognitive distortions.
- Record thoughts: write down the situation you are in, the thought that appears, the emotion and the behavior.
- Search for an alternative thought more functional than distorted thinking.
The procedures that the psychologist uses for this change of thoughts are:
- Analyze the thought. Ask yourself if the thought is true and make a rational analysis of it.
- He socratic questioning: ask yourself questions like “is what I’m thinking totally true?” or “what evidence do I have of this?”
- Examine the utility of the thought: “does this thought help?” or “pros and cons of thinking.”
- Get in worst of cases: ask yourself “what would happen if…?” or “what’s the worst that could happen?”
- Test by action. Check if what you thought happens. For example, if the irrational thought is “I speak, I ask in class, they will think I am stupid and laugh at me”, it is about asking in class and checking if that happens.
Exposure techniques
The exposure technique bases its effectiveness on the habituation principlewhich has shown that Repeated exposure to a stimulus produces a smaller response each time. by the subject. For example, if one day he sees a spider, his body will react because the alarm system will be activated. However, if you see a spider every day and it has no consequences, each time the interpretation of danger is less and therefore the psychophysiological reaction is less.
This technique is especially indicated for anxiety problems, fears and phobias, and avoidant behaviors. The exhibition must have planning and support provided by a specialist. The types of exposure are: live exhibition or the exhibition in a symbolic way through imagination or virtual reality technological devices.
Systematic desensitization
Systematic desensitization also aims to reduce the psychophysiological reaction to anxiety-inducing stimuli. The first part consists of break down the situation that produces the activation of fear or anxiety in small parts and rank them from the least to the most feared. For example, with the fear of speaking in public we could put, as a first step, the situation of saying a couple of sentences in front of a completely trustworthy person; As a second step, make a 2-minute speech in front of two trusted people; As a third step, make a 4-minute speech in front of some family members or trusted people. And so on until reaching the most feared situation. It is recommended that the hierarchy of…