Cognitive therapy and cognitive-behavioural therapy (CBT) refer to a group of interventions that are based on identifying and changing unhelpful patterns of thinking (your “cognitions”) and behaving to positively impact emotions. While historically cognitive therapy and behaviour therapy developed independently, today most psychotherapists who offer these types of therapies use a combination of both cognitive and behavioural techniques in their work. Thus, this treatment approach is referred to as cognitive-behavioural therapy.
Cognitive-behavioural therapy is a brief, effective type of psychotherapy that focuses on alleviating symptoms and solving problems. In collaboration with a skilled therapist, beliefs and behaviours that may be contributing to the client’s presenting problem are examined, and strategies are learned to foster change and reduce emotional distress. The focus of therapy is on how you are thinking and behaving today, rather than on your childhood experiences.
There are a few basic principles that define cognitive-behavioural therapy and differentiate it from some other treatment approaches:
CBT relies on collaboration between the therapist and the client. The client and therapist work together, as a team, to understand and develop strategies to address the client’s difficulties.
CBT is goal-oriented. The client and therapist decide upon clear, measurable goals, and progress toward these goals is regularly evaluated.
CBT is active. The therapist can take on the role of teacher or coach, and the client has regular “homework” exercises outside of the therapy sessions during which strategies learned during therapy are practiced.
CBT is time-limited. Sometimes, clients can begin to notice improvement in as little as 4 to 6 sessions. More typically, 8 to 12 sessions are needed. In situations where a client’s presenting problems are more complex or severe, 20 or more sessions may be needed.
When you first meet with your therapist, you can expect to fill out several forms that ask you questions about symptoms and problems you may have. Your therapist may also ask you questions about your personal history, such as when the problems first started, what makes things better or worse, or how your everyday life is affected. The purpose of this first meeting is to gather as much information as quickly as possible so you and your therapist can learn about the type and extent of your difficulties. Depending on your particular issues, sometimes more than one meeting is needed to gather all the information need to develop a plan of therapy.
Once the necessary information is collected, you and your therapist will work together to determine the most appropriate treatment plan. This might include things like discussing how often you will come, your goals, your diagnosis, developing a problem list, consideration of medication options, and other items.
Cognitive-behavioural therapy can be more structured than other types of therapy. Sessions often start with you and your therapist working together to set an agenda. The agenda may include things like reviewing homework, discussing your experience in the previous session, selecting one or two current problems to work on, and assigning homework for the next week. The goal is to solve problems, not just complain about them.
Your therapist relies on regular feedback from you in order to figure out what’s working and what’s not so adjustments to the treatment plan can be made as needed. Goals set at the start of therapy can be modified as therapy proceeds. These goals are frequently revisited so you and your therapist can determine if you are getting better. Your therapist may also ask you to complete additional forms at various points during treatment to collect information about your symptoms so he or she can determine if things are progressing as planned.
Cognitive-behavioural therapy has been found to be helpful for a wide range of psychological problems, including depression, anxiety, anger, marital conflict, phobias, eating disorders, and others. Numerous studies have demonstrated that cognitive-behavioural therapy is as effective as medication for depression and certain kinds of anxiety problems. An added benefit of cognitive-behavioural therapy is that clients learn strategies that they can use for the rest of their lives to manage psychological symptoms. Therefore, they are often able to maintain their improvement after therapy has finished, whereas people who are only treated with medication often need to keep taking it to remain well. In collaboration with your physician, CBT is sometimes combined with medication to maximize benefit.
While all the professional staff at Connect Cognitive Therapy are skilled in CBT and use this approach when evidence shows it is the best available for a particular problem, we also recognize that CBT is not effective for all problems, and CBT does not suit all clients. In these cases, our therapists use other evidence-based approaches as needed.
CBT is often considered to be an umbrella term that includes a number of different therapies, some developed for very specific problems. Clinicians at Connect Cognitive Therapy have expertise in many of these therapies, some of which are listed below:
- Mindfulness-Based Cognitive Therapy (MBCT)
- Dialectical Behaviour Therapy (DBT)
- Acceptance and Commitment Therapy (ACT)
- Emotion Focused Therapy (EFT)
- Cognitive Processing Therapy (CPT)
- Prolonged Exposure Therapy
- Exposure and Response Prevention (ERP)
- Motivational Interviewing (MI)
- Schema Therapy
- Habit Reversal Training