Cognitive behavioral therapy aims to change our thought patterns, our conscious and unconscious beliefs, our attitudes, and, ultimately, our behavior, in order to help us face difficulties and achieve our goals. Psychiatrist Aaron Beck was the first to practice cognitive behavioral therapy.
While practicing psychoanalysis, Beck noticed the prevalence of internal dialogue in his clients and realized how strong the link between thoughts and feelings can be.
Beck found that a combination of cognitive therapy and behavioral techniques produced the best results for his clients. In describing and honing this new therapy, Beck laid the foundations of the most popular and influential form of therapy of the last 50 years.
This form of therapy is not designed for lifelong participation and aims to help clients meet their goals in the near future. Most CBT treatment regimens last from five to ten months, with clients participating in one to minute session per week.
CBT is a hands-on approach that requires both the therapist and the client to be invested in the process and willing to actively participate.
The therapist and client work together as a team to identify the problems the client is facing, come up with strategies for addressing them, and creating positive solutions Martin, Filtering refers to the way a person can ignore all of the positive and good things in life to focus solely on the negative. Overgeneralization is taking a single incident or point in time and using it as the sole piece of evidence for a broad conclusion.
For example, someone who overgeneralizes could bomb an important job interview and instead of brushing it off as one bad experience and trying again, they conclude that they are terrible at interviewing and will never get a job offer. Similar to overgeneralization, this distortion involves faulty reasoning in how one makes conclusions. Unlike overgeneralizing one incident, jumping to conclusions refers to the tendency to be sure of something without any evidence at all.
For example, we might be convinced that someone dislikes us without having any real evidence, or we might believe that our fears will come true before we have a chance to really find out. This distortion involves expecting that the worst will happen or has happened, based on an incident that is nowhere near as catastrophic as it is made out to be.
Alternatively, one might minimize the importance of positive things , such as an accomplishment at work or a desirable personal characteristic.
This is a distortion where an individual believes that everything they do has an impact on external events or other people, no matter how irrational that may be. A person with this distortion will feel that he or she has an exaggerated role in the bad things that happen around them.
For instance, a person may believe that arriving a few minutes late to a meeting led to it being derailed and that everything would have been fine if they were on time. This distortion involves feeling like everything that happens to you is either a result of purely external forces or entirely due to your own actions. We might assume that difficult coworkers are to blame for our own less-than-stellar work, or alternatively assume that every mistake another person makes is because of something we did.
We are often concerned about fairness, but this concern can be taken to extremes.
As we all know, life is not always fair. The person who goes through life looking for fairness in all their experiences will end up resentful and unhappy.
Sometimes things will go our way, and sometimes they will not, regardless of how fair it may seem. One method of assigning responsibility is blaming others for what goes wrong.
Sometimes we may blame others for making us feel or act a certain way, but this is a cognitive distortion. Only you are responsible for the way you feel or act. When others break our rules, we are upset. When we break our own rules, we feel guilty. For example, we may have an unofficial rule that customer service representatives should always be accommodating to the customer. When we interact with a customer service representative that is not immediately accommodating, we might get angry.
This distortion involves thinking that if we feel a certain way, it must be true. This cognitive distortion boils down to:. Clearly, our emotions are not always indicative of the objective truth, but it can be difficult to look past how we feel. The fallacy of change lies in expecting other people to change as it suits us.
This ties into the feeling that our happiness depends on other people, and their unwillingness or inability to change, even if we demand it, keeps us from being happy.
This is a damaging way to think because no one is responsible for our own happiness except ourselves. This cognitive distortion is an extreme form of generalizing, in which we generalize one or two instances or qualities into a global judgment. For example, if we fail at a specific task, we may conclude that we are a total failure in not only that area but all areas. Alternatively, when a stranger says something a bit rude, we may conclude that he or she is an unfriendly person in general.
Mislabeling is specific to using exaggerated and emotionally loaded language, such as saying a woman has abandoned her children when she leaves her children with a babysitter to enjoy a night out.
While we all enjoy being right, this distortion makes us think we must be right, that being wrong is unacceptable.
This distortion involves expecting that any sacrifice or self-denial will pay off. We may consider this karma, and expect that karma will always immediately reward us for our good deeds. This results in feelings of bitterness when we do not receive our reward Grohol, Many tools and techniques found in cognitive behavioral therapy are intended to address or reverse these cognitive distortions.
There are many tools and techniques used in cognitive behavioral therapy, many of which can be used in both a therapy context and in everyday life. The nine techniques and tools listed below are some of the most common and effective CBT practices.
A CBT journal can include the time of the mood or thought, the source of it, the extent or intensity, and how we reacted, among other factors.
This technique can help us to identify our thought patterns and emotional tendencies, describe them, and change, adapt, or cope with them. This is a primary goal of CBT and can be practiced with or without the help of a therapist. In order to unravel cognitive distortions, you must first become aware of the distortions from which you commonly suffer.
Part of this involves identifying and challenging harmful automatic thoughts, which frequently fall into one of the 15 categories listed earlier.
Once you identify the distortions you hold, you can begin to explore how those distortions took root and why you came to believe them.
25 CBT Techniques and Worksheets for Cognitive Behavioral Therapy
When you discover a belief that is destructive or harmful, you can begin to challenge it. This technique is specifically effective for those who suffer from obsessive-compulsive disorder OCD.
You can practice this technique by exposing yourself to whatever it is that normally elicits a compulsive behavior, but doing your best to refrain from the behavior.
You can combine journaling with this technique, or use journaling to understand how this technique makes you feel. This technique is intended to treat panic and anxiety. It involves exposure to feared bodily sensations in order to elicit the response. Doing so activates any unhelpful beliefs associated with the sensations, maintains the sensations without distraction or avoidance, and allows new learning about the sensations to take place.
It is intended to help the sufferer see that symptoms of panic are not dangerous, although they may be uncomfortable. Nightmare exposure and rescripting are intended specifically for those suffering from nightmares. This technique is similar to interoceptive exposure, in that the nightmare is elicited, which brings up the relevant emotion. Once the emotion has arisen, the client and therapist work together to identify the desired emotion and develop a new image to accompany the desired emotion.
This technique is especially useful for those suffering from fear and anxiety.
What is Cognitive Behavioral Therapy
In this technique, the individual who is vulnerable to crippling fear or anxiety conducts a sort of thought experiment in which they imagine the outcome of the worst case scenario. Letting this scenario play out can help the individual to recognize that even if everything he or she fears comes to pass, the outcome will still be manageable. This is a familiar technique to those who practice mindfulness.
Similar to the body scan, this technique instructs you to relax one muscle group at a time until your whole body is in a state of relaxation. You can use audio guidance, a YouTube video, or simply your own mind to practice this technique, and it can be especially helpful for calming nerves and soothing a busy and unfocused mind.
This is another technique that will be familiar to practitioners of mindfulness.
There are many ways to relax and bring regularity to your breath, including guided and unguided imagery, audio recordings, YouTube videos, and scripts. Bringing regularity and calm to your breath will allow you to approach your problems from a place of balance, facilitating more effective and rational decisions Megan, These techniques can help those suffering from a range of mental illnesses and afflictions, including anxiety, depression, OCD, and panic disorder, and they can be practiced with or without the guidance of a therapist.
To try some of these techniques without the help of a therapist, see the next section for worksheets and handouts to assist with your practice. You or your client will work backwards to list risk factors above i. Once you have defined the problems and understand why you are struggling with them, you then list coping strategies.
These are not solutions to your problems, but ways to deal with the effects of those problems that can have a temporary impact.
What is CBT?
Next, you list the effectiveness of the coping strategies, such as how they make you feel in the short- and long-term, and the advantages and disadvantages of each strategy. Finally, you move on to listing alternative actions. If your coping strategies are not totally effective against the problems and difficulties that are happening, you are instructed to list other strategies that may work better. This worksheet gets you or your client thinking about what you are doing now and whether it is the best way forward.
This technique helps you or the client learn about yourself, specifically, what leads to specific behaviors and what consequences result from those behaviors. These are factors that led up to the behavior under consideration, either directly or indirectly. This ABC Functional Analysis Worksheet can help you or your client to find out whether particular behaviors are adaptive and helpful in striving toward your goals, or destructive and self-defeating.
They help us understand what might be leading a perceived problem to arise, and what might prevent them from being tackled effectively. Examples might include genetics, life events, or their temperament.
Cognitive therapy for anxiety pdf
Then they consider perpetuating factors , to discover what reinforcers may be maintaining the current problem. This worksheet builds on the last.
This formulation process can help you or your client connect the dots between core beliefs, thought patterns, and present behavior. This worksheet presents six boxes on the left of the page Part A , which should be completed before moving on to the right hand side of the worksheet Part B. On the right, there is a flow chart that you can fill out based on how these behaviors and feelings are perpetuated. You are instructed to think of a situation that produces a negative automatic thought and record the emotion and behavior that this thought provokes, as well as the bodily sensations that can result.
Filling out this flow chart can help you see what drives your behavior or thought and what results from it. This worksheet is especially helpful for people who struggle with negative thoughts and need to figure out when and why those thoughts are most likely to pop up.
Learning more about what provokes certain automatic thoughts makes them easier to address and reverse.