When it comes to psychotherapy, there is no shortage of options for people seeking mental health care. Talk therapy, also known as counselling, is the most popular and traditional option, in which individuals or couples meet with a mental health professional to put into words their thoughts, concerns, attitudes, feelings and behaviours in order to understand their causes and learn coping mechanisms and strategies.
Other sought-after therapies include Eye Movement Desensitization and Reprocessing (EMDR), exposure therapy, music therapy, integrative therapy, and hypnotherapy.
However, none of these compare to the proven benefits and universal acceptance of the most commonly recommended treatment of the past two decades: cognitive behavioral therapy (CBT).
What is CBT?
CBT is a type of therapy developed in the early 1970s by renowned psychiatrist Aaron Beck to help patients understand the connection between their behavior and their thoughts, fears, and emotions. “His model was validated in 1977 and has been validated by experts who have applied it in numerous research studies and clinical settings,” says Joan Broder, a practicing psychologist, Fellow of the American Psychological Association, and co-founding editor of the peer-reviewed journal Psychology of Popular Media.
She explains that CBT works by first helping patients understand what is going on between an event or situation and the resulting feelings and behaviors.
As an example, she says, imagine you’ve been insulted by someone else with an insensitive comment or rude slur, and your first reaction would be to decide whether you want to return the insult, ignore them completely, or escalate the situation with a physical altercation. “Your belief system helps you make that choice,” she says. “So the goal of CBT is to create a healthy belief system that provides the foundation for making good decisions.”
This is often referred to as cognitive restructuring, and it is rooted in replacing irrational or destructive thoughts with realistic, balanced, positive thoughts.
CBT-trained professionals will often introduce behavioral experiments, share helpful tools and techniques such as mindful meditation or relaxation breathing exercises, introduce new approaches to problem-solving, and encourage self-monitoring practices to help patients track their behavior, symptoms, and progress, usually in a time-limited, structured way.
“This process can lead to greater self-awareness and self-understanding, which can lead to improved self-control,” says Juanita Guerra, a clinical psychologist in New Rochelle, N.Y., who adds that CBT “can help improve a person’s self-esteem and increase their confidence.”
Broder agrees, saying a benefit of CBT is that it improves patients’ ability to make thoughtful decisions that are in line with their values, rather than making impulsive decisions or following the crowd. “Patients become more self-aware, gain control over negative thoughts, and make better behavioral choices,” Broder says.
important:Intrusive thoughts are normal, but there are ways to reduce their intensity.
Who is CBT for?
Cognitive behavioral therapy has been proven effective in a variety of situations and with many groups of people, but it’s especially effective “for treating symptoms of anxiety and depression,” says psychiatrist Elizabeth Hogue, director of the Anxiety Disorders Research Program at Georgetown University.
She says the therapy can also be useful in helping people overcome their fears: “For example, if someone is afraid of heights, the therapist might have them slowly (over a few weeks) go up to the higher floors of a building to get used to the feeling, and the fear will usually subside,” she explains.
Guerra says the therapy has also proven effective in treating hoarding disorder, PTSD, obsessive-compulsive disorder and addiction.
Notes:How does social media affect mental health? It’s complicated.
Are there any drawbacks to CBT?
CBT is generally not as controversial as other forms of psychotherapy. But Guerra says its limitations are that it is very structured, time-consuming, and requires a lot of work and individualized exercises. “If the client isn’t consistent with the work, the treatment won’t be effective,” she warns.
And because CBT relies on reality-based logic and training, it is less effective for people with severe personality disorders, such as antisocial personality disorder, or personality pathologies that distort their perception of reality, she adds.
Another drawback, Hoge points out, is that some insurance companies won’t cover the cost of treatment. CBT can be emotionally uncomfortable, and it doesn’t work for everyone, even if you’re willing to put in the time and effort required. “Therapy is not a one-size-fits-all process,” Broder says. “There may be other therapies that work better for some people than CBT.”
To find out if CBT is the right option for you, Guerra recommends consulting with a mental health professional who is trained in CBT. “That way, you can make an informed decision about whether cognitive behavioral therapy is the appropriate or best treatment approach for your mental health concerns and desired outcomes,” Guerra says.
