What is Cognitive Behavioral Therapy?
Cognitive behavioral therapy (CBT) is an effective treatment for depression. At the heart of CBT is an assumption that a person’s mood is directly related to his or her patterns of thought. Negative, dysfunctional thinking affects a person’s mood, sense of self, behavior, and even physical state. The goal of cognitive behavioral therapy is to help a person learn to recognize negative patterns of thought, evaluate their validity, and replace them with healthier ways of thinking.
At the same time, therapists who practice CBT aim to help their patients change patterns of behavior that come from dysfunctional thinking. Negative thoughts and behavior predispose an individual to depression and make it nearly impossible to escape its downward spiral. When patterns of thought and behavior are changed, according to CBT practitioners and researchers, so is mood.
How Does Cognitive Behavioral Therapy Differ From Other Depression Treatments?
The focus and method of cognitive behavioral therapy sets it apart from other, more traditional therapies:
CBT is based on two specific tasks: cognitive restructuring, in which the therapist and patient work together to change thinking patterns, and behavioral activation — in which patients learn to overcome obstacles to participating in enjoyable activities. CBT focuses on the immediate present: what and how a person thinks more than why a person thinks that way.CBT focuses on specific problems. In individual or group sessions, problem behaviors and problem thinking are identified, prioritized, and specifically addressed.
CBT is goal oriented. Patients working with their therapists are asked to define goals for each session as well as longer-term goals. Longer-term goals may take several weeks or months to achieve. Some goals may even be targeted for completion after the sessions come to an end.
The approach of CBT is educational. The therapist uses structured learning experiences that teach patients to monitor and write down their negative thoughts and mental images. The goal is to recognize how those ideas affect their mood, behavior, and physical condition. Therapists also teach important coping skills, such as problem solving and scheduling pleasurable experiences.
CBT patients are expected to take an active role in their learning, in the session and between sessions. They are given homework assignments at each session — some of them graded in the beginning — and the assignment tasks are reviewed at the start of the next session.
CBT employs multiple strategies, including Socratic questioning, role playing, imagery, guided discovery, and behavioral experiments.
CBT is time limited. Typically, treatment with CBT lasts 14 to 16 weeks.
Who Can Benefit From CBT?
Anyone with mild or moderate depression can potentially benefit from cognitive behavioral therapy, even without taking medication. A number of studies have shown CBT to be at least as effective as antidepressants in treating mild and moderate depression. Studies also show that a combination of antidepressants and CBT can be effective in treating major depression.
CBT can be an effective treatment for mild and moderate depression in adolescents as well. It’s also been shown to be effective at reducing relapses in patients who experience frequent relapses after having gone through other treatments.
Nearly two out of every three patients who are treated successfully for depression are treated with medications alone. Other patients, though, have lingering symptoms even when medication is partially working. CBT can be effectively used to treat many of these patients.
Although a wide range of people respond well to cognitive behavioral therapy, experts point out that the type of person likely to get the most benefit is someone who:
Has an Internal Locus of Control
Has the Capacity for Introspection
What is Dialectical Behavioral Therapy?
DBT is a psychotherapy developed by Dr. Marsha Linehan and her colleagues at the University of Washington to treat Borderline Personality Disorder and other disorders of emotion regulation. DBT combines behavior therapy, cognitive therapy, and both eastern and western contemplative practices. DBT has been extensively researched and shown to be effective in reducing impulsive, self destructive behaviors such as suicide attempts, gestures, and thoughts; cutting and other non-suicidal self injurious behavior; substance abuse; angry outbursts; and disordered eating. DBT helps individuals gain control of their behaviors and emotions; develop deep understanding of their emotion, thought, and behavior patterns; and replace maladaptive, self defeating behaviors with skillful, adaptive coping.
DBT can help individuals suffering from a range of problems related to emotional and behavioral dysregulation. These include:
Suicidal Thoughts and Behavior
Non Suicidal Self Injurious Behavior, Such As Cutting
Sense of Emptiness
Anger Management Problems
Fear of Rejection and Abandonment
Sometimes skills classes aren’t the best solution. As an alternative, skills can be learned in a one-on-one setting. This is essentially a “class of one”, just you and I.
About Individual Skills Coaching:
Sessions are weekly
Each week the previous skill is reviewed and a new skill is introduced.
Progression and skills can be customized for each individual.
Each week a small homework assignment is given. Members are asked to try that week’s skill in their real life.
Individual skills coaching is always done in conjunction with ongoing psychotherapy. This can be with me.
What is actually taught?
Their are four main sets of personal skills: Mindfulness, Interpersonal Effectiveness, Emotional Regulation and Distress Tolerance. Each subject is covered for a period of four to ten weeks.
Mindfulness means being aware of the present moment, exactly as it is unfolding without judging it or needing to respond to it.
Interpersonal Effectiveness means being effective with others: asking for things or saying no in such a way that you get what you really want, maintain relationships and enhance your self-esteem.
Emotional Regulation means understanding, moderating or changing your emotions so they work for you, not against you. It also means becoming less vulnerable to problem emotions in general.
Distress Tolerance is the ability to experience distressing, aggravating or upsetting events without resorting to damaging or unwanted behaviors.