Different therapists use different approaches when helping people. Cognitive behavioral therapy is a frequently used approach that has a strong evidence base supporting its effectiveness with a variety of problems. CBT has been shown to be particularly effective with feelings of depression and anxiety and aggressive behavior.
Cognitive behavioral therapy focuses on helping you understand, manage and change your thoughts or cognitions as a first step in changing patterns of behavior and feelings. So from this perspective, if you change the way you think, you will begin to feel and behave better.
This counseling approach is used by many clinical psychologists, psychiatrists and counselors. Some therapists will specialize in this form of therapy while others will integrate some of the techniques with other approaches to help you work through your difficulties. Cognitive behavioral therapy is often used in conjunction with medication.
How does CBT work for depression?
If you are depressed you may feel hopeless, empty and/or anxious, and have a lack of energy. These feelings make it difficult to think positively about yourself, your relationships with other people and life in general.
Cognitive behavioral therapy will help you review how you managed certain events and situations in your life. Together with a therapist you look at troubling events in your life and talk about your thoughts related to those events.
Someone who uses cognitive behavioral therapy believes that depressive feelings come from a person’s illogical or negative thinking. When a therapist works with a person using this approach the therapist will teach the person how to challenge negative thoughts (“I’m worthless”, “I’ll never be any good at this)”, and then helps the person develop more positive ways of thinking (I might not be able to do this perfectly, but that doesn’t mean I’m worthless”).
Through this process, negative, unhelpful, or irrational thoughts are identified along with more positive thoughts about the situation. Through this process you learn how to replace negative thinking patterns with more positive ones that will eventually help you to feel better about yourself, your relationships and life in general.
Cognitive behavioral therapy will help give you strategies for managing problems both small and large so they don’t get on top of you.
How does CBT work for anxiety?
CBT for anxiety disorders aims to help a person develop a more adaptive, or positive, response to a fear. The cognitive part helps people change the thinking patterns that support their fears, and the behavioral part helps people change the way they physically react to the situations that provoke their anxiety. Another name for this CBT approach is stress inoculation training.
A CBT therapist may expose the person gradually to the object or situation that is feared, perhaps at first only through pictures or video, then later face-to-face. At the same time, the person practices new thought patterns and new behaviors. When the time comes to confront the feared situation in person, the therapist often accompanies the person to provide support and guidance.
How does CBT work for aggressive behavior?
Aggression replacement training is the name of the approach used with a person who has difficulty managing anger and behaves aggressively. Aggression replacement training is based on CBT principles. With this approach, the therapist helps the person identify the triggers that lead to angry feelings and aggressive behavior, how to anticipate and prepare for these triggers, and then how to keep calm when faced with situations that arouse anger and aggressive responses. The person learns a variety of skills, including things to say to themselves (also known as “self talk”) to keep from losing control. This type of therapy also focuses on helping the person develop positive social skills and moral reasoning.
What is likely to happen when you visit a therapist who practices CBT?
Usually, cognitive behavioral therapy is structured so that you have regular sessions with the counselor or therapist. How often will depend on a number of factors but it will usually be weekly at the start and may become less often over time.
Many therapists will also agree with you to come for a set length of time. For example you may see the therapist weekly for eight weeks and then assess progress and reassess the need for future sessions.
Reviewing progress is often an important part of the process. The sessions may vary in length but are usually an hour long. It is not uncommon for the therapist to also give you some tasks that you do between sessions.
The first time that you see your therapist, you will likely talk about what may be the best arrangement for you. You should feel comfortable bringing it up if your therapist doesn’t.