eflections Counseling of Denton - "Compassionate, Unbiased Care"
Cognitive Behavioral Therapy

Developed by Dr. Aaron T. Beck

What is Cognitive Behavior Therapy (CBT)?
Cognitive Behavioral Therapy (CBT) is the term used for a group of psychological treatments that are based on scientific evidence. These treatments have been proven to be effective in treating many psychological disorders.

Some people have an inaccurate view of what psychological therapy is, perhaps because of the old-fashioned treatments shown on TV or in the movies. For example, on TV, psychotherapy may seem to involve dream interpretation or complex discussions of one's past childhood experiences. This type of psychotherapy is outdated. In fact, very few psychotherapists (e.g., psychologists, social workers, or psychiatrists) use this type of treatment.

Cognitive behavioral therapy is usually a short-term treatment (i.e., often between 6-20 sessions) that focuses on teaching clients specific skills. CBT is different from many other therapy approaches by focusing on the ways that a person's cognitions (i.e., thoughts), emotions, and behaviors are connected and affect one another. Because emotions, thoughts, and behaviors are all linked, CBT approaches allow for therapists to intervene at different points in the cycle.

In cognitive therapy:
  • The therapist and client work together with a mutual understanding that the therapist has theoretical and technical expertise, but the client is the expert on him- or herself.
  • The therapist seeks to help the client discover that he/she is powerful and capable of choosing positive thoughts and behaviors.
  • Treatment is often short-term. Clients actively participate in treatment in and out of session. Homework assignments often are included in therapy. The skills that are taught in these therapies require practice.
  • Treatment is goal-oriented to resolve present-day problems. Therapy involves working step-by-step to achieve goals.
  • The therapist and client develop goals for therapy together, and track progress toward goals throughout the course of treatment.

In cognitive therapy, clients learn to:
  • Distinguish between thoughts and feelings.
  • Become aware of the ways in which thoughts can influence feelings in ways that sometimes are not helpful.
  • Learn about thoughts that seem to occur automatically, without even realizing how they may affect emotions.
  • Evaluate critically whether these "automatic" thoughts and assumptions are accurate, or perhaps biased.
  • Develop the skills to notice, interrupt, and correct these biased thoughts independently.

The basis of cognitive therapy is that thoughts can influence feelings, and that one's emotional response to a situation comes from one's interpretation of that situation. An example is below.

Imagine experiencing the sensations of your heart racing and shortness of breath. If these physical symptoms occurred while sitting quietly on a park bench, they would likely be attributed to a medical condition, such as a heart attack, may cause fearful and anxious emotions. In contrast, if these physical symptoms occurred while running on a treadmill, they likely would not be attributed to a medical ailment, and may not lead to fear or anxiety. In short, different interpretations of the same sensations could lead to entirely different emotions.

Cognitive therapy suggests that many of our emotions are due to our thinking - i.e., the ways that we have perceived or interpreted our environments. Sometimes these thoughts may be biased or distorted. For instance, one might interpret an ambiguous phone message as suggesting interpersonal rejection, or physical symptoms as suggesting a medical disorder. Others may set unrealistic expectations for themselves, or harbor pervasive concerns regarding their acceptance among others. These types of thoughts can contribute to distorted, biased, or illogical thinking processes that then affect feelings.