Thursday, January 30, 2014

Cognitive Behavioural Therapy - An Introduction and History

Cognitive Behavioural Therapy or CBT is a psychotherapeutic approach used by therapists to help to promote positive change in people by addressing their thought patterns, feelings and behavioural issues. Difficulties with irrational thinking, dysfunctional thoughts and faulty learning are identified and then treated using CBT. Therapy can be conducted with individuals, groups or families and the goals of CBT are to restructure one's thoughts, perceptions and responses which facilitate changes in behaviours.

The earliest form of CBT was developed by an American Psychologist, Albert Ellis (1913-2007) in 1955, naming his approach Rational Emotive Behavioural Therapy (REBT). Ellis (right) is looked on as 'the grandfather of cognitive behavioural therapies' Ellis credits Alfred Korzybski (who developed the theory of general semantics, which in turn influenced NLP) and his book 'Science and Sanity' for starting him on the path of founding REBT.

In the 1960s an American Psychiatrist, Aaron T Beck, (below) developed another CBT approach called 'cognitive therapy' which was originally developed for depression but rapidly became a favourite model to study because of the positive results it achieved. CBT therapists believe that clinical depression is typically associated with negatively biased thinking and irrational thoughts. CBT is now used to provide treatment in all psychiatric disorders and also increases medication compliance, resulting in a better outcome in mental illness. A major aid in CBT is the ABC technique of irrational beliefs, the three steps are:

A is the Activating event, the event that leads to a negative thought.

B is the Beliefs, the client's belief around the event.

C is the Consequence, the dysfunctional behaviour that ensued from the thoughts and feelings originating from the event. An example would be: Susan is upset because she got a low mark in her math's test, the Activating event A is that she failed her test, the Belief, B is that she must have good grades or she is worthless, the Consequence C is that Susan feels depressed. In the above example, the therapist would help Susan identify her irrational beliefs and challenge the negative thoughts based on the evidence from her experience and then reframe it, meaning, to re-interpretate it in a more realistic light. Another very useful aid in CBT is to help a client identify with the ten distorted thinking patterns:

1 All or nothing thinking - seeing things in black or white, if your performance falls short of perfect, you see yourself as a total failure.

2 Overgeneralization - seeing a single negative event as a never ending pattern of defeat.

3 Mental Filter - you pick out a single negative defeat and dwell on it so as your vision of reality becomes darkened.

4 Disqualifying the positive - you dismiss positive experiences by insisting that they 'don't count' maintaining a negative belief.

5 Jumping to conclusions - you make a negative interpretation even though there are no definite facts that convincingly support your conclusion, this includes 'mind reading' and 'fortune telling' or 'assuming.

6 Magnification (Catastrophising) minimization - exaggerating things or minimizing things, this is also called the 'binocular trick'.

7 Emotional reasoning - assuming that your negative emotions reflect the way things really are, 'I feel it, therefore, it must be true'.

8 Should statements - 'shoulds', 'musts' and 'oughts' are offenders.

9 Labeling and mislabeling - instead of describing your error, you attach a negative label to it, ie 'Im a loser'.

10 Personalisation - you see yourself as the cause of some negative external event which in fact you were not responsible for.

These are just some of the techniques used in CBT, others are, relaxation tecniques, communication skills training, assertiveness training, social skills training and giving the client homework assignments.

In a nutshell, Cognitive Behavioural Therapy aims to help a client to become aware of thought distortions which are causing psychological distress and of behavioural patterns which are reinforcing it, and to correct them.

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