What is Cognitive Behavioural Therapy and How Does it Help?

Cognitive Behavioural Therapy (CBT), as the name suggests, is a therapeutic modality incorporating both cognition and behaviour. Cognition refers to the mental processes such as attention, memory, thinking, reasoning and decision-making. Behaviour is the observable action that a person undertakes, based on their cognition. CBT is based on the principle that our thoughts, feelings and behaviour are interconnected and changes in any one of these modalities can bring a change in the other two domains. To put this simply, the thoughts we have can influence our feelings and, in turn, our behaviour; our behaviour can influence our thoughts and feelings; and the way we feel about a situation can impact our thoughts and behaviour in that situation.
For example, if you are cooking and put in too much salt by mistake, you might have an automatic thought, an idea that just seemed to pop up in your mind: “I can’t do anything right.” This thought might then lead to a particular reaction: you might feel sad (emotion) and avoid cooking or trying to do anything new (behaviour). This can create a cycle where any subsequent mistake is seen as proof that you can’t do anything right, causing increasing distress and avoidance behaviour. However, if you examined the truth of the first thought and looked for alternative evidence, you might conclude that you had overgeneralized and that, in fact, you actually do many things well. Looking at your experience from this new perspective would probably make you feel better and lead to more functional behaviour. This is the crux of CBT: identifying and altering inaccurate and/or unhelpful thinking and behaviour to reduce distress.
Effectiveness of CBT
CBT is one of the most widely researched therapies and has proven effective in treating many concerns including depression, anxiety, phobias, bipolar disorder, personality disorders, eating disorders, panic attacks, substance use or other addictions, anger issues, insomnia, low self-esteem, relationship issues, grief, chronic pain and stress management. It recognizes that we might not be able to modify our circumstances, but by modifying our attributions and thoughts about a situation, we can feel and act in better ways.
How it works and what it entails
CBT focuses on the inaccurate or unhelpful thoughts people have in situations and identifies the underlying beliefs people form based on these thoughts. By collecting evidence for these beliefs and reframing these thoughts, CBT provides realistic, alternative perspectives which can positively impact one’s emotions and behaviours. It uses a process of disputing and challenging one’s negative thoughts. Behavioural changes are also emphasized to bring about new positive outcomes. Homework is assigned to clients to help track progress and bring about changes outside the therapeutic setting. New skills and coping techniques are taught and modelled to provide the client with novel ways of responding to their situations.
CBT is an active therapeutic modality requiring active participation of the client. The client and therapist work together to set goals, identify errors in thinking, find alternatives and implement adaptive behaviours. It involves self-reflection on the part of the client into their motives, biases, judgements and assumptions. These are discussed and modified in therapy so that they become adaptive. The client is also self-empowered through techniques to monitor their thoughts and feelings and gradually becomes independent and capable of regulating themselves.