Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy is a form of treatment that is proven to be one of the most effective in reducing or eliminating symptoms of anxiety and depression. It can help you make concrete, observable changes in your life.
After determining that this is the approach that most suits your needs, I will work with you using interactive techniques.
You can expect to:
- Discover how your thoughts and feelings impact your behaviors
- Challenge irrational/negative/unwanted beliefs
- Develop more rational coping thoughts
- Alter unwanted behaviors
- Learn to become more mindful in your daily life
- Become aware of your mind-body connections
- Learn various relaxation techniques
- Decrease anxiety associated with stressful situations
- Reduce procrastination
- Improve organization
- Increase productivity
- Learn self- compassion tools
- Reduce feelings of shame
- Learn to increase your motivation
- Integrate more pleasurable and productive activities into your schedule
- Manage chronic pain
- Adjust to life changes including physical and cognitive disabilities
- Eliminate panic and phobias
- Reduce or eliminate obsessive thinking
- Engage in progress monitoring in order to ensure that the treatment is working and that your symptoms are decreasing
- Provide feedback regarding whether each session is beneficial and/or if certain approaches were unhelpful
How Does CBT Work?
Cognitive refers our beliefs regarding the world, others, and ourselves. Behavioral refers to actions that we perform that we wish to do differently. Therapy refers to the treatment, which includes techniques described below. CBT assists in identifying how our thoughts impact how we feel and how our feelings impact how we behave.
Cognitive behavioral therapy is rooted evidence-based methods designed to change thoughts, feelings, and behaviors and improve overall life satisfaction and daily functioning. CBT techniques are empirically validated, result oriented, active, and typically provided on a short-term basis. Cognitive behavioral therapy is designed to be time-sensitive, structured, and present-oriented. It helps you identify relevant goals and conquer obstacles that negatively impact you daily life. CBT helps people get better and stay better.
What are some examples of CBT techniques?
The Socratic Method has been defined as “a method of guided discovery in which the therapist asks a series of carefully sequenced questions to help define problems, assist in the identification of thoughts and beliefs, examine the meaning of events, or assess the ramifications of particular thoughts or behaviors” (Beck & Dozois, 2011). Using Socratic Questioning allows me to encourage your self-awareness, focus in on the problem definition, expose your core belief system, and challenge irrational beliefs while revealing your cognitive processes.
Developed collaboratively during therapy sessions, homework assignments are an important component of CBT and may be used to practice new skills, utilize new coping strategies, and restructure unproductive beliefs. Typical CBT homework assignments may include worksheets, activities in behavioral activation, monitoring automatic thoughts, monitoring and logging behaviors, following through with planned exposures, reviewing the previous therapy session, and preparing for the next therapy session.
Self-monitoring is used to record the amount and degree of thoughts and behaviors focused on during treatment utilizing a behavioral log. This provides information regarding the degree of your negative beliefs and subsequently assists with treatment.
One practice in CBT is to examine our beliefs and assumptions, and put them to the test. Many of us maintain beliefs that are not supported by evidence, and we allow these irrational/false/unsupported beliefs to dictate how we live our lives. It can be extremely liberating to let go of beliefs and assumptions that have been holding us back. Behavioral experiments are planned activities, based on experimentation or observation, undertaken by you in session or between sessions. They challenge existing beliefs and predictions and/or help develop more adaptive beliefs. They are designed based on each individual case formulation. The experiment process may include experiencing, observing, reflecting, and/or planning. Behavioral Experiments are an excellent way of finding out the truth about our beliefs concerning ourselves, other people, and the world around us.
Systematic desensitization, also known as graduated exposure therapy, is a type of behavior therapy and is based on the principle of classical conditioning. This technique aims to remove the fear response of a phobia, by pairing relaxation with exposure to something stressful. You are taught to relax in anxiety producing situations.
Cognitive Restructuring Techniques
The process of identifying, challenging, and changing, irrational/negative thoughts that are responsible for negative moods and ineffective behavior. This is done collaboratively together in session. We will work together so that you may learn to identify and dispute irrational or maladaptive thoughts known as cognitive distortions, such as all-or-nothing thinking (splitting), magical thinking, catastrophizing, rumination, over-generalization, magnification, black and white thinking, and emotional reasoning.
Graded Exposure Assignments
Graded Exposure is an evidence-based technique that helps people systematically approach feared situations, activities or objects. Generally, fear causes people to avoid situations. Unfortunately, avoidance of feared situations is what maintains feelings of fear and anxiety. Through systematic exposure, people master feared situations. Exposure is one of the most effective psychological treatments that exists with some anxiety disorders.
Designed to develop behavioral activation, activity scheduling is a CBT technique designed to help you engage in behaviors you ordinarily would avoid due to depression, anxiety, or other obstacles. By identifying and scheduling helpful behaviors, such as meditating, going for a walk, or working on a project, it increases the likelihood of their getting done. This technique is especially helpful for people who do not engage in many rewarding/pleasurable activities due to lack of motivation due to depression, avoidance due to anxiety, or for people who have difficulty completing tasks due to procrastination and poor time management.
Successive Approximation is occasionally called ‘shaping’. This cognitive behavior therapy technique works for people who have difficulty completing a task, either due to lack of familiarity with the task, or because the task feels overwhelming for some reason. The technique works by helping people master an easier task that is similar to the more difficult task. In successive approximation, each successive step towards the desired behavior is identified and rewarded. The series of rewards for different steps of the behavior increases the likelihood that the steps will be taken again and that they will lead to the desired end result being fulfilled. By having rehearsed one behavior, one that is slightly more difficult feels more manageable.
Mindfulness based techniques are borrowed from Buddhism. These techniques focus on awareness of thoughts and feelings without attachment or judgment. Mindfulness is a strategy to help people develop a new relationship to experiences such as anxiety, not to eliminate these experiences. The goal of mindfulness is to help you disengage from negative patterns of thought such as ruminating or obsessing about negative things and redirect your attention to what is actually happening in the present moment. Mindfulness-based cognitive therapy (MBCT) combines cognitive behavioral techniques with mindfulness strategies in order to help you better understand and manage your thoughts and emotions in order to achieve relief from feelings of distress.
Many problems result from not having the appropriate skills to achieve your goals. CBT builds a set of skills that enables you to be aware of your thoughts and emotions, identify how situations, thoughts, and behaviors influence your emotions, and and improve feelings by changing dysfunctional thoughts and behaviors. The process of CBT skill acquisition is collaborative. Skills training serves to remedying skills deficits such as social skills, communication, assertiveness and perspective taking. You will learn skills through direct instruction, modeling, and role-plays.
Exposure Response Prevention (ERP)
Exposure Response Prevention, commonly referred to as ERP, is a therapy that encourages you to face your fears and let obsessive thoughts or behaviors occur without neutralizing them with compulsions. The Exposure in ERP refers to exposing yourself to the thoughts, images, objects and situations that make you anxious and/or start your obsessions. While the Response Prevention part of ERP, refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.” All of this is done under the guidance of your therapist at the onset of treatment and you will then learn to do your own ERP exercises independently to help manage symptoms.