The Emerging Popularity of Cognitive-Behavioral Therapy

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By: James P. Krehbiel

Cognitive-behavioral therapy is currently receiving a significant degree of attention as the treatment of choice for individuals needing assistance with a variety of psychological disorders. It is a structured, pragmatic approach to dealing with problems and is appealing to those seeking therapeutic treatment. People in need of counseling are seeking out clinicians who have specialized training in CBT. Understanding the reason for this current trend in popularity of cognitive-behavioral therapy can be found in the unique characteristics which are pivotal to this modality of treatment. There is a simplicity and yet effectiveness in the model which characterizes the concepts of CBT.

Cognitive-behavioral therapy facilitates a collaborative relationship between the patient and therapist. Together, patient and counselor develop a trusting relationship and mutually discuss the presenting problems to be prioritized and explored in therapy. In CBT, the most pressing issue troubling the patient typically becomes the initial focus of treatment. As a result, the patient tends to feel relieved and encouraged that the primary problem that brought him to therapy is immediately being acknowledged and addressed.

Problems are tackled head-on in a very practical manner. The patient is coached on the ABC's of cognitive-behavioral therapy. The therapist explains the connection between thoughts and beliefs and their impact on behavior. How the patient thinks about problems determines the way in which the individual responds to various issues. It's the manner of thinking about life's issues that steers the patient's way of behaving.

Let's assume that you work in an office and for an entire week a co-worker has walked past you without acknowledging your presence. Each day you go back to your cubicle and wonder why this colleague is treating you so unjustly. You build up thoughts about her being condescending and snobbish and begin questioning what you might be doing to annoy her. Anger begins to emerge and your start thinking, "How dare she treat me this way!" Eventually, you settle down and start to rationally consider the problem. You think, "This is stupid, why don't I go visit her at her office and see what's going on in her life that might be affecting this situation. You enter her office and begin starting a conversation. In the midst of your discussion, she reveals that her son is suffering from depression and needs to see a counselor. Your colleague is disturbed about the situation and confides in you that she has been on edge with everyone at the office. She asks you if you know of a qualified therapist. You give her some ideas and before you leave, she gets up from her chair and gives you a firm hug. This incident demonstrates how our thinking can be faulty and can be based upon some erroneous assumptions.

CBT is effective because it teaches the patient to modify patterns of thinking which affect behavior. CBT is a straight-forward therapy which is designed to alert the patient to self-defeating ways of thinking. Locating distorted or maladaptive thinking is accomplished through an exploratory process which is dependent upon a solid patient/counselor therapeutic alliance.

Cognitive-behavioral therapy focuses on the patient's negative self-talk, and offers practical suggestions on how to untwist one's thinking to make it more adaptive. The CBT therapist assists the client in thinking more rationally by examining the individual's spontaneous thoughts, observing ways in which they may distort reality, and ferreting out underlying assumptions or beliefs that affect ways of thinking and behaving.

Spontaneous thoughts are the nonsensical things that we tell ourselves when we are under stress — "I'll never get a date, who would ever want me!" Cognitive distortions are the lenses out of which we perceive reality — "You always make me feel like a loser" (either or thinking). Underlying assumptions are the "hot buttons" which crystallize as a way of coping and getting our needs met during childhood — "I must avoid conflict at all costs; I hate disapproval and getting my feelings hurt."

Cognitive-behavioral therapy seeks to refute the nonsensical things we tell ourselves and assists us in developing more rational ways of responding to our maladaptive thought processes. Since homework is an integral part of therapy, patients will be encouraged to complete exercises designed to change negative thinking. One concrete procedure helps the client to identify current troubling events, negative self-talk, and ways of rationally responding to situations sited. The individual logs difficult situations, identifies self-defeating thinking and refutes the negative thought processes with more rationally, adaptive way of responding to events. During each therapy session, the log sheet is reviewed for patient progress.

With CBT, clients are in control of their own progress. They are aware of the process that is necessary for change, and diligently work at modifying faulty thought patterns. Therapeutic progress is easily monitored through self-inventories and patient feedback. Time is always left at the end of sessions to review the benefits or pitfalls of the counseling sessions. Clients are asked to assess the effectiveness of their counselor's treatment process.

Patients often ask, "How long will this counseling treatment take?" Although each case is unique, six to eight sessions are generally sufficient to teach clients strategies for reshaping their thinking. CBT is a time-limited, user-friendly, practical process for helping individuals to assess their negative thinking and making needed transformation in the way they respond to themselves and others. Individuals with anxiety, addictive patterns and depressive disorders are particularly well suited to benefiting from this from of treatment. The good news is that many behavioral health disorders can be treated successfully through cognitive-behavioral therapy. NACBT or The National Association of Cognitive-Behavioral Therapy is a good resource for locating counselors who are sufficiently trained, certified, and specialize in this treatment approach.

James P. Krehbiel, Ed.S, LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at krehbielcounseling.com.