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Cognitive Behavioral Therapy

Alternate Names

  • CBT
  • cognitive therapy

Definition

Cognitive behavioral therapy is a way of treating mental and emotional disorders, such as:
  • anxiety
  • depression
  • eating disorders such as anorexia nervosa and bulimia
  • alcohol and drug abuse problems
  • What is the information for this topic?

    This type of therapy is very different from other types of treatment. For instance:
    • it usually lasts 2 to 3 months if sessions are weekly
    • the person needs to do homework between weekly sessions
    • the therapist spends a lot of time talking and teaching, not just listening
    When treating someone with depression, the therapist will help the person see how negative thoughts affect mood. The therapist will help him or her identify negative thoughts and learn how to replace them with more positive ones.
    For instance, if a person is having trouble with a project at work or school, he may think that he is no good at anything. The therapist will help him see that this thought not only makes him feel worse, but also that it is false. The person will be taught to change his thought from "I'm not good at anything" to something that feels better and is true, such as "I may not be good at doing this task, but there are other things that I do very well."
    The therapist will also help the depressed person change behavior that may be contributing to low self-esteem. For instance, if a person has a project that is overwhelming, he or she may not start it right away because he or she feels it cannot be finished. The therapist would help break the job down into smaller parts that are easier to do. They would set a weekly goal of completing 1 or 2 of the smaller parts. Very soon the person will have completed the big project that was thought of as too hard at first.
    The person will learn to will feel much better by finding creative ways to get the job done. He or she will also learn how to schedule more pleasurable activities into each day. By succeeding at work and spending more time on things he or she likes to do, the depressed person will begin to enjoy life more and feel better.
    This type of therapy is also very helpful for people with anxiety. People who are anxious or nervous a lot often have frightening thoughts that are not true. The therapist will help this person identify the frightening thoughts and change them to be more realistic. For instance, some people are afraid of flying in a plane for fear that it will crash. The therapist can help the person see that while there is a chance that the plane could crash, the odds of it happening are really very small- perhaps 1 in 10 million. The therapist may help the person realize how unlikely this is by having him or her imagine how long it would take to write the word "airplane" 10 million times or to count 10 million pennies.
    The therapist may also help someone overcome certain fears by slowly exposing the person to the thing which makes him or her afraid. This is called desensitization. For instance, if a person is afraid of snakes, the therapist might have him or her look at pictures of snakes for several hours at a time.
    After a while, the individual will be able to look at the pictures without feeling afraid. Then, the therapist could have the person hold a rubber snake until he or she is relaxed doing this. Using this method of gradual desensitization, the person will eventually become comfortable looking at and even holding a real snake.
    The same treatment can work for people with other fears, such as heights, speaking in front of people, or having their blood drawn. This therapy can be used along with medicine to treat anxiety and depression. It may take 6 to 8 weeks for a person to see a change in symptoms, although sometimes it occurs sooner. Once this type of therapy is completed, the person does not usually need to return again. However, some people may find it helpful to have periodic checkups with their therapists.

    Sources

    Cognitive and Behavioral Therapies. Thase ME and Wright JH. In Psychiatry, Vol 2. Edited by Tasman A, Kay J, Lieberman JA. Pgs. 1418-1438. W.B. Saunders Company, Philadelphia; 1997.

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