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What is cognitive-behavioral therapy?

 

Cognitive behavioral therapy (CBT) is a specific psychotherapy approach. The cognitive behavioral therapy is now widely used and considered a treatment method that has been demonstrated valid and effective from a scientific point of view by a considerable amount of evidence-based articles and reviews.

 

Cognitive-behavioral therapy incorporates multiple psychological theories, behavior models, protocols, and treatment techniques that share common features.

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In general terms, cognitive-behavioral therapy explains emotional distress through a complex relationship of thoughts, emotions, and behaviors. Events influence our emotions, but thoughts and behaviors determine their intensity and duration in each individual.

 

Everyone has typical ways of thinking and acting that can produce distress and these ways are targeted by cognitive-behavioral psychotherapy. We are often unaware of our harmful patterns and habits: cognitive-behavioral psychotherapy aims to identify and modify them.

 

Cognitive-behavioral therapy, therefore, acts on emotions, thoughts (or cognitive patterns), and behaviors in an active way and proposes itself as a guide for the subject in his improvement path.

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How cognitive behavioral therapy works

 

Cognitive-behavioral therapy primarily requires very high attention in defining the therapy goals, and they must be defined in a cooperative and consensual way between patient and psychotherapist, according to the diagnosis and by agreeing with the patient a treatment plan.

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It is good practice for the therapist to evaluate objectively (even through tests and surveys) the changes in symptoms and the progress according to the goals that have been defined at the start and of psychotherapy.

 

After having defined specifically the treatment goals, in cognitive behavioral therapy the psychotherapist and the patient both actively collaborate first to identify thoughts, emotions, and behaviors that come into play in situations of malaise and psychopathology; secondly, they actively collaborate to modify maladaptive and dysfunctional thought and behavior habits as well as to manage their emotions more effectively.

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The patient is challenged to take active action in the course of therapy, including identifying his thoughts and emotions, getting stimulated to formulate alternative thoughts and beliefs, experimenting with different behavioral patterns, and practicing various techniques to facilitate emotional regulation, both during therapy sessions and at home throughout the week.

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Cognitive-behavioral psychotherapy involves relaxation and breathing exercises, to be practiced whenever needed.

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Cognitive-behavioral therapy indications

 

Cognitive-behavioral psychotherapy is an effective treatment that is indicated in a variety of symptomatic situations and conditions including:

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• Anxiety disorders: panic attacks (with or without agoraphobia), generalized anxiety, hypochondria, other specific phobias

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• Unipolar and bipolar mood disorders: the so-called and frequently widespread depression in its various diagnostic facets, and bipolar disorders (in combination with drug therapy)

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• Eating disorders: anorexia, bulimia, binge eating disorder

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• Obsessive-compulsive disorder

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• Post-traumatic stress disorder

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• Pathological addictions

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• Sexual disorders

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• Insomnia and sleep disorders

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• Personality disorders

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• Schizophrenia and psychosis (in combination with drug therapy)

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What are the effects on the brain and health?

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Cognitive-behavioral therapy aims to restructure the brain by establishing new neural pathways. For example, a depressed or anxious brain has typically reinforced negative thought patterns for some amount of time.

In many cases, these established pathways influence the brain's willingness to process negative information more easily than positive information, often resulting in the formation of what are known as “distorted thought patterns”.

 

Neuroscience tells us that psychotherapy is not only effective but also has effects on our neural networks. We can imagine neural networks as a set of intertwined roads and paths where our emotions, thoughts, and ways of seeing things run. Each of us has its network and the ability to activate different paths according to the situation.

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Sometimes, however, we tend to take the same road, the same path, without being able to move differently. Some neuronal circuits have become excessively predominant compared to others and they lead us to replicate the same behaviors and the same negative emotions

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Psychotherapy works through cognitive restructuring, in order to weaken the connections between the neurons that process information and negative thoughts and strengthen or create new connections between neurons capable of processing positive emotions.

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This improves the way we think and handle emotions and consequently improves our lives.

 

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REFERENCES

 

[1]: Thoma N, Pilecki B, McKay D. Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence. Psychodyn Psychiatry. 2015 Sep;43(3):423-61. doi: 10.1521/pdps.2015.43.3.423. PMID: 26301761.

 

[2]: Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci. 2015 Sep;17(3):337-46. doi: 10.31887/DCNS.2015.17.3/akaczkurkin. PMID: 26487814; PMCID: PMC4610618.

 

[3]: McKay D, Sookman D, Neziroglu F, Wilhelm S, Stein DJ, Kyrios M, Matthews K, Veale D. Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder. Psychiatry Res. 2015 Feb 28;225(3):236-46. doi: 10.1016/j.psychres.2014.11.058. Epub 2014 Dec 8. PMID: 25613661.

 

[4]: Agras WS. Cognitive Behavior Therapy for the Eating Disorders. Psychiatr Clin North Am. 2019 Jun;42(2):169-179. doi: 10.1016/j.psc.2019.01.001. Epub 2019 Apr 2. PMID: 31046920.

 

[5]: Brewin CR. Theoretical foundations of cognitive-behavior therapy for anxiety and depression. Annu Rev Psychol. 1996;47:33-57. doi: 10.1146/annurev.psych.47.1.33. PMID: 8624137.