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Derived from cognitive and behavioral theories and proven beneficial by scientific research, Cognitive Behavioral Therapy (CBT) has become increasingly popular in the field of psychotherapy. So, what is Cognitive Behavioral Therapy? In this article, we explore what CBT is, how it is applied, and in which situations it is preferred.
The cognitive-behavioral therapy method emerged in the mid-20th century, drawing on the work of Albert Ellis and Aaron Beck, combining cognitive and behavioral psychology models. Clinical psychologist Ellis developed Rational Emotive Behavior Therapy in the 1950s, suggesting that irrational beliefs led to emotional distress.
Around the same time, Aaron Beck proposed the theory that distorted and dysfunctional thought patterns were the cause of emotional and behavioral problems. Over time, these two therapeutic methods intertwined, forming the treatment method known today as Cognitive Behavioral Therapy. From its early years, research has explored its scientific validity and effectiveness, revealing its benefits in resolving many mental health issues.
The goal of cognitive-behavioral therapy is described as helping individuals identify and change dysfunctional and distressing thought patterns affecting their behaviors and emotions. In other words, CBT assists in identifying maladaptive thought patterns, emotional responses, and unhelpful behaviors, helping individuals replace them with more adaptive and healthier patterns. Today, it is used in the treatment of various mental health issues such as depression, anxiety, substance abuse, and eating disorders.
According to cognitive-behavioral therapy, partly flawed, dysfunctional, and unrealistic thought patterns lie at the core of our psychological problems. Therefore, to solve psychological issues, the focus is on these thought patterns, working to change them into more healthy, realistic, and functional thought forms. In cognitive-behavioral therapy, we work on our distorted thought patterns, motivations, and problem-solving skills. While the "past" may be an important source of information to solve the problems we face, working on the reflections of our past in our current lives and focusing on the problems of the current life stage contribute to more effective results. In other words, instead of only dealing with the origin or only the result of the problems, a more holistic approach is aimed at addressing both areas.
One of the significant advantages of CBT is that the therapy is not limited to the session duration. Therapists using cognitive-behavioral methods not only provide exercises during sessions but also ensure the continuity of psychological work by assigning exercises for daily life, a kind of homework, to work on our thoughts and behaviors. In this perspective, by learning how to benefit ourselves, we can make the gains in the therapy process more permanent.
The main advantages of cognitive-behavioral therapy can be listed as follows:
CBT is typically applied in the form of a 45-minute session once a week. If the individual's reason for coming to therapy is a specific complaint, emotions, thoughts, and physical manifestations are identified based on this complaint. If the person is experiencing an unnamed complaint, dysfunctional and unrealistic thoughts feeding this feeling are explored during the sessions with the therapist. Later, the therapist and the client begin working on these areas. They analyze together why these thoughts are ineffective or unrealistic. Subsequently, the therapist and the client determine which healthy thoughts can replace these, and, guided by the therapist, the process of replacing dysfunctional thoughts with healthy ones begins. The therapist encourages the client to gradually use the methods used to change thoughts in their daily life outside of sessions. In this way, through a continuous exercise process, the client internalizes healthy thought patterns and acquires keys they can use in various difficulties throughout their life.
Cognitive-behavioral therapy incorporates many exercises and therapeutic techniques. Knowing what these methods are and examining an example of cognitive-behavioral therapy can help us better understand this approach. Here are the main subcategories of cognitive-behavioral therapy:
Examining a clinical example, as mentioned above, can help us better understand CBT. Here's a good example of cognitive-behavioral therapy:
Let's consider a cognitive-behavioral therapy session between 30-year-old Alison and her therapist. Alison's reason for coming to therapy is her long-standing high social anxiety. Due to embarrassment and fear of judgment, she avoids company meetings, speaking in public, and even everyday interactions with colleagues. Negative thoughts such as "I will say something foolish and embarrass myself" or "People will find me strange" cross her mind in such situations. Avoidance behaviors significantly affect her professional and social life.
The therapist first assists Alison in identifying negative thought patterns, such as "I will embarrass myself," that arise in such situations or even just thinking about these situations. Then, they start working to challenge these negative thought patterns. To do this, the therapist asks Alison to question and answer questions like "What evidence do I have that this thought is true?" or "Have I had experiences that show this thought may not always be true?" or "What would I say to a friend who has the same thought?" In this way, Alison has the chance to see that her negative beliefs about social situations are based more on fear and past experiences than on reality.
After Alison identifies and challenges her negative thoughts, the next step is to replace these patterns with more balanced, realistic, and functional thoughts. For example, with the progress made in sessions, Alison can now think, "Instead of embarrassing myself, everyone makes mistakes, and people are more understanding of mistakes than I think. Even if I make a mistake, it's not the end of the world." After completing these steps, Alison gradually faces social situations that she avoids, starting with small steps such as chatting with a colleague. In this progress, she uses new, balanced, and realistic thought patterns. Later, the therapist asks her to continue these steps in challenging situations in her daily life to maintain the gains. Alison takes note of her negative thoughts, challenges them, and replaces them with more rational thoughts. In this way, by gradually facing other challenging situations, she improves her quality of life.
Did you know that many of the journeys, tasks, and Wellbeing exercises in Relate's content are largely inspired by CBT? If you have thought patterns, anxieties, or behaviors that are not serving you well or that you want to bring to a healthier dimension, #RelateWithYou!
Although it is commonly associated with the treatment of depression and anxiety disorders, research shows that cognitive-behavioral therapy is highly effective in the treatment of many mental health issues. We've listed the main mental health problems where cognitive-behavioral therapy is used:
