What is it?

Cognitive Behavioural Therapy (CBT) is a form of psychotherapy, conducted either in person or remotely, that aims to enhance mental health by managing and altering dysfunctional thoughts and behaviors.

CBT is based on the idea that our thoughts, feelings, and behaviors are interconnected. It suggests that automatic negative thoughts can lead to depressive feelings, anxiety, and harmful behaviors. Through CBT, therapists help individuals identify and change negative thoughts, adopting healthier ways of thinking and behaving.

Why it is the dominant form of psychotherapy internationally

1. Scientific documentation: There is a rich research base supporting its effectiveness in various mental disorders, including depression, anxiety disorders, sleep disorders, and eating disorders(Butler, Chapman, Forman, Beck, 2006).

2. Structured approach: CBT is a structured, goal-oriented treatment that enables clear monitoring of progress and the achievement of specific objectives.

3. Specific techniques: It employs specific techniques, such as thought recording, cognitive restructuring, and gradual exposure, which have been proven effective in reducing symptoms.

How it differs from other forms of psychotherapy

CBT differs significantly from other forms of psychotherapy, such as psychoanalysis, mainly in the following areas:

1. Focus on the present: CBT primarily focuses on present and current dysfunctional thoughts and behaviors, whereas psychoanalysis often looks to the past and childhood experiences to identify the roots of problems.

2. Duration: CBT is a short-term treatment, typically lasting from 10 to 20 sessions, whereas psychoanalysis can extend for years.

3. Role of the therapist: In CBT, the therapist takes an active, educational role, helping the patient learn and apply new strategies. In contrast, in psychoanalysis, the therapist maintains a more passive role, allowing for the patient’s free associative thinking.

Indications

CBT is effective for a range of problems, including:

1. Depression
   
   CBT helps patients identify and change the negative thoughts that contribute to depression.

2. Anxiety disorders
   
   It is effective in treating disorders such as generalised anxiety disorder, panic attack disorder, agoraphobia and other phobias, social anxiety disorder (social phobia) and obsessive-compulsive disorder.

3. Food intake disorders
   
   Used in the treatment of anorexia nervosa, bulimia and hyperphagia.

4. Sleep disorders
   
   It helps to improve sleep problems such as insomnia.

5. Post-traumatic stress disorder (PTSD)

   CBT, especially techniques like exposure and trauma reprocessing, has been effectively used to treat PTSD. These techniques help individuals to process traumatic experiences and reduce symptoms of anxiety and flashbacks.

6. Obsessive Compulsive Disorder (OCD)

   CBT, in the form of exposure and response prevention (ERP), is the treatment of choice for OCD. This technique involves exposing the person to stressful situations without allowing the use of compulsions, thereby reducing their dependence on these behaviors.

7. Bipolar Disorder

   CBT is an excellent complementary therapy for bipolar disorder. It helps patients manage the symptoms of depression and develop strategies to prevent relapses.

8. Chronic Pain

   CBT has been shown to be effective in managing chronic pain, helping patients to develop techniques to reduce their perception of pain and enhance their functioning.

9. Substance Use Disorders and Gambling Disorders

   CBT is useful in the treatment of addiction, helping addicts to recognise and change the thoughts and behaviours associated with abuse, and to develop skills to prevent relapse.

10. Psychotic Disorders

    CBT is used as a complement to medication for psychotic disorders, such as schizophrenia, to help people manage symptoms and improve their quality of life.

11. Dysfunctional Relationships

    CBT is effective in treating interpersonal difficulties and dysfunctional relationships, helping individuals to develop healthy ways of communicating and managing conflict.

12. Self-esteem and self-image

    CBT can help boost self-esteem and improve self-image by changing negative thoughts and promoting positive self-concepts.

13. Anxiety Disorders in Children and Adolescents

    CBT is also effective for children and adolescents who are experiencing various anxiety disorders in order to develop coping skills and reduce anxiety symptoms.

Duration

The duration of CBT is usually short-term, ranging from 10 to 20 sessions, depending on the nature and severity of the client’s condition. In some cases, more time may be needed, especially if there are complex or chronic problems.

Bibliography

• Beck, J. S. (2011) Cognitive Behavior Therapy: Basics and Beyond, Guilford Press.

• Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review, 26(1), 17-31.

• Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses, Cognitive Therapy and Research, 36(5), 427-440.

• Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. Psychiatric Clinics, 33(3), 557-577.