Cognitive Behaviour Therapy

Cognitive Behaviour Therapy (CBT) is a type of psychotherapy used to treat depression, anxiety disorders, phobias, delusional disorder, eating disorders and other forms of mental illness. It has been clinically demonstrated in over 400 studies to be effective for many psychiatric disorders and medical problems for both children and adolescents.


CBT is, in fact, an umbrella term for many different therapies that share some common elements. Two of the earliest forms of Cognitive Behaviour Therapy were Rational Emotive Behaviour Therapy (REBT), developed by Albert Ellis in the 1950s, and Cognitive Therapy, developed by Aaron T. Beck in the 1960s.


Other types of CBT include Dialectical Behaviour Therapy, Self-Instructional Training, Schema-Focused Therapy and Acceptance and Commitment Therapy (ACT).


CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. Specifically, our thoughts determine our feelings and our behaviour. So if someone is experiencing negative and unrealistic thoughts, this may cause distress and result in problems.


By seeing thoughts as the cause of emotions rather than an outcome, cognitive therapists reverse the causal order more generally used by psychotherapists. Therefore, therapy identifies irrational or maladaptive thoughts that lead to negative emotion, in an effort to reject the distorted thoughts and replace them with more realistic alternative thoughts.


CBT is not an overnight process. Even after patients have learned to recognise when and where their thought processes go awry, it can take months of concerted effort to replace an irrational thought process or habit with a more reasonable, salutary one.


Cognitive behavioural group therapy is a similar approach, where clients participate in a group and recognise they are not alone in suffering from their problems and can share their own understanding of the CBT process with others.


CBT has a good evidence base in terms of its effectiveness in reducing symptoms and preventing relapse. It is an integrative, interactive approach that involves recognising unhelpful or destructive patterns of thinking and reacting, evaluating whether or not these patterns are realistic or accurate, learning to see the causal connections between thoughts, feelings, actions and physiological responses, and learning how to address and change all of the above through a variety of techniques.


One of the most well known techniques is to modify or replace dysfunctional thoughts with more realistic or helpful ones. Cognitive therapists work from the cognitive model, which says that a person's core beliefs (often formed in childhood) contribute to 'automatic thoughts' that arise in everyday life in response to situations. As such, clinical depression is typically associated with negatively biased thinking and irrational thoughts.


CBT is often used in conjunction with mood stabilising medications, to treat rapidly changing moods.