Cognitive-Behavioral Therapy (CBT) (Procedure) Overview

Cognitive-behavioral therapy (CBT) is a form of talk therapy. This means that you discuss your thoughts, feelings, and behaviors with a mental health professional. CBT focuses on how the way you think affects the way you feel and act.

Your therapist helps you identify negative thoughts and evaluates how realistic these thoughts are. Then, he or she teaches you to unlearn negative thought patterns and learn new, helpful ones.

CBT is a problem-solving approach. While you cannot control other people or situations, you can control the way you perceive and react to a particular situation. CBT teaches you the skills to change your thinking. It can also help you manage your reactions to stressful people and situations.

Prior to Procedure

There is no specific preparation for CBT. You may be asked to fill out a questionnaire about your feelings.

Description of the Procedure

You may receive CBT in one-on-one therapy sessions or in a group format. CBT can be divided into two parts: functional analysisand skills training.

Functional Analysis

You and your therapist will identify stressful situations. You will also determine the thoughts that lead to or worsen these situations. These thoughts will then be analyzed to see if they are realistic and appropriate. For example, your therapist may point out negative thought patterns, such as “I cannot handle this” or "people are laughing at me.”

Skills Training

Next, your therapist guides you to reduce unhealthy ways of thinking and to learn healthier ways. Instead of thinking “I cannot handle this,” you will learn to draw on your strengths: “I have handled difficult situations before, so I can handle this one.”

You will also learn to ask more questions about yourself before making a conclusion. For example, “Could those people be laughing at something other than me?” The goal is to replace irrational thought patterns with better ones.

Skills training takes a lot of practice. You will often be given “homework.” You might practice deep-breathing exercises or role-play how to act in certain social situations. For example, a person dealing with substance abuse might practice ways to decline an alcoholic drink.

Homework is vital to the success of CBT. You must practice new, rational responses until they replace your previous, unhealthy responses. Homework also allows you to try new skills. You will then be able to give feedback on which works best for you.

How Long Will It Take?

The length of an individual session is usually 50-100 minutes. Group sessions may last longer. Treatment sessions may occur 1-2 times per week for 12-16 weeks.

This is a general guideline. Depending on your situation, treatment may be longer or shorter. Keep in mind that it may take several tries to unlearn poor habits and to learn healthy ones.

Post-therapy Care

You may be given homework between sessions. You will need to practice the strategies you and your therapist have discussed.

Some therapists advise that you return for a check-up about three, six, and twelve months after therapy has ended. In addition, you may call your therapist whenever the need arises.

The goal of CBT is to change your thought process. This will allow healthy and realistic responses to difficult situations. Many patients notice an improvement in their symptoms within 3-4 weeks of beginning CBT.

RESOURCES:

American Psychological Association
http://www.apa.org/

The Beck Institute for Cognitive Therapy and Research
http://www.beckinstitute.org/

National Association of Cognitive—Behavioral Therapists
http://www.nacbt.org/index.htm/

CANADIAN RESOURCES:

BC Health Guide, British Columbia Ministry of Health
http://www.bchealthguide.org/

Canadian Psychiatric Association
http://www.cpa-apc.org/

References:

About cognitive therapy. The Beck Institute for Cognitive Therapy and Research website. Available at: http://www.beckinstitute.org/InfoID/220/RedirectPath/Add1/FolderID/237/SessionID/{F703BF2C-4363-4997-B964-170D984B48F8}/InfoGroup/Main/InfoType/Article/PageVars/Library/InfoManage/Zoom.htm . Accessed November 30, 2005.

About cognitive therapy. The Beck Institute for Cognitive Therapy and Research website. Available at: http://www.beckinstitute.org/Library/InfoManage/Guide.asp?FolderID=200&SessionID={C2B865B0-C678-401C-B776-47F352D4CFC9} . Accessed June 10, 2007.

Bush JW. The CBT website. Available at: http://www.cognitivetherapy.com/index.html . Accessed November 29, 2005.

Butler AC, Chapman JE, Forman EM, et al. The empirical status of cognitive-behavioral therapy: a review of meta-analyses [abstract]. Clin Psychol Rev. 2005.

A cognitive-behavioral approach: treating cocaine addiction. National Institute on Drug Abuse website. Available at: http://www.nida.nih.gov/TXManuals/CBT/CBT1.html . Accessed November 22, 2005.

Cognitive-behavioral therapy. National Association of Cognitive-Behavioral Therapists website. Available at: http://www.nacbt.org/whatiscbt.htm . Accessed November 22, 2005.

Morris N, Raabe B. Some legal implications of CBT stress counselling in the workplace. British Journal of Guidance & Counselling. 2002 Feb;30(1):55-62.