Introduction to Cognitive Behavior Therapy # 1300

Introduction to Cognitive Behavior Therapy
Harvey C. Parker, Ph.D.
Clinical Psychologist


What is Cognitive Behavior Therapy?
Cognitive Behavior Therapy (CBT) combines two very effective kinds of psychotherapy—cognitive therapy and behavior therapy.

Behavior therapy helps you weaken the connections between stimuli (people, situations, or events) and your habitual, undesirable reactions to them. These undesirable reactions may include fear, sadness, anger, self-defeating or self-damaging behavior, worry, panic, etc. Behavior therapy also teaches relaxation strategies to calm the mind and body so you can feel better and think more clearly.

Cognitive therapy emphasizes the role of thinking in how we feel and what we do. Cognitive therapists instruct clients to identify unhealthy thoughts that can lead to unwanted feelings and behavior. Clients are taught how to replace unhealthy thoughts with healthier thoughts that lead to more desirable reactions.

When combined into CBT, behavior therapy and cognitive therapy provide very powerful tools for stopping symptoms of worry, fear, anxiety, anger, depression, etc.

There are several "schools" or approaches to CBT. These include Rational Emotive Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy. In general, most of these approaches follow the principles listed below.
Basic Principles of Cognitive Behavior Therapy
  1. Thoughts cause us to feel or behave in certain ways, not external things like people, situations, and events. This is the foundation of CBT. The benefit of this fact is that healthier thinking can lead to feeling better and reacting better even if people, situations, or events around us do not change.
  2. CBT is relatively short-term. While other forms of therapy can take many months or years (i.e., psychoanaysis), CBT can achieve results in much shorter periods of time--from a few weeks to a few months. This is because CBT is based on direct teaching and makes use of homework to encourage clients to practice what is taught. However, there are many factors that affect the length of CBT treatment. Among them are:
    a. the condition of the client at the time he or she begins CBT
    b. the number of symptoms that are present and their severity
    c. the degree of impairment these symptoms cause
    d. the chronicity of symptoms
    e. the client's motivation to succeed
    f. the client's expectatons

  3. CBT works best when the therapist or coach teaching the principles has a positive relationship with the client. The therapist/coach listens carefully to the issues brought up, guides the client to identify unhealthy patterns in their thinking, and encourages the client to try new ways of thinking that could result in more desirable feelings and behavior.
  4. CBT is based on an eductional model. The goal is to help clients unlearn their unwanted reactions and to learn a new way of reacting to people, situations, or events.

  5. Homework is important in CBT. Instructors who use a CBT model will frequently assign homework to their clients. The purpose of homework is to practice healthy ways of thinking and reacting to people, situations, or events. Homework assignments may make use of charting thoughts/feelings/behavior to reinforce healthy ways of thinking or practicing calming techniques such as relaxation, visual imagery, and affirmations.
  6. CBT sees behavior as either "adaptive" or "maladaptive", "learned" vs "unlearned", and "rational" vs "irrational." Behavior that is "not learned" is the result of physical problems—an injury, heart attack, mitral valve prolapse, brain tumor, etc. Behavior that is learned is the result of our learning and is caused by the thoughts we have. Behavior that is rational meets these three criteria:
    a. it is based on fact
    b. it helps us achieve our goals
    c. it helps us feel how we want to feel
    Behavior that does not meet these criteria is not rational.

Suggested Reading
Beck, Aaron. Cognitive Therapy and the Emotional Disorders. This is a basic introduction to cognitive therapy by its most famous founder. This book is among the most cited on the subject.

Beck, Judith. Cognitive Therapy: Basics and Beyond. This book was written as a training manual for therapists but it is an excellent introduction to CBT for non-therapists as well.

Burns, David. The Feeling Good Handbook.This is an excellent guide to help the reader change thinking, control mood swings, deal with troublesome situations, and feel better about yourself.

Luciani, Joseph. Self-Coaching: How to Heal Anxiety and Depression. A terrific book for those who want to work on improving their thoughts and feelings by using a CBT approach. Contains practical worksheets and exercises.
Parker, Harvey. Introduction to Cognitive Behavior Therapy. 2004. This form may be copied for personal use by active members of myADHD.com. For further information refer to: www.myADHD.com.

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