Wednesday, February 3, 2010

Cognitive Behavioral Therapy

Team, this week Christy is hosting the discussion on Cognitive Behavioral Therapy

6 comments:

  1. According to the National Association of Cognitive Behavioral Therapists, CBT is “a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do.” This therapy works on the idea that an outside stimulus (i.e. another person, an event at work, etc.) causes a thought which then causes an emotion. When the thought about the outside situation is distressing, this then leads to a distressing emotional response, rather than the situation directly causing the emotional response. CBT addresses the thought part of the process, so that emotional and behavioral reactions can be changed.

    CBT is a general term for a class of therapies including Rational Emotive Behavioral Therapy, Rational Behavioral Therapy, Rational Living Therapy, Cognitive Therapy, and Dialetical Behavioral Therapy. Studies have shown CBT to be helpful in treating mood disorders, anxiety disorders, eating disorders, personality disorders, substance abuse disorders, and psychotic disorders.

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  2. The primary characteristics of CBT are:
    o Based on a cognitive model of emotional response. This emphasizes that our thoughts cause our feelings and behaviors. We have the ability to change our thoughts, but rarely have the ability to change external circumstances.
    o Time limited and briefer than some other forms of therapy. CBT tends to provide fairly rapid results. The average number of sessions is 16. This is accomplished by being an instructive form of therapy and using homework to reinforce teaching. It is not open-ended and the decision to end therapy is made by the client and therapist together.
    o The therapeutic relationship is not a primary focus. Although a good relationship is important, the focus is on teaching the client to be able to counsel themselves through different situations.
    o Collaborative. The therapist helps the client to achieve his or her own goals, not the therapist’s goals.
    o Based on aspects of stoicism (although not all approaches emphasize this). This teaches that it is important to have the ability to remain calm even when faced with difficult external circumstances.
    o Uses the Socratic method. The therapist asks questions and also teaches the client to question themselves.
    o Structured and directive. Sessions are planned around specific goals. The therapist helps the client learn how to achieve their goals, but does not tell them what to do.
    o Based on an educational model. The client unlearns unwanted emotional and behavioral reactions, and learns new reactions. This leads to long-term results in that the client can apply these skills to new situations that arise after therapy has ended. This is based on the assumption that most emotional or behavioral reactions are learned responses.
    o Relies on the inductive method. The client learns to look at his or her thoughts as hypotheses that can be questioned and tested.
    o Homework is an important feature. This includes both reading and practicing techniques learned during therapy sessions.

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  3. What I appreciate about this is that it gives me the language to articulate what I practice and know. That awareness translates into a more aware practice.

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  4. I'm wondering what kind of exposure others in this group have had to CBT. I had an idea of what it was before, but now I feel like I could actually articulate what it is and who it might be useful for. For me it is helpful because in my practice I'm often asked to facilitate connecting kids/teens to therapy in the community. I think understanding the different therapeutic modalities is definitely helpful in allowing me to connect that child or teen to appropriate referrals. With the population that I work with I also see some limitations, in that I don't think CBT would be appropriate with younger children who haven't developed the cognitive skills necessary for this type of therapy. Does anyone see any strengths/limitations of this type of therapy with the populations you work with?

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  5. Pardon my use of the word "awareness" so many times in my earlier post-it's been a long week!

    I use this approach with homeless families all the time. It's not just about budgeting, but the thoughts and feelings around money, or health, or a myriad of issues that may have contributed to homelessness, or act as additional stressors in addition to the homelessness. There is a clear beginning, middle and end to the therapy; housing case management usually has the same structure(we have time limits around supporting families to get into stable housing), so CBT works really well with this population.

    A strength of CBT is the teaching aspect. People often recognize their own strengths as they work through changing their behavior/thought patterns, and I think that supports the change long after we have exited the clients/families/consumers.

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