By Chay Tanchanco, PPS, AMFT
Sometimes shopping around for therapy is like standing in a grocery store with no categories, no shelves, just piles of boxes with labels you don’t quite understand. You aren’t sure what you need for your recipe, and you aren’t even sure what you really want your finished product to look like. On top of that, people are throwing boxes with letter acronyms and abbreviations at you, as though helping. “Here is some ACT!” or “Try this, it’s DBT! It’s good for you!” Obviously, this is overwhelming.
Luckily for you, we can break each of these down, one at a time.
Let’s start with CBT: Cognitive Behavioral Therapy, AKA the popular kid on the block.
Why It’s Popular: Short term and Evidence based
CBT has gained mega-popularity in the therapy world over the last few decades for being an effective modality of therapy. From the general public’s perspective, the basics of CBT are relatively easier to understand than other modes of therapy. From a research standpoint, the results are clearer cut than “feeling better”, which has always been hard to quantify, so there is plentiful research on CBT. It’s short-term, goal-oriented, and evidence-based (also makes a great case for insurance companies), which makes it more accessible and affordable than its psychotherapeutic predecessors.
According to a meta-analysis (that is, taking a large number of studies using one form of treatment and analyzing their results all together) of CBT studies (Hofmann, 2012), CBT was most effective with:
Somatoform Disorders (when your body feels what your mind can’t communicate)
Anger Control Problems
We actually don’t need to do heavy work in the past; in fact, it is the opposite. Working on the present is our main focus.
CBT is founded on Albert Ellis’ original modality: Rational Emotive Behavior Therapy, and it’s fundamental concept is as easy as A-B-C:
Antecedent → Behavior → Consequence
Looking at your behavior differently and learning what is and isn’t in your control is the key to feeling better about your life.
Through understanding the beliefs which cause your brain to produce Automatic Negative Thoughts, you can change how you react. It’s like a reality check for your mind. In a mode of anxiety, for example, you can run circles through the same thoughts: "I did something so embarrassing -- everyone thinks I’m stupid." By slowing your thoughts and emotions, you and your therapist can walk through this process with clearer eyes, pointing out evidence (and lack thereof) for each belief and replace them with healthier, more productive ones.
CBT uses a variety of interventions to aid in reframing the mind, including journaling, role-play, mindfulness techniques such as deep breathing and progressive muscle relaxation, and worksheets. It’s meant to be a very collaborative effort between you and your therapist.
As with all therapeutic modalities, there are limitations to CBT, especially when there is a deeper past trauma or emotional blockage that needs to be uprooted, and not everyone will respond in the same way to any method.
The advice I can give is the same as with any article I’ll ever write: the relationship with your therapist is modality number 1. You will not progress with a therapist if your relationship isn’t balanced and healthy. And if CBT is their method, you’ll learn a lot about yourself and see a change in how you interact with your everyday life.