Examples of How Cognitive Behavioral Therapy Works
For example, many people with depression have an overly negative, self-critical view of themselves and feel hopeless about the future. Cognitive therapy works to help clients identify certain types of thinking “errors” in which people tend to minimize accomplishments and dwell on problems in ways that are unhelpful and may generate ways of reacting or behaving that are unhelpful and cause additional problems. The therapist also helps individuals recognize and address environmental stressors (major life changes, relationship problems, conflictual situations, etc) that may exacerbate their depression, anxiety, mood swings or other problems. Such changes in habitual ways of thinking and behaving may require a great deal of practice, individualized attention and encouragement. However, once individuals learn that they can manage depression, mood swings, anxiety, stress and other problems more effectively, their sense of self-efficacy and self-esteem typically improves, and they are much more likely to apply their newly learned skills in the future.
Most of us use many of these skills on a daily basis in our attempts to cope with the stresses and strains of daily living, but we apply them so naturally and easily that we simply have little awareness that we have done so. In our experience, these mood and anxiety management skills or techniques can be taught effectively even to clients who have had very serious histories of hospitalization and long-term illness.
The Importance of Collaboration in Psychotherapy
Cognitive behavioral therapy uses a collaborative approach in which the therapist and client work together to develop specific goals for treatment identify specific problems and develop solutions. From the initial session, I will emphasize that therapy is a working partnership and that successful treatment depends on active participation in therapy and a willingness to engage in new behaviors and to test out new ways of thinking. Most often, the most effective approach to exploring problems and developing solutions is not giving advice or direction but helping the client discover helpful solutions that they may have tried in the past using open-ended questioning and exploration sometimes called “Socratic Questioning”.
An Active and Structured Therapy Approch
Cognitive behavioral therapy tends to be an active, directive, structured type of therapy in which each session has a specific “agenda” or set of problems to be worked on that is mutually identified by the client and the therapist. The client is expected to be an active partner in therapy including identifying problems, setting the agenda for sessions, trying out new thoughts and behaviors, setting up experiments to test out and develop solutions, and doing activities between sessions (called “homework”). The client is also expected to give periodic weekly feedback to the therapist about how things are going in the therapy and to identify any concerns or issues about treatment.
Important Information for Your First Session