Cognitive Behavioral Therapy - CBT

Cognitive behavioral therapy (CBT) is a psychotherapeutic approach that addresses dysfunctional thoughts, beliefs, emotions and maladaptive behaviors that are influencing psychological problems. CBT is present, action-oriented, brief, controlled, and is customized for each person. 1

The core of behavior therapy

Scientific - commitment to a scientific approach that involves precision and empirical evaluation. Your progress is monitored before, during, and after therapy using quantitative measurements of the behaviors to be changed.

Active - you engage in specific actions to alleviate your problems. You do something about your difficulties, rather than just talk about them. Exercising self-control has three important advantages.

  1. Being responsible for the change is personally empowering.

  2. People who take action in changing their own behaviors are more likely to maintain the change. 

  3. People who become skilled in dealing with their problems may be able to cope with future problems on their own, which makes a self-control approach cost effective in the long run.

Present focus - the focus of behavior therapy is in the present. Although your problem may have originated in the past, it exists in the present. Behavior therapy is focused on the present rather than the past.

Learning focus - most problem behaviors develop, are maintained, and change primarily through learning. Although not all behaviors result from learning, almost all behaviors are affected by learning, even if they have biological components. Behavior therapy provides people with learning experiences in which new (adaptive) behaviors replace old (maladaptive) behaviors.

CBT Principles

The cognitive principle: it is interpretations of events, not events themselves, which are crucial.2

The behavioural principle: what we do has a powerful influence on our thoughts and emotions.

The continuum principle: mental-health problems are best conceptualised as exaggerations of normal processes.

The here-and-now principle: it is usually more fruitful to focus on current processes rather than the past.

The interacting-systems principle: it is helpful to look at problems as interactions between thoughts, emotions, behaviour and physiology and the environment in which the person operates.

The empirical principle: it is important to evaluate both our theories and our therapy empirically.

The Four Systems

Problems can usefully be described in terms of the interactions between four systems:

  • The cognitive system - what a person thinks, imagines, believes.
  • The behavioural system - what they do or say that can be directly observed by others.
  • The affective system - their emotions.
  • The physiological system - what happens to their body, such as autonomic arousal or changes in appetite.

Three levels of cognition

  • Negative automatic thoughts - specific thoughts that arise spontaneously in various situations, which have a negative effect on mood, and which are relatively accessible to consciousness.

  • Dysfunctional assumptions - “rules for living” that guide behaviour and expectations in a variety of situations, and which are often in conditional (if … then …) form.

  • Core beliefs - very general beliefs about oneself, other people or the world in general, which operate across a wide range of situation but which are often not immediately conscious.

Problem Solving in Cognitive Therapy

Problem solving refers to a systematic process by which a person generates a variety of potentially effective solutions to a problem, chooses the best of these solutions, and implements and evaluates the chosen solution.

Problem solving helps people deal with immediate problems and prepares them to deal with future problems on their own, which may help prevent psychological disorders from developing. Problem-solving therapy divides the problem-solving process into seven basic stages:

  1. Adopting a problem-solving orientation
  2. Defining the problem
  3. Setting goals
  4. Generating alternative solutions
  5. Choosing the best solution
  6. Implementing the solution
  7. Evaluating its effects

Visual Summary

Click the image to enlarge.

  1. Spiegler, M. D., & Guevremont, D. C. (2010). Contemporary behavior therapy (5th ed.). Belmont, CA: Wadsworth, Cengage Learning. 

  2. Westbrook, D. E., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: skills and applications (2nd ed.). Los Angeles: SAGE.