CBT: The Basics

What is it like to do CBT?

Honestly, it looks and feels just like your standard talk therapy. And it needs to. Because it is important that you feel supported, accepted, and comfortable when you are talking to any therapist. It is important that you trust your therapist not to judge you. Cognitive Behavioral Therapy is built on the same empathic listening that other therapies are built on. It does not have time limit. We are not looking to push you out the door. But we do want to make sure that you are getting what you are asking for.

It is important that you trust that your therapist knows what they are doing. We listen and interact the same as other therapists. But we have scientifically-derived ideas of what causes the patterns you are stuck in – and what to do about them. We are not only going to sit and listen. We are going to actively help you.

The Underlying Theory

Cognitive behavioral therapy is partially based on the premise that emotions cannot be changed simply by talking about them. Instead, our emotions are a result of our thought, our behaviors, our biology, and our interaction with our environment (family, friends, co-workers, our jobs, culture, living conditions, etc.). Only by changing the way that we think and act can change the way we feel. Our thoughts have a lot to do with why we act the way we do, as well as how we feel. And our behaviors have a significant impact on both our emotions and our environment (for example, how the people in our lives treat us).

The Method

Cognitive Behavioral Therapy (CBT) is a combination of cognitive therapy and behavior therapy.  The primary goal of cognitive therapy is to change self-defeating thought processes so that they are more accurate and so that they lead to more adaptive behaviors and emotions.  The primary intervention is socratic questioning which is designed to help clients learn to think more logically about the way that they see, for example, themselves, their environment, their future and the actions of others.  Cognitions are viewed as the driving force behind emotions (and many behaviors), which thus makes them, and not emotions, the target of intervention. When thought patterns change, emotions follow. When beliefs about how to solve problems change and become more functional, we get more of what we want.

Behavior therapy has two potential focuses, depending on the client: behavior change and conditioning.  Interventions for behavior change include identifying factors that motivate unhelpful behaviors as well as barriers to more helpful behaviors; helping clients actively engage in helpful behaviors by making them easier, by removing barriers and through education about how those behaviors will likely be helpful.  Conditioning, which is particularly relevant to anxiety (e.g., GAD, Panic) and anxiety-related disorders (e.g., OCD), is typically treated with exposure and by teaching clients adaptive ways to face their fears so that anxiety is no longer in control.