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What is Cognitive Behaviour Therapy (CBT) ?
If you have received any sort of assistance for a psychological or mental health problem in recent years, the chances are you have come across the term “Cognitive Behaviour Therapy”. Despite the fact that the term Cognitive Behaviour Therapy is so frequently bandied around, for the average person there is a lot of confusion about (a) what Cognitive Behaviour Therapy is, and (b) who is able to provide it. People often complain that different professionals who claim to be providing Cognitive Behaviour Therapy seem to be doing something quite different from each other.
The following is an attempt to provide some clarification.
Cognitive Behaviour Therapy in Brief
Cognitive Behaviour Therapy, also known as Cognitive Behavioural Therapy, is a form of, frequently brief, psychological therapy which involves a range of techniques aimed at altering patterns of thoughts, behaviour, and in turn, emotion. It is an approach that has been successfully applied to a wide range of psychological problems from anxiety disorders and depression, through to eating disorders and schizophrenia. In recent years Cognitive Behaviour Therapy has also been applied to the management of physical problems such as chronic pain, irritable bowel syndrome and tinnitus.
It is now several decades since the beginnings of Cognitive Behaviour Therapy, and not surprisingly it has since developed into several related strands. Hence it is difficult to provide a comprehensive definition that adequately covers all strands. However the following is a list of some of the key features characteristic of many of these strands of modern Cognitive Behaviour Therapy. (Nonetheless, it must be stressed that these are generalisations which are not without exceptions).
(1) A collaborative approach to psychological therapy
Unlike earlier approaches to psychotherapy which emphasised the therapist as an expert providing advice or treatment to the patient, Cognitive Behaviour Therapy typically aims to establish a collaborative relationship between client and therapist. In Cognitive Behaviour Therapy the client and therapist ideally operate as a team in tackling the client's problems.
(2) Practical techniques
Cognitive Behaviour Therapy has an emphasis on the use of practical techniques to address current problems in contrast to traditional 'talking' therapies which often focused on childhood experiences through extended dialogue.
(3) Empowering the clients
Cognitive Behaviour Therapy typically aims to equip clients with the skills to tackle their own problems rather than the therapist doing all the work. “Homework tasks” where the client practices skills between sessions are usually integral to therapy. This also means that the client is able to continue to put techniques into practice once therapy has concluded. Not surprisingly this often reduces the risk of relapse.
(4) Brief therapy
Cognitive Behaviour Therapy, with some exceptions, favours brief, goal focused therapy rather than therapy such as Freudian psychodynamic therapy, which has earned a reputation in some circles for involving weekly visits over many years with limited measurable progress. (A key exception is CBT / schema therapy for personality disorders which is often highly intensive running for well in excess of 12 months). This also has the benefit of making therapy more affordable.
(5) Emphasis on scientific validation
Cognitive Behaviour Therapy places a high value on Evidence Based Practice. It assumes that psychological therapies should be informed by, and subjected to, rigorous scientific investigation. This is in contrast to many therapy approaches that are based on sometimes credible, but untested, theories.
Cognitive Behaviour Therapy has earned a positive reputation due to the strong scientific support for its effectiveness. Many hundreds of controlled research trials have now been conducted on Cognitive Behaviour Therapy for a wide range of psychological problems. Studies have frequently shown it to produce strong verifiable improvements, often superior to other therapies with which it is compared.
In Australia, Cognitive Behaviour Therapy is one form of therapy explicitly mentioned in the Federal Government's guidelines for the provision of psychological services under Medicare.
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more on the origins of Cognitive Behaviour Therapy.