Cognitive-behavioral Therapy: What It Is And What Techniques It Uses

The cognitive-behavioral current is a set of theories and techniques that establish a psychotherapeutic system. Therefore, cognitive behavioral therapy is a form of psychotherapy.

Cognitive behavioral therapy (CBT) is based on the relationship between thoughts, emotions, physical sensations and behaviors. All of these areas are interconnected and influence each other. By example: you find yourself in the situation of having failed an exam. You can think:

1. “I failed because I am stupid. I will never pass”
2. “I failed an exam. I’ll have to try harder next time.”

• After thought 1 will surely come an emotion of sadness, frustration and resignation. Such thinking and emotions will lead to a state of demotivation and reluctance. From that state, The action, surely, will be not to study. As a consequence, it is likely that the situation will repeat itself again. On the other hand, after thought 2 an emotion of certain sadness but acceptance and hope may come. Such thinking and emotions will lead to a state of motivation and willingness to make an effort. This state pushes the action of studying, consequently, the probability of passing the next exam will be greater.

Other example It may be that of a person who believes he or she is incapable of running 10 kilometers. The behavior may be not doing it or it may be trying. If you try and succeed, the change in behavior will have an impact on your thinking.

With the previous examples we can see that, in the same situation, thinking, emotional state and behavior are different and influence each other.

The cognitive behavioral therapy intervenes at a cognitive level, that is, in the thoughts and also in behavior, that is, in actions that are carried out. It consists of changing the way of thinking, replacing thoughts based on irrational beliefs and cognitive distortions with more objective and adaptive thoughts. As well as transforming less useful behaviors into beneficial behaviors. Cognitive-behavioral therapy focuses on the present and the immediate future, it does not usually delve into the past.

The use of cognitive-behavioral psychotherapy has grown greatly as a therapeutic system in the practice of psychology and psychiatry. Currently, cognitive-behavioral interventions They are widely accepted and their effectiveness has been recognized by empirical studies and by authors such as Albert Ellis and Aroon Beck. His procedures and techniques have been investigated with rigorous experimental methods, therefore It is a scientific therapy. Its scientific basis does not ensure absolute success, but it guarantees its effectiveness in general.

What is cognitive-behavioral therapy for?

First of all, it is a form of psychological intervention, but it can be applied in many areas and for different problems. Cognitive behavioral therapy has been shown to be helpful in treating the following psychological disorders:

• Anxiety disorders
• Depressive disorders
• Affective disorders
• Phobias
• Eating disorder
• Obsessive compulsive disorder
• Post-traumatic stress disorder
• Substance use disorders
• Sleep disorders
• Sexual disorders

In addition, it is also useful for people without a mental health diagnosis, as it helps to better manage the stressful life situations such as:

• Life crises
• couple problems
• emotional upset
• School or work difficulties
• Lack of social skills

How is cognitive-behavioral therapy applied?

In the context of clinical psychology, cognitive-behavioral therapy should be conducted by an accredited professional, with the corresponding degree and certification. Therapy can be done individually or in a group. Regarding the duration of the therapy, it is not considered a long therapy, quite the opposite. The average number of sessions can range from Approximately 15 and 20 sessions, lasting between 30 and 60 minutes that can be weekly or biweekly. It is recommended that the sessions be weekly at the beginning to be spaced out later. On the other hand, the therapy must be applied in a physical space prepared for it and totally confidential.

Both the mode of application, the duration and the effectiveness will depend on many factors, including the complexity of the problem presented by the patient, the involvement of the patient and the collaboration received from those around them.

Cognitive-behavioral therapy includes parts of cognitive therapy and parts of behavioral therapy. The main difference between the two is the starting theoretical approach, whether it is cognition or behavior. Meanwhile, the cognitive-behavioral approach is based on the relationship between cognition and behavior. In fact, its fundamental principle is that cognitive, affective and behavioral aspects are related and that a change in one of the parts will affect the others.

Cognitive therapy

Cognitive therapy starts from an intrapsychic point of view and is focused on cognition. It is based on the premise that the explanation of behavior is found in cognitive processes and thoughts. Cognitive therapy intervenes in thoughts identifying and replacing distorted thoughts and beliefs with other more flexible, adaptive and functional interpretations.

behavioral therapy

In behavioral therapy, the explanation of the behavior that a person presents is based on the environment, on the influence of the environment. Therefore, behavioral therapy techniques focus on modify behaviors maladaptive behaviors and learn new, more functional behaviors, thus causing a change in emotions and thoughts.

Cognitive-behavioral therapy techniques are those that have been scientifically proven to be most effective in clinical psychology. These techniques focus on modifying thoughts and behaviors by learning new, more adaptive ways of thinking and acting. The techniques of cognitive-behavioral therapy focus on the present, although their objective is acquisition of habits and skills that provide greater well-being and quality of life and that last over time.

Below are explained some of the cognitive-behavioral techniques most important and used:

Rational Emotive Behavioral Therapy (REBT)

Rational emotive behavioral therapy is based on the premise that emotional discomfort is due to the person’s interpretation of a situation and not the situation itself. The objective of rational emotive behavioral therapy is for the person to achieve a change in thinking patterns to change the way they interpret situations. That is, it begins to evaluate situations with conclusions based on fact and not on subjective assumptions. The REBT follows the following scheme:

• A. Real situation or event.
• B. Interpretation of the situation: thoughts, beliefs, conceptions, conclusions, etc.
• C. The emotions that arise from the interpretation of the situation. If the interpretation is negative, surely the emotions are unpleasant.
• D. Question the validity of the interpretation of the situation through discussion of irrational thoughts.
• AND. Favorable change in emotions after becoming aware of irrational cognitions.

Cognitive restructuring

Cognitive restructuring is a cognitive therapy technique that consists of modifying thought patterns:

1. Understand what cognitive distortions are that is, negative and irrational thoughts that affect mood and behavior.
2. Be aware of thoughts: learn to identify one’s own cognitive distortions.
3. Record thoughts: write down the situation you are in, the thought that appears, the emotion and the behavior.
4. Search for an alternative thought more functional than distorted thinking.

The procedures that the psychologist uses for this change of thoughts are:

• Analyze the thought. Ask yourself if the thought is true and make a rational analysis of it.
• He socratic questioning: ask yourself questions like “is what I’m thinking totally true?” or “what evidence do I have of this?”
• Examine the utility of the thought: “does this thought help?” or “pros and cons of thinking.”
• Get in worst of cases: ask yourself “what would happen if…?” or “what’s the worst that could happen?”
• Test by action. Check if what you thought happens. For example, if the irrational thought is “I speak, I ask in class, they will think I am stupid and laugh at me”, it is about asking in class and checking if that happens.

Exposure techniques

The exposure technique bases its effectiveness on the habituation principle which has shown that Repeated exposure to a stimulus produces a smaller response each time by the subject. For example, if one day he sees a spider, his body will react because the alarm system will be activated. However, if you see a spider every day and it has no consequences, each time the interpretation of danger is less and therefore the psychophysiological reaction is less.

This technique is especially indicated for anxiety problems, fears and phobias, and avoidant behaviors. The exhibition must have planning and support provided by a specialist. The types of exposure are: live exhibition or the exhibition in a symbolic way through imagination or virtual reality technological devices.

Systematic desensitization

Systematic desensitization also aims to reduce the psychophysiological reaction to anxiety-inducing stimuli. The first part consists of break down the situation that produces the activation of fear or anxiety in small parts and rank them from the least to the most feared. For example, with the fear of speaking in public we could put, as a first step, the situation of saying a couple of sentences in front of a completely trustworthy person; As a second step, make a 2-minute speech in front of two trusted people; As a third step, make a 4-minute speech in front of some family members or trusted people. And so on until reaching the most feared situation. It is recommended that the desensitization hierarchy be composed of between 20 and 50 phases. Next, it comes to face situations following this hierarchy the psychologist’s instructions and applying relaxation techniques.

Techniques of breathing and relaxation

Breathing and body relaxation are basic aspects to learn to manage the physiological aspects of emotional reactions. Some examples of breathing and relaxation techniques are:

• The diaphragmatic breathing: consists of learning to perform conscious breathing using the diaphragm. This breathing allows air to be brought to the lower part of the lungs, which guarantees better oxygen uptake and activates the body’s relaxation response.
• The progressive muscle relaxation: consists of learning to relax all the muscles in the body. It’s about being aware of muscle tension and learning to relax it through training. The objective of the progressive muscle relaxation technique is to turn it into a habit that we can use in stressful situations. One of the most well-known and effective is Jacobson’s progressive muscle relaxation.

Troubleshooting techniques

The problem solving technique consists of applying a set of steps to resolve a situation or make a decision that is complex. The steps to follow are:

1. Identify the problem
2. Define the situation and the relevant interfering factors
3. Brainstorm different alternatives to solve the problem
4. Make a decision: evaluate the options generated, choose one and create the action plan
5. Evaluate the results of the applied solution

The operant techniques

Operant conditioning techniques behavior modification They allow you to acquire new behaviors, increase behaviors and reduce or eliminate behaviors. They are very effective. They are based on the conditioning form of learning through the use of reinforcement. In this article we explain what operant conditioning is and how it works with examples.

Modeling or observational learning technique

The modeling technique is a behavioral technique that consists of acquire behaviors through vicarious learning or imitation. Behaviors are learned or modified through observation of the behavior of others and the consequences they entail. It consists of 3 main steps:

1. Exposure to the model
2. Observation: attending to and retaining the most important aspects of the model behavior
3. Behavior execution: imitating the same or similar behavior

Social skills training

Social skills training aims to improve the quality of interpersonal relationships, to reduce discomfort in relationships with others and obtain all the benefits of sociability. It is about learning behavioral strategies that allow you to establish social relationships effectively. Among the procedures for acquiring and maintaining social skills are:

• role-playing
• positive reinforcement
• Vicarious learning
• Personal feedback
• Developing self-efficacy expectations

Other cognitive-behavioral techniques are

• Self-instruction training
• Stress inoculation training
• Covert Conditioning Techniques
• Habit Reversal Training
• Thought stopping technique
• Paradoxical intention techniques
• Biofeedback techniques
• Intervention for emotional regulation

Depression is defined by a set of cognitive, affective and behavioral symptoms. It is mainly characterized by negative thoughts about oneself, the environment and the future. There are different depressive disorders included in the DSM-V with their corresponding criteria and characteristics, the most common being major depressive disorder. Depression is a disabling disorder that affects many people, therefore, a large amount of research has been carried out for its treatment.

Cognitive-behavioral treatment for depression consists of learning to interpret situations more objectively, also changing behaviors. Psychological intervention begins with a functional analysis and psychoeducation that is, the explanation of the factors that have caused and maintain the situation, as well as the way to solve it.

Cognitive-behavioral treatment for depression is usually start with behavioral changes, since they are simpler and have more immediate effects. Therefore, we could start with the behavioral activation, which consists of carrying out pleasant and rewarding behaviors and activities. They may be activities that the patient already did before, or even new activities. For this, activity scheduling and task assignment are used.

Next, the cognitive strategies. We would continue with cognitive techniques to identify dysfunctional cognitions and change them to more adaptive thoughts, such as cognitive restructuring and the Problem resolution. Depression treatment must be applied by a qualified and accredited professional.

Anxiety is made up of a set of cognitive, physiological and behavioral symptoms. It is mainly characterized by worried thoughts and physiological arousal. There are different anxiety disorders included in the DSM-V with their corresponding criteria and characteristics, such as generalized anxiety disorder, panic disorder, agoraphobia and other phobias.

Cognitive-behavioral treatment for anxiety consists of learning to interpret situations more objectively and understand and reduce physical sensations.

Psychological intervention begins with a functional analysis and psychoeducation that is, the explanation of the factors that have caused and maintain the situation, as well as the way to solve it.

Cognitive behavioral therapy techniques for anxiety include exposure to the stimuli that generate anxiety and also to the physical signs of anxiety, the systematic desensitization to get used to both external and internal stimuli, the cognitive restructuring and reality tests in which the patient can verify that what he feared has not happened or has not been as serious as he imagined. Cognitive behavioral therapy techniques for anxiety also include Techniques of breathing and relaxation to manage the physical sensations of anxiety, and also meditation, such as mindfulness perfect for focusing attention on the present

Anxiety treatment must be applied by a qualified and accredited professional.

This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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