What principle underlies cognitive behavioral therapy?

What principle underlies cognitive behavioral therapy?

There are 10 principles that underlie cognitive behavior therapy that Judith Beck defined for all patients.

1. CBT is based on an ever-evolving formulation of patients’ problems and an individual conceptualization of each patient in cognitive terms
The patient’s current thinking patterns and problematic behaviors are identified. Several factors must be considered including the patient’s life experiences, throughout childhood, and even through the therapy sessions.

A conceptualization of the patient is formulated based on the information gathered to provide an accurate picture of the patient’s whole situation. This conceptualization is refined each session as more information becomes available.

2. CBT requires a sound therapeutic alliance
It is important to have a strong trusting relationship between the therapist and patient. The therapist should be able to provide care, warmth, empathy, and competence.

3. CBT emphasizes collaboration and active participation
Teamwork is encouraged throughout the sessions and decisions of what to work on and how often are decided together. Active participation from the patient is important for making a lasting impact in their treatment.

4. CBT is goal-oriented and problem-focused
The patient should set specific goals during the initial sessions. Goals are necessary to evaluate and respond to thoughts that interfere with those goals. This helps the patient easily identify and interrupt those thoughts.

5. CBT initially emphasizes the present
The treatment should be focused on current problems and specific situations that are distressing to them.

CBT only considers the past when the patient expresses a strong preference to do so or the patient gets stuck in dysfunctional thinking and trying to understand their childhood can potentially help modify their core beliefs.

6. CBT is educative, aims to teach the patient to be their own therapist, and emphasizes relapse prevention
Teaching the patient to understand the process, how their thoughts influence emotions and behavior, how to identify and evaluate their thoughts and beliefs, and plan for behavioral changes is an essential part of CBT.

7. CBT aims to be time-limited
Straightforward anxiety and depression can typically be treated within 6 to 14 sessions. However, for those with more severe mental illnesses and rigid beliefs, the time frame can range from a few months to years if necessary.

8. CBT sessions are structured
Structured treatment helps maximize efficiency and effectiveness. This process includes:

  • Introduction: doing a mood check, a brief review of the week, collaboratively setting an agenda for the session
  • Middle: reviewing homework, discussing problems on the agenda, setting new homework, and summarizing
  • Final: eliciting feedback

9. CBT teaches patients to identify, evaluate, and respond to their dysfunctional thoughts and beliefs
Therapists help patients identify key cognitions and adopt more realistic, rational perspectives.

This is achieved through the process of guided discovery by questioning their thoughts to evaluate their thinking. Also, the therapist creates behavioral experiments for the patient to directly test their thinking.

10. CBT uses a variety of techniques to change thinking, mood, and behavior
Behavioral and problem-solving techniques are essential in CBT. The types of techniques the therapist will select will be influenced by the conceptualization of the patient, the problem you are discussing, and your objectives for the session.

You can read more about cognitive behavioral therapy here.