Cognitive behavior therapy - Overview

Cognitive behavioral therapy (CBT) is a psycho-social intervention[1][2] that aims to improve mental health.[3] CBT focuses on challenging and changing unhelpful cognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotional regulation,[2][4] and the development of personal coping strategies that target solving current problems. Originally, it was designed to treat depression, but its use has been expanded to include treatment of a number of mental health conditions, including anxiety.[5][6]

The CBT model is based on the combination of the basic principles from behavioral and cognitive psychology.[2] This wave of therapy has been termed the second wave. Behavioral therapy is thus now referred to as the first wave. The most recent wave is the third wave, containing the mindfulness-based therapies. CBT sits firmly within the second wave. It is different from historical approaches to psychotherapy, such as the psychoanalytic approach where the therapist looks for the unconscious meaning behind the behaviors and then formulates a diagnosis. Instead, CBT is a "problem-focused" and "action-oriented" form of therapy, meaning it is used to treat specific problems related to a diagnosed mental disorder. The therapist's role is to assist the client in finding and practicing effective strategies to address the identified goals and decrease symptoms of the disorder.[7] CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of psychological disorders,[3] and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.[1][7][8]

When compared to psychoactive medications, review studies have found CBT alone to be as effective for treating less severe forms of depression and anxiety, posttraumatic stress disorder (PTSD), tics, substance abuse, eating disorders and borderline personality disorder. It is often recommended in combination with medications for treating other conditions, such as severe obsessive compulsive disorder (OCD) and major depressive disorder, opioid use disorder, bipolar disorder and psychotic disorders.[1] In addition, CBT is recommended as the first line of treatment for majority of psychological disorders in children and adolescents, including aggression and conduct disorder.[1][4] Researchers have found that other bona fide therapeutic interventions were equally effective for treating certain conditions in adults.[9][10] Along with interpersonal psychotherapy (IPT), CBT is recommended in treatment guidelines as a psychosocial treatment of choice,[1][11] and CBT and IPT are the only psychosocial interventions that psychiatry residents are mandated to be trained in.[1]

1. Hollon SD, Beck AT (2013). "Chapter 11 Cognitive and Cognitive-Behavioral Therapies". In MJ Lambert. Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (6th ed.). Hoboken, NJ: John Wiley & Sons. pp. 393–394. ISBN 9781118418680.

2. Beck JS (2011), Cognitive behavior therapy: Basics and beyond (2nd ed.), New York, NY: The Guilford Press, pp. 19–20

3. Field TA, Beeson ET, Jones LK (2015), "The New ABCs: A Practitioner's Guide to Neuroscience-Informed Cognitive-Behavior Therapy" (PDF), Journal of Mental Health Counseling, 37 (3): 206–220, doi:10.17744/1040-2861-37.3.206, archived from the original (PDF) on 2016-08-15, retrieved 2016-07-06

4. Benjamin CL, Puleo CM, Settipani CA, et al. (2011), "History of cognitive-behavioral therapy in youth", Child and Adolescent Psychiatric Clinics of North America, 20 (2): 179–189, doi:10.1016/j.chc.2011.01.011, PMC3077930, PMID21440849

5, McKay D, Sookman D, Neziroglu F, Wilhelm S, Stein DJ, Kyrios M, Matthews K, Veale D (28 February 2015). "Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder" (PDF). Psychiatry Research. 225 (3): 236–246. doi:10.1016/j.psychres.2014.11.058. PMID25613661.

6. Zhu Z, Zhang L, Jiang J, et al. (December 2014). "Comparison of psychological placebo and waiting list control conditions in the assessment of cognitive behavioral therapy for the treatment of generalized anxiety disorder: a meta-analysis". Shanghai Archives of Psychiatry. 26 (6): 319–31. doi:10.11919/j.issn.1002-0829.214173. PMC4311105. PMID25642106.

7. Schacter DL, Gilbert DT, Wegner DM (2010), Psychology (2nd ed.), New York: Worth Pub, p. 600

8. Brewin C (1996). "Theoretical foundations of cognitive-behavioral therapy for anxiety and depression". Annual Review of Psychology. 47: 33–57. doi:10.1146/annurev.psych.47.1.33. PMID8624137.

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