Cognitive Behaviour Therapy

Cognitive Behaviour Therapy (CBT) is a type of psychotherapy that involves helping individuals to recognise harmful ways of thinking and reacting, and replace them with alternative more realistic or helpful ones. Different people interpret the same set of circumstances in many different ways, resulting in a range of emotional and behavioral consequences. Some of these consequences can facilitate goal achievement, whilst others can actually block us from getting what we want from life. As a result it is not what happens to us in life that cause us to have certain emotional responses and behave in certain ways, but the ways we interpret those events. Therapists employing CBT understand that people's thoughts, feelings and actions interact, however they particularly emphasise the causal role of thoughts in driving feelings and ultimately behavioral reactions. The theory goes on to identify certain types of negative thoughts that are believed to cause emotional distress and goal blocking behaviour.

For example, an individual may have learned the belief that "All people must like me or it would be awful". Such a thought would likely leave the person feeling anxious if they perceived that anyone dislikes them. As a result the individual may change their behaviour and be overly nice to people, inadvertently bringing on disapproval. Further they may develop a habit of scanning their environment looking for any evidence that might indicate disapproval. Things may become worse when that individual starts to avoid being around people from fear of being disapproved of, ultimately further feeding the individuals anxiety. Such a situation would be addressed by helping the individual to identify how they think in certain situations, and ultimately provide them with the skills to challenge their unhelpful interpretations and replace them with thought patterns that are more likely to result in less intense emotional responses and goal directed behaviour.

Notably, CBT is not about seeing things in a positive light, but more about learning to interpret life circumstances in a more realistic way. Approaches aimed at teaching the individual to interpret life differently are collectively called 'cognitive restructuring'. CBT teaches the individual to test assumptions they hold about the world, to determine whether these assumptions are accurate and where they aren't, shift them toward more realistic and fact based interpretations. As a result, people learn to think about life situations in a more helpful and constructive manner, and as a result respond with less emotional distress, leaving them better able to problem solve and ultimately cope better with challenges.

Cognitive Behavioral Therapy is often referred to as an 'evidence based' form of therapy. These approaches have solid research support, and tend to be largely based on the scientific method, thereby emphasizing measurable changes in cognition and behavior in relation to the individual's goals.

A commonly used framework in CBT is what Albert Ellis called the ABC analysis technique. Using this approach, individuals are taught to collect information about typical thoughts, feelings and behaviors that are associated with certain triggers. Once harmful beliefs have been identified, the therapist will often work with the client to challenge them, and ultimately re-interpret those beliefs in a more realistic ways. When combined with changes in behaviour, and much practice, the individual is expected to learn to react in alternate and more facilitative ways to those triggers that would have previously been associated with strong emotions and goal blocking behaviour.

Aside from being used in regular one-on-one therapy, CBT has also been effectively applied using a group format. With some minor modifications, CBT has also been found to be effective with children and adolescents, and is often used in combination with medicinal treatment.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is fundamentally based in the way humans arbitrarily relate events. This ability has enabled us to create symbols and use language as a means of constructing the world. As a result we can predict outcomes before they happen. The dark side of this capacity is our ability to experience strong emotions based on imagined experiences. Humans are socialised into the belief that we can make emotional discomfort go away, yet life experience often casts doubt on this validity of this assumption. We see the results of fighting or suppressing emotions in an epidemic of low frustration tolerance, the frequency and intensity of mental-health problems experienced in the developed world, and our high levels of consumption of prescription drugs designed to remove difficult thoughts and feelings.

Acceptance and Commitment Therapy (ACT) differs from typical therapeutic attempts in that it does not attempt to control thoughts and feelings. ACT therapists recognise that attempts to control negative private experiences often aren't successful, and that the attempts themselves can perpetuate the problem through association. Unlike CBT approaches which attempt to change the content of our thoughts and quality of our feelings, ACT therapists help individuals to change the way they relate to such experiences. In other words, people are taught to see thoughts as just thoughts and feelings as just feelings, without necessarily trying to change them. At the same time they are encouraged to get on with living their life according to their values. ACT therapists predict that by not being so preoccupied with trying to control the uncontrollable, and instead focusing our action on what we deem important, we are more likely to move in a direction we really value. In other words, ACT is about learning to accept our thoughts and feelings, without allowing them to dictate our behaviour. The approach is more about learning to watch our thoughts, without reflexively adopting the worldview mindlessly structured by them.

ACT has been applied successfully with individuals and groups for a range of conditions. The approach has also been successfully used with children and adolescents.

Want to read more about the distinction between these two types of therapy?

Hypnotherapy

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Motivational Interviewing

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