Articles                                

Cognitive-Behavioural Therapy, or CBT, is a type of psychological treatment that has been shown in numerous research studies to help people overcome many different types of problems. CBT can help individuals with anxiety, phobias, depression, eating disorders, insomnia, hoarding, chronic pain, and many other difficulties. For many disorders, CBT combined with medications from your physician tends to be more effective in the long term.

In CBT, the basic theory is that problems with anxiety, depression, anger, insomnia and other disorders is that a person’s beliefs and behaviours help maintain the problem. With anxiety, for example, people often make negative predictions and interpretations about the future, which simply increase the anxiety. In depression, people have negative thoughts and assumptions about themselves, the world, and the future. An individual’s behaviours may maintain the problem. For example, someone with panic attacks while away from home may hurry back home as soon as a panic attack begins. By learning relaxation techniques and the physiology of panic attacks, the person can learn that panic attacks last no more than 20-30 minutes no matter what, and that simple relaxation techniques and self-talk will end a panic attack sooner.

CBT focuses on the here and now, rather than on what happened a long time ago in a person’s childhood (though at times, childhood events are discussed in therapy). CBT also looks for ways to change the here and now behaviours that affect functioning.

Strategies focus on behaviours and cognitions. Changing behaviours may focus on communication training (such as assertive rather than aggressive communications), structured exposure to feared situations, and relaxation training. Changing cognitions involve using thought records and discussion to examine negative beliefs, thoughts, predictions and interpretations. The goal is to replace these thoughts and beliefs with realistic ones (not just positive ones). Homework is also a strategy used in CBT. Homework helps the individual carry newly learned behaviours and thoughts into their world. Clients are expected to practice the new techniques between sessions.

Treatment can last anywhere from 2 or 3 sessions to a year. Simple phobias require typically a few sessions, while depression and anxiety treatment can last longer. We look at whether or not the problem has improved enough that it no longer distresses the individual, and if the problem is not improving or no longer changing. CBT also looks at the person’s progress along the way, to determine if the method is working, or if there is another problem to be addressed. The decision to continue or stop is usually made by both the client and therapist. Of course, if you decide that CBT is not working for you, or that you would like to try another method, please discuss with your therapist, who can provide appropriate referrals.