June 26, 2009

cognitive behavioral therapy, 101

I get a lot of phone calls from new clients who want to schedule with a therapist who specializes in Cognitive Behavioral Therapy (CBT). They've been told by their doctor, attorney or friend to seek out CBT but they don't know what it is, exactly.

I welcome these questions. When clients are more informed about their treatment, they tend to feel more comfortable in our sessions and do better when they get home. And I don't believe clients who ask these questions are dummies, just so you know (I can't speak for the authors of the book). I expect that most people have little idea what CBT is and I'm happy to explain.

CBT refers to two different components: Cognitive is the thinking part of therapy; Behavioral is the doing.

Very simply, CBT aims to help us change how we think and change how we behave. To recognize patterns of thinking that lead to unpleasant
feelings. To change what we do so that we feel better more of the time.

The example I give most often: You're depressed because you've gained a lot of weight. You feel hopeless about ever losing the extra pounds. Your depression leaves you feeling unmotivated to exercise more.

The cognitive piece of CBT will help identify faulty thinking patterns
that contribute toward gaining weight and feeling depressed:

"I'm never going to lose this weight. Why even try? I give up."
"All I can think about is food."
"I deserve to eat this dessert."

"I can't stand how I look."
"I feel just awful."
"I want to crawl into bed and stay there."

The behavioral component will help identify small changes in behavior that will help you reach your goals (exercise more, eat less). Tweaking the goals in such a way that you are more likely to succeed. Small, doable steps replace lofty, out-of-reach goals.

There are many common, nearly universal thinking patterns that I listen for and teach my clients to hear within themselves. And to change. We'll get to those in later posts.

1st image source here
2nd image source here, but originally found here

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