What Does Cognitive Therapy Involve?
Cognitive therapy entails identifying, testing and altering dysfunctional beliefs and thought patterns. This process may include reframing distorted thoughts as well as reassessing one’s goals and values. Therapists use guided discovery to assist patients in addressing mental health issues such as depression, other mood disorders, anxiety issues, addiction issues, self-esteem issues and interpersonal relationships.
Cognitive therapists believe that individuals’ negative thoughts, feelings and behaviors are caused by an accumulation of automatic maladaptive’schemas’ (patterns of thinking) and irrational ‘default’ responses, and they work to help people recognize and modify these core assumptions. Schemas develop through genetic factors, selective attention allocation and adverse environmental life events (Beck et al., 1979).
Schemas are deeply-seated in an individual’s early experiences, which may be difficult to recall. They shape how we process information and evaluate it appropriately. Schemas have the potential to exacerbate emotional and behavioral disorders such as depression, bipolar disorder, chronic pain, anxiety, obsessive-compulsive disorder (OCD), eating disorders and substance abuse problems.
The initial step in treating any client is to assess their beliefs about themselves and others. For instance, if Ray believes he is stupid because he failed a test in Psychology 101 class, this irrational thought can have an immense effect on his mood and behavior.
Therapists help clients explore the “schema” formed around an irrational belief, emphasizing how it limits their capacity for objectively assessing situations and other people. Armed with this information, clients can devise strategies to combat this negative “schema,” manage their emotions more effectively, and transcend it altogether.
Ultimately, the client learns to break free of their distorted negative schema that had been hindering them in dealing with unfamiliar circumstances. They begin distancing themselves from this “schema”, which now appears as an archetypal panic response triggered by an unfamiliar circumstance that holds no personal significance for them.
Therapists also assist clients in recognizing when they exaggerate something and reframing negative thoughts in more constructive ways. For example, the’schema’ that caused Ray to believe he was worthless due to his failed exam could be replaced with the idea that he is intelligent and capable of overcoming any obstacles placed before him.
In addition to Beck and Ellis’ work, many therapists have also developed cognitive therapy approaches for various disorders. Some, like Marsha Linehan’s Dialectical Behaviour Therapy, combine CBT knowledge and techniques with mindfulness meditation practices.
One form of cognitive therapy known as Mindfulness Based Cognitive Therapy, or MBCT, is a psychological approach that integrates CBT knowledge and techniques with mindful awareness and distress tolerance practices. Research suggests it may be effective at preventing relapse among those suffering from depression.
Cognitive therapy was once a widely-used treatment for depression, but its application has since spread to include many other disorders as well. Studies have demonstrated its efficacy over drug therapy and reduced relapse rates; making it increasingly popular among those suffering from mild to moderate depression, anxiety disorders and other mental illnesses.