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What is Cognitive Behavioral Therapy? |
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As the name implies, Cognitive-Behavioral Therapy is comprised of both cognitive and behavioral techniques. The premise underlying a cognitive-behavioral orientation is that difficulties in living, relationships, general health, etc., have their origin in (and are maintained by) both cognitive and behavioral factors.
The cognitive strategies of Cognitive-Behavioral Therapy aim to uncover
the irrational and problematic thinking styles that often accompany
psychological distress. These strategies are based on the established
finding that one's feelings are a direct extension of one's thoughts.
Simply put, how you think determines how you feel. Thus, the aim of
cognitive interventions is to challenge, and ultimately change, maladaptive,
self-defeating cognitions, and allow the client to lead a more productive
and satisfying life. Simple to learn cognitive strategies provide
clients with practical and powerful skills that can be applied over
a lifetime as effective tools in life-management. Cognitive strategies
have been shown to be especially effective in the treatment of anxiety
and depression.
Behavioral techniques are also central to Cognitive-Behavioral Therapy.
These techniques follow from the premise that maladaptive behaviors
are learned, and therefore be unlearned as well. Among the behavioral
techniques employed are training in both assertiveness and relaxation,
and gradual desensitization to feared objects. Behavioral interventions
have been demonstrated to be highly successful in the treatment of
a broad range of specific problems including phobias,
repetitive habits (nail-biting, hand- wringing, etc.), and bed-wetting,
as well as more non-specific generalized complaints such as anxiety
and/or depression.
Taken together, the cognitive and behavioral strategies create a balanced approach to understanding and treating common life-problems. This approach provides a means of examining not only the manner in which individuals view themselves and their environment (cognitions), but also the way in which they act on that environment (behavior). Ultimately, the Cognitive-Behavioral Therapist seeks to effect positive and lasting change by working with the client to modify their maladaptive thoughts and/or behaviors.
Cognitive-Behavioral Therapy has its roots in behavioralism as well as cognitive therapy. Most modern cognitive-behavioral therapists integrate principles from both these schools of thought. A distinguishing characteristic of this field of clinical psychology is its reliance on techniques that have been subjected to scientific research and demonstrated to be effective clinical methods.
Tenets of behavior therapy lie in classical conditioning and operant techniques. The behavior of individuals is thought to be governed by contingencies. Behavior that is rewarding or reinforcing will be repeated and the individual will learn from experience. Early research in behavioralism also explored the role of punishment, however modern therapists rarely if ever utilize punishment, as it has generally been found to be ineffective (and ethically questionable) in a clinical context. Classical conditioning (often associated with the work of Pavlov) is another important feature of behavior therapy. As a result of experience, or associative learning, individuals often respond in predictable ways to certain stimuli or life events. Notably, these learned responses are not always adaptive or effective in the present lives of individuals. Events that may have resulted in profound emotional responses during childhood may no longer be relevant.
Consider the case of a child reared in a family in which any kind of conflict regularly resulted in physical punishment administered by a parent. On the basis of this formative experience, the individual in later life, perhaps in the context of a love relationship, may react with undue fear and distress in the face of minor conflicts. The reaction in this case may serve as an obstacle to the development of a healthy fulfilling relationship. By helping an individual to see this situation and develop more effective coping techniques and communications skills, the patient learns through experience that some conflict can be tolerated in the context of a relationship without extremely unpleasant consequences. It is a popular but false notion that cognitive-behavior therapists are unconcerned with an individual's life history. Historical events and relationships oftentimes represent essential information in understanding present functioning.
Cognitive therapy essentially involves helping an individual think
in more effective ways. Central to this theory is the notion that
our feelings are influenced to a large extent by the ways in which
we view life events. By changing one's thought or thinking processes,
it is possible to change resulting feelings as well. Consider a person
who is very fearful of public speaking. Underlying
that fear is usually an irrational thought that it will be catastrophic
if one does not perform well. That person may also espouse a belief
that somehow their value or worth as a human being will be markedly
diminished as a result of a poorly delivered speech. By helping an
individual think more rationally in this situation the resulting subjective
experience of anxiety will likely decrease.
While this is a relatively simple example and the human mind is infinitely
complex, the same techniques can be applied to far more involved human
problems. As opposed to more psychodynamic or psychoanalytic theories
in which feelings are viewed as primary and borne of formative experiences,
cognitive therapy holds that our feelings can be modified by examining
and changing our automatic thoughts processes.
Because human beings are such complex creatures most, if not all problems that present themselves in clinical settings have both cognitive and behavioral components. Research on the whole has demonstrated that an integration of these methods is generally more effective than either delivered in isolation. Cognitive-Behavioral techniques are frequently perceived to be effective in addressing only in the treatment "short-term" psychological problems. However it is becoming increasingly clear that this is not the case, and that a wide variety of problems can be addressed in this rapidly expanding and empowering framework. |
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