How to do Cognitive Behavioral Therapy? | Practical aspects of CBT | Steps of CBT | CBT Techniques

How to do Cognitive Behavioral Therapy? | Practical aspects of CBT | Steps of CBT

Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.

CBT can be a very helpful tool ― either alone or in combination with other therapies ― in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. CBT can be an effective tool to help anyone learn how to better manage stressful life situations.

Cognitive behavioral therapy is used to treat a wide range of issues. It's often the preferred type of psychotherapy because it can quickly help you identify and cope with specific challenges. It generally requires fewer sessions than other types of therapy and is done in a structured way. CBT is a useful tool to address emotional challenges.

You might decide on your own that you want to try cognitive behavioral therapy. Or a doctor or someone else may suggest therapy to you. Here's how to get started:

Find a therapist. You can get a referral from a doctor, health insurance plan, friend or other trusted source. Many employers offer counseling services or referrals through employee assistance programs (EAPs). Or you can find a therapist on your own — for instance, through a local or state psychological association or by searching the internet.

Cognitive behavioral therapy may be done one-on-one or in groups with family members or with people who have similar issues. Online resources are available that may make participating in CBT possible, especially if you live in an area with few local mental health resources.

CBT often includes:

Learning about your mental health condition
Learning and practicing techniques such as relaxation, coping, resilience, stress management and assertiveness

Steps in CBT

CBT typically includes these steps:

Identify troubling situations or conditions in your life. These may include such issues as a medical condition, divorce, grief, anger or symptoms of a mental health disorder. You and your therapist may spend some time deciding what problems and goals you want to focus on.

Become aware of your thoughts, emotions and beliefs about these problems. Once you've identified the problems to work on, your therapist will encourage you to share your thoughts about them. This may include observing what you tell yourself about an experience (self-talk), your interpretation of the meaning of a situation, and your beliefs about yourself, other people and events. Your therapist may suggest that you keep a journal of your thoughts.

In guided discovery, the therapist will acquaint themselves with your viewpoint. Then they’ll ask questions designed to challenge your beliefs and broaden your thinking. You might be asked to give evidence that supports your assumptions, as well as evidence that does not.
In the process, you’ll learn to see things from other perspectives, especially ones that you may not have considered before. This can help you choose a more helpful path.

Identify negative or inaccurate thinking. To help you recognize patterns of thinking and behavior that may be contributing to your problem, your therapist may ask you to pay attention to your physical, emotional and behavioral responses in different situations.

Reshape negative or inaccurate thinking. Your therapist will likely encourage you to ask yourself whether your view of a situation is based on fact or on an inaccurate perception of what's going on. This step can be difficult. You may have long-standing ways of thinking about your life and yourself. With practice, helpful thinking and behavior patterns will become a habit and won't take as much effort.

Activity scheduling can help establish good habits and provide ample opportunity to put what you’ve learned into practice.

Behavioral experiments are typically used for anxiety disorders that involve catastrophic thinking.

Before embarking on a task that normally makes you anxious, you’ll be asked to predict what will happen. Later, you’ll talk about whether the prediction came true.

Over time, you may start to see that the predicted catastrophe is actually not very likely to happen. You’ll likely start with lower-anxiety tasks and build up from there.

CBT is a popular treatment that can be applied to a wide range of issues, including the management of bipolar disorder.

Treatment with CBT focuses on identifying problems and your reactions to them. It then helps you replace these reactions with more objective, balanced thoughts. This can create self-awareness and strengthened coping skills.