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Cognitive Behavioral Therapy and Cognitive Restructuring

CBT uptown DallasCognitive Behavioral Therapy (CBT) is based on the theory that our Thoughts, Emotions, and Behaviors all impact each other.

During therapy, the client learns how to identify distorted thinking patterns.  The client then learns the connection between distorted thinking and her emotions and behaviors.   By making changes to distorted thinking, the client experiences changes in feelings.

 

A CBT therapist teaches clients techniques to make theses changes.  Cognitive restructuring is a key technique of CBT therapy.  Dr. Aaron Beck, the founder of Cognitive Therapy, talks about cognitive restructuring techniques.

CBT Uptown Dallas Counseling

Dr. Aaron Beck, founder of CBT

Uptown Dallas Counseling provides CBT: Aaron Beck’s Blueprint

CBT Uptown Dallas Counseling

Dr. Aaron Beck, founder of CBT

Uptown Dallas Counseling provides CBT or Cognitive Behavioral Therapy.  The founder of CBT, Dr. Aaron Beck, explains his view of CBT in this 6-minute audio track.

Dr. Beck founded the Beck Institute of Cognitive Therapy in 1994.  From the Beck Institute website:

Beck Institute for Cognitive Behavior Therapy is a leading international source for training, therapy, and resources in CBT. Our Center for Training delivers workshops to a worldwide audience of mental health professionals, researchers, and educators, and our Philadelphia-based Center for Psychotherapy provides state-of-the-art therapy and consultations.
Dr. Aaron T. Beck developed Cognitive Behavior Therapy (CBT) at the University of Pennsylvania in the 1960s. In 1994, Dr. Beck and his daughter, Dr. Judith Beck, established Beck Institute as a non-profit 501(c)(3). Their goal was to create a new clinical setting that would provide both state-of-the-art psychotherapy and comprehensive training opportunities for professionals worldwide.
Over the past 20 years, our organization has carried out Dr. Beck’s therapeutic model and guiding principles in training more than 3,500 professionals through our Center for Training, and providing clinical therapy services to over 2,000 individuals, couples, and families through our Center for Psychotherapy.
In addition to our professional workshops and on-site psychotherapy practice, Beck Institute remains an international authority on, and resource for, CBT information and research. Our organization continues to partner with universities, hospitals, community mental health centers, health systems, and other institutions to create and improve cognitive behavior therapy programs.

Uptown Dallas Counseling provides CBT for anxiety, depression, bipolar disorder, and other mental health problems.

Does Cognitive Behavioral Therapy Work? Will it Work for ME??

CBT-therapy

As a Cognitive Behavioral Therapist, I believe in what I do, see daily results, and know that Cognitive Behavioral Therapy (CBT) can change lives.  My confidence in this type of therapy was strengthened when I came across a scientific study analyzing the effectiveness of CBT.  Experts in the psychology field reviewed the therapeutic results of using CBT when working with patients with differing mental health disorders.  The study was published in the Clinical Psychology Review 26 (2006) under the title:  The empirical status of cognitive-behavioral therapy: A review of meta-analyses by Andrew C. Butler, Jason E. Chapman, Evan M. Forman, and Aaron T. Beck.

The psychologists found CBT to be an effective treatment for:

Cognitive behavioral therapy
  • depression
  • generalized anxiety disorder
  • panic disorder with or without agoraphobia
  • social phobia
  • posttraumatic stress disorder
  • childhood depressive and anxiety disorders
  • marital distress
  • anger
  • childhood somatic disorders
  • chronic pain

(Savannah Krantz (Greenhill, 2014) provides a comprehensive summary of the study at the end of this post.)

These results are so encouraging to patients and treatment providers who deal with the pain of mental illness everyday.  This wide-ranging, scientifically significant study gives confidence and hope to people entering therapy.  If you are reading this post, and looking for help with a mental health challenge, consider finding a Cognitive Behavioral Therapist.  You can find more information and details about the treatment process by going to the Beck Institute of Cognitive Therapy.

If you live in the Dallas area, and would like to talk about treatment with a Cognitive Behavioral Therapist, please read my web page at Holly Scott, MBA, MS, LPC.

Effectiveness of Treatment with Cognitive Behavioral Therapy

by Savannah Krantz (Greenhill, 2014)

therapy for depression 
Cognitive Behavioral Therapy, also known as CBT or CT, has been closely examined in many psychological studies relating to treatment results. The cognitive-behavioral treatment of mental disorders is often compared and contrasted with other treatments. CBT differs from behavioral therapy because it suggests that cognitive thoughts produce aberrant behavior, and therefore, CBT focuses on cognation. In an attempt to determine whether CBT has a higher success rate than other treatments, this study required a meta-analysis. This type of research pulls results from previous studies, works to sort out their differences, and essentially combines them. Meta-analysis measures what is called the effect size, which is the measure of strength in statistics. This process aims to estimate the effect size with a large sample of studies rather than a single study, which would only provide data drawn from a single set of circumstances. Similar to using a large sample size in an experiment, using meta-analysis sharpens the precision of the effect size because it eliminates the involvement of erroneous factors.

therapy for depression

This CBT study examined many mental disorders: adolescent and adult unipolar depression, generalized anxiety disorder, panic disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, anger, bulimia nervosa, internalizing childhood disorders, sexual offending, and chronic pain. Not only does the meta-analysis inspect the effects of CBT treatment, but the study also compares the results to other treatment results whenever possible. Out of these disorders, three used data from an uncontrolled effect size: obsessive-compulsive disorder, schizophrenia, and bulimia nervosa. Unlike a controlled effect size, the improvement was measured within its group, rather than being compared to other treatments and/or conditions.

In the results, the U3 score is provided next to the effect size. The U3 score is a percentage that indicates whether or not CBT was more successful than other treatments. If the U3 score is 50%, that means that on average, the CBT patient experienced the same results as the control patient who received other treatment. If the percentage is above 50% and the effect size is positive, the CBT patient’s outcome was superior. If the percentage is above 50% and the effect size is negative, the CBT patient’s outcome was inferior to the control. The higher the percentage, the more (if positive ES) or less (if negative ES) successful CBT was on average.

CBT was proved to be superior to all other treatments for adult and adolescent depression, but was only very slightly more successful than behavioral treatment, with a U3 score of 52%. CBT was more successful than all other treatments for general anxiety disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, anger, bulimia nervosa, internalizing childhood disorders, and sexual offending. Two exceptions, chronic pain and panic disorder (with and without agoraphobia), had either one or two elements that were proven to be less successful when treated by CBT.

couple couple

Overall, the meta-analysis proved that CBT appears to be the superior treatment for these sixteen mental disorders. This can be accredited in part to the fact that CBT differs from other treatments due to its ability to teach the patient therapeutic skills that the patient can then apply, without external assistance, into his or her everyday life.

Source:

Clinical Psychology Review 26 (2006), The empirical status of cognitive-behavioral therapy: A review of meta-analyses by Andrew C. Butler, Jason E. Chapman, Evan M. Forman, and Aaron T. Beck.

 

Therapy for Managing Depression, Anger and Aggression

Classic Cognitive-Behavioral Therapy models are based on the assumption that thoughts(cognitive processes) dictate feelings.  Those feelings then dictate behaviors (or actions).

450px-Fire-lite-bg-10Here is a basic example:
A fire alarm goes off in a hotel at night
.

Person A thinks:  some kids pulled the alarm and now I am awake!
Person A feelsanger at the kids andannoyance about being awake.

Person B thinks: there must be a fire, I must get out!
Person B feelsfear of being trapped in the fire, worry about how to escape

Person C thinks: I remember when my friends and I liked to pull the fire alarm.
Person C feelsunderstanding of kids having fun and comfortable to go back to sleep.

You CAN control you thoughts, which leads to the ability to have more positive feelings.

Christy Motta, MA summarizes a Cognitive-Behavioral approach to dealing with aggression below:

In the case of aggression, the individual must change the perceptions and beliefs that contribute to increased anger. In order to do this, the individual must: 1. Cope with arousal. The first step is to identify (observe) what is happening. The individual must become aware of when they are angry and notice the physical sensations and thoughts that accompany it.

2. Replace problem thoughts with thoughts that are helpful in dealing with PROVOCATION. “This could be rough, but I can deal with it” “easy does it” “Live and let live” “Stick to the issues. Don’t take it personally.”

3. Modify problem thoughts to those that are helpful in dealing with CONFRONTATION. “keep my cool, walk away, take a time out” “I don’t need to prove myself” “There’s no point in getting mad”

4. Change appraisals and reflections AFTER A CONFRONTATION.

a. Unresolved: “They don’t have to agree” “let it go” “don’t take it personally”
b. Resolved. Label (Describe) what happened. Praise self.

People frequently need some external limits in order to identify their aggression as a problem and begin actively working on modifying their thoughts. Probation, the risk of losing housing and the risk of losing important valued relationships are common consequences that get people thinking about their aggression.

How to YOU choose your therapist?

women smilingOnce you make the decision to pursue counseling, you must then decide WHICH therapist to call.  Many people ask friends or family members for recommendations, others search the internet, and still others use the old-fashioned yellow pages.  No matter how you choose, that first session is your opportunity to see if you have found a therapist who will meet your needs.

Dr. John Grohol, CEO of PsychCentral, writes 
The four most important attributes of a good therapist are:
1. A good therapist is positive and empathetic.
2. A good therapist is professional, courteous, and respectful.
3. A good therapist recognizes her strengths and limitations.
4. A good therapist is genuine.

As you meet and talk with your therapist the first time, look for these characteristics. Here are some suggestions of questions you could ask as you are determining if your therapist has the four key criteria listed above:

  1. How are you licensed? What are your training credentials? Do you belong to any professional groups?
  2. How would you describe your treatment style? Many different treatment styles exist. Different approaches may be more or less appropriate for you depending on your situation and needs.
  3. What kind of evaluation process do you use to recommend a treatment plan?
  4. What are the measurable criteria you use to assess how well treatment is working? Can you give me a few examples?
  5. Do you use published clinical practice guidelines to guide your treatment planning? How?
  6. What psychotherapeutic approaches and tools do you use?
  7. How do you decide which approach is best for the patient? Do you ever use more than one approach? When?
  8. How will you work with other medical providers, such as psychiatrist, who may also provide care?
  9. How often will we meet?  How long will treatment last?  How do I know when treatment is complete?

Think about how well you will be able to relate to the therapist as she answers these questions.  You want to achieve the best possible match in order to have the greatest chance of meeting your goals.

If you would like to ask me any of the above questions, or learn more about my practice.  Please contact me.