What is Cognitive Behaviour Therapy and why is it important?
Cognitive Behaviour Therapy (CBT) is a diverse collection of therapeutic ideas and strategies. It is a synthesis of two forms of therapy that emerged from different theoretical traditions. In essence Cognitive Behaviour Therapy uses the principles of learning theory to teach the client new ways of responding to challenging situations. Behaviour Therapy teaches new behavioural responses, while Cognitive Therapy teaches new ways of thinking about our experience. Both continue to be practised separately and in combination, with either behavioural or cognitive techniques given differential emphasis depending on the problem, the person and the context.
CBT has been successfully applied in the treatment of a very wide range of diagnosed conditions affecting children and adolescents as well as adults. This includes substance use disorders, depression and anxiety (internalising) disorders, conduct (externalising) disorders, post-traumatic stress disorder, and various combinations of these (Macgowan & Engle, 2010). The wide applicability of CBT is perhaps partly due to the fact that it possesses a very large range of therapeutic elements designed to target maladaptive clusters or patterns of cognitions and behaviours that are prevalent across these diagnostic categories. These maladaptive clusters of cognitions and behaviours can also affect many individuals who do not have such diagnoses. They render such individuals vulnerable to emotional and behavioural health problems and can be targeted in prevention and early intervention.
When should it be used?
CBT should be used when the client and practitioner have identified specific behavioural or emotional problems that appear to be caused or maintained by unhealthy patterns of thoughts, feelings and behaviours, or a lack of certain types of skills. Some common behavioural problems best addressed by CBT include difficulties getting on with other people, managing anger, coping with common life stressors, solving everyday problems, and being appropriately assertive. Key emotional problems amenable to CBT include depression and anxiety.
While CBT should be used to address specific behavioural and emotional problems, such problems rarely occur in isolation. Hence CBT will usually need to be employed as just one part of a comprehensive multidimensional strategy.
CBT is useful for clients who are ready to take action to address a specific problem. Practitioners seeking to employ CBT when a client is not ready to change are likely to encounter resistance.
The sections below have been organised on the basis of two dimensions: (i) a set of techniques that are applied to all types of processes addressed in CBT (Section C1), and (ii) sets of problems that are usually addressed by the same practice elements (Sections C2 to C5).
C1. Technique elements
C2. Assertiveness, communication, and social skills training
C3. Problem solving and coping skills training
C4. Cognitive restructuring
C5. Experiential behavioural strategies