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Cognitive-Behavioral Therapy: what is it and what does it consist of?

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The cognitive behavioral therapy It is one of the most important concepts in applied psychology, since it allows us to tackle very diverse problems by applying techniques that have scientific endorsement.

This is a form of intervention inherited from the theoretical-practical principles of behavioral psychology, to which methods and objectives of cognitive therapy are added. In this article we will see what it is and why it is so widely used among psychologists.

  • Related article: "History of Psychology: main authors and theories"

What is Cognitive-Behavioral Therapy?

Within the areas of psychological intervention and Clinical psychology There is a large number of proposals that are offered to many kinds of patients and problems. The offer is very varied, and easy to get lost in the jungle of therapeutic approach labels, names and descriptions.

However, one of these types of therapy receives special attention nowadays, both in consultations and clinics as well as in psychology faculties.

It is about cognitive-behavioral therapy, a therapeutic orientation that has a

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scientifically proven efficacy in different types of intervention. In addition, one of the most characteristic aspects of this is that it adapts to a wide variety of needs and problems to be addressed in the treatment of patients.

Modifying behaviors and thoughts

If you have ever stopped to think about the conventional idea of ​​what a "psychological problem" is, you may have realized that this type of problem has two faces.

On the one hand, a material and objective aspect, which is recognizable by many people and which can be measured from specific scales. On the other hand, a side that responds to subjective states of consciousness, that is, aspects of life mental and private of the person who has the problem and who usually have a translation in terms emotional

Cognitive-behavioral therapy responds to the need to intervene in these two areas. And he does it by pushing himself thanks to the synergies established between the part of the intervention focused on mental processes and one that is oriented towards actions and changes in the patient's material environment. That is to say, this therapeutic orientation that acts both on actions and on thoughts.

The basics of this form of psychological intervention

Cognitive behavioral therapy is considered was born from the fusion of behavioral therapies and those derived from Cognitive Psychology.

On the one hand, behaviorism (and very especially radical behaviorism of B. F. Skinner) serves as an example of an exhaustive methodology and very close to the precepts of the scientific method, which allows objectively assessing the progress made during therapy.

On the other hand, Cognitive Therapy emphasizes the need not to renounce the consideration of directly unobservable mental processes, since a large part of The usefulness of a therapy lies in the subjective well-being of the patients and this factor does not have to be able to be registered through the pure analysis of the conduct.

However, and although cognitive-behavioral therapy in any of its forms works with constructs that refer to the "mental world" not directly observable, Efforts are made so that the mental elements that come into play in the diagnosis and intervention respond to well-defined and translatable categories to quantitative variables in order to be able to exhaustively monitor the changes that are made on a subjective level.

Therefore, all kinds of esoteric and ambiguous formulations about the way of thinking of the person are avoided and systems of categories in which recurring ideas are classified one within another in classifications that respond to a single criterion.

Delving into the differences with behaviorism

Cognitive-behavioral therapy is heir to certain foundations of Behavioral Psychology, such as the emphasis on practical learning processes and the idea that association is a central concept in therapy. However, it incorporates the need to act, in addition to behavior, on the person's thoughts. Mainly, the intervention on the "mental" part focuses on cognitive schemes and conceptual categories from which the person interprets reality.

The non-adaptive beliefs are also explored, once these have been located, to train the client in their ability to locate day-to-day events that contradict these assumptions. Thus, if the person has self esteem issues, he can be taught to pay attention to the admiration of his friends and family, which are a type of encouragement easily ignored when self-image is severely damaged.

In short, any type of cognitive-behavioral therapy is based on the idea that emotions and behavior styles do not depend only on stimuli physical that come to us from the environment but also from the thoughts that shape our way of perceiving both these stimuli and our own processes mental.

How do you intervene in this type of therapy?

Cognitive-behavioral therapy works by teaching to recognize the styles of thinking that predispose to reaching conclusions that are not very useful for the patient, or dysfunctional thoughts. For this, it is necessary to train the person to be able to reflect on their own way of thinking and consider which points are conflictive and which are not. In this way, it is intended that the client has more capacity to question the categories with which he works (such as "success and failure") and detect typical thought patterns that cause you problems.

The process by which it is achieved that the patient recognizes the cognitive aspects that cause discomfort and can act on them is based on an action model inspired by the Socratic dialogue. This implies that during a part of the cognitive-behavioral therapy sessions, the professional will return the feedback It is necessary for the patient so that he, by himself, detects the contradictions or the unwanted conclusions to which his styles of thought and his cognitive schemes lead him.

The therapist  does not guide the patient in this process, but rather poses questions and highlights assertions that the client himself has made so that the latter goes deeper into the study of his own thinking.

The second part of cognitive-behavioral therapy involves intervening on the cognitive and material foci that have been detected. This entails, on the one hand, setting specific objectives to be met, and on the other, train the patient to be able to determine from their own criteria the strategies that bring them closer to and away from these goals. Furthermore, as the objectives have been defined in such a way that it can be impartially verified whether they have been met or not, it is easy to measure the objectives. progress that is being made and the pace at which it occurs to take note of it and, if necessary, introduce changes in the program of intervention.

Meeting the goals by going through a program of sessions with cognitive behavioral therapy may involve, for example, significantly minimize the effects of aphobia, end an addiction or, quit a obsessive thinking style. In short, problems with a material aspect and another subjective or emotional aspect.

In what cases is it used?

Cognitive behavioral therapy can be practically applied in all ages, and in a wide variety of problems. For example, it is used to intervene in anxiety disorders and phobias, dysthymia, Bipolar disorder, depression, etc. It can also be used as an aid in cases of neurological disorders in which it is necessary to provide support to know how to manage symptoms in the best possible way, and even in psychotic disorders related to schizophrenia.

Of course, in some disorders, behavioral therapy has been shown to be practically as effective as cognitive-behavioral, without the need to carry out tasks to modify beliefs and patterns of thought. For example, it is common for psychologists to turn to behavioral therapy, rather than cognitive-behavioral therapy, when it is necessary to care for very young children, given that they do not yet have good control over abstract thinking and the articulation of concepts through language.

The effectiveness of this type of psychotherapy

Currently, cognitive-behavioral therapy is considered to be the only type of psychotherapy whose results have been validated through the scientific method. With this, it is understood that its efficacy is supported by empirical observations in which many groups of patients who have undergone treatment with Cognitive Behavioral Therapy have improved significantly more than would be expected if they had not attended therapy or followed a program of Placebo effect.

When it is said that cognitive behavioral therapy has been shown to be effective through the application of the scientific method, that means that there are powerful reasons for think that the improvement experienced by people who have tried this type of therapy is caused by the use of these psychological interventions, and not by others variables. This It does not imply that 100% of the people who go to Cognitive Behavioral Therapy sessions will improve, but a very significant portion does of this.

In addition, this improvement can be translated into objective and observable criteria, such as success or not at the time of give up smoking. This is a characteristic that distinguishes cognitive-behavioral therapy from other forms of intervention, many of which, by not paying attention to measurable objectives under a well-defined criterion, can hardly be subjected to empirical examination to determine their effectiveness through the method scientific.

On the other hand, it must be taken into account that the degree of effectiveness of each type of therapy depends on the disorder to be treated; Bearing this in mind, cognitive-behavioral therapy is the one that has been shown to be effective in a greater number of psychological disorders.

Bibliographic references:

  • Field, T.A., Beeson, E.T., Jones, L.K. (2015), The New ABCs: A Practitioner's Guide to Neuroscience-Informed Cognitive-Behavior Therapy, Journal of Mental Health Counseling, 37 (3): pp. 206 - 220.
  • Froggett, L. and Richards, B. (2002). Exploring the Bio-psychosocial. European Journal of Psychotherapy & Counseling, Vol. 5 (3). pp. 321 - 326.
  • Seligman, L.D., Ollendick, T.H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child and Adolescent Psychiatric Clinics of North America. 20 (2): pp. 217 - 38.
  • Spurgeon, J.A., Wright, J.H. (2010). Computer-assisted cognitive-behavioral therapy. Current Psychiatry Reports. 12 (6): pp. 547 - 52.
  • Wampold, B.E., Flückiger, C., Del Re, A.C., Yulish, N.E., Frost, N.D., Pace, B.T., et al. (2017). In pursuit of truth: A critical examination of meta-analyzes of cognitive behavior therapy. Psychotherapy Research. 27 (1): pp. 14 - 32.
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