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What is CBT?

By now you’ve probably heard of CBT (Cognitive Behavioural Therapy) as it’s one of the most popular types of therapy, and it’s often mentioned on social media. We thought we’d take a minute to write a bit about what it actually is, how it works, and discuss its strengths and limitations.

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that focuses on identifying and changing negative thoughts and behaviors that are contributing to mental health issues. The theory behind CBT is that our thoughts, feelings, and behaviors are all interconnected, and that negative thoughts and behaviors can lead to emotional distress. By identifying and challenging, and ultimately changing these negative thoughts and behaviors, individuals can work towards improving their mental health.

CBT is a structured, short-term therapy that typically lasts for 8-16 sessions. Each session attempts to focus on a specific problem or goal. The therapist and the individual work together to identify negative thoughts and behaviors, and to develop strategies to change them. That’s not to say that all sessions disconnected from each other, as we use aim to teach clients how to use a certain set of skills/tools to address a variety of problems. However, the length of therapy may vary depending on the individual’s specific needs and goals. Some individuals may require more or fewer sessions. Additionally, some individuals may choose to continue therapy on a maintenance basis to prevent relapse or to address other areas of concern.

Here’s a practical example of the model that CBT follows: if an individual has the belief that “I am not good enough,” they may experience feelings of low self-esteem and worthlessness. By identifying and changing this negative belief, the individual may be able to improve their emotional well-being.

The therapist will also help the individual to develop strategies to change these negative thoughts and behaviors. This may involve teaching the individual new coping skills, such as problem-solving, stress management, and relaxation techniques. The therapist may also teach the individual how to ID, challenge, and consequently reframe negative thoughts.

CBT is a collaborative therapy, the therapist doesn’t just give the client tools and send them on their way. The therapist and client work together to ID negative thoughts and behaviors, and then jointly explore which strategies would be the most helpful to address them. We try to be as realistic as possible about it, as not every strategy works for everyone. At the next session, the therapist usually follows up to see what worked for the client, and what didn’t, and make tweaks accordingly.

CBT is a flexible and adaptable therapy that can be delivered in a variety of settings, such as in-person, over the phone, or online. It can also be adapted to meet the needs of different populations, such as children, adolescents, and older adults. It’s this flexibility that helps CBT be positioned as a really accessible modality for people. It’s helpful that it’s also quite straightforward and easy-to-understand. Therapists are usually taught this as the first modality during their Masters training. All of our therapists learned it first, and have continued to dedicate time to professional development to keep learning more about the mind works.

CBT is also a relatively time-efficient therapy. As it is a structured and short-term therapy, individuals can expect to see improvements in their emotional well-being within a relatively short period of time. This can be beneficial for individuals who may not have the time or resources to commit to a longer-term therapy.

CBT also has mountains of research behind it supporting that it is a highly effective therapy. It has been found to be effective for a wide range of mental health conditions. Additionally, the skills and strategies that individuals learn in CBT can be applied to other areas of their life, such as work and relationships, which can improve overall well-being.

However, it’s worth mentioning that, like any other therapy, CBT isn’t suitable for everyone. Here are few of its limitations and critiques

  • Limited Focus on the Past: CBT primarily focuses on present thoughts, feelings and behaviors and their relationship to current problems. It does not delve deeply into past experiences and may not address underlying issues that may be contributing to current problems.

  • Simplistic View of Emotion: CBT assumes that negative thoughts lead to negative emotions, and by changing these thoughts, one can change their emotions. However, emotions are complex and multifaceted and cannot be reduced to this simplistic view.

  • Limited in Dealing with Complex Trauma: CBT is not always effective in dealing with complex trauma or severe mental health conditions such as Borderline Personality Disorder. It may not address the deep-seated emotional and psychological issues that underlie these conditions.

  • Limited in Addressing Social and Environmental Factors: CBT does not take into account the impact of social and environmental factors on mental health. It may not address how societal issues such as poverty, discrimination, and lack of access to healthcare impact mental health.

  • Limited in Addressing Systemic Issues: CBT is often criticized for placing the responsibility for change solely on the individual, and not addressing the systemic issues that may be contributing to mental health problems. If you’d like to learn more about this, check out the book Sedated by Davies.

  • Limited in Addressing Cultural Issues: CBT is a Western-based therapy and may not be appropriate or effective for individuals from different cultural backgrounds. It may not take into account the unique cultural experiences and beliefs of individuals.

It’s important to note that these critiques do not mean that CBT is not effective, but rather that it is not a one-size-fits-all approach and may not be suitable for everyone. It’s important to consult with a qualified therapist to determine the most appropriate treatment for an individual’s specific needs and circumstances.

In conclusion, CBT is a type of psychotherapy that focuses on identifying and changing negative thoughts and behaviors that are contributing to mental health issues. It is a structured, short-term therapy that is based on the cognitive model of emotional disorders, and it is an evidence-based treatment that has been found to be effective for a wide range of mental health conditions. It is a relatively straightforward and easy-to-understand therapy, and it is highly effective. It can also be adapted to meet the needs of different populations and can be delivered in a variety of settings. However, it is not suitable for everyone and it’s important that individuals work with a qualified therapist to determine if CBT is the right therapy for them.

***It’s important to note that insurance and funding have played a significant role in the rise of Cognitive Behavioral Therapy (CBT) as the dominant form of psychotherapy. CBT is often seen as a cost-effective and evidence-based treatment for a wide range of mental health conditions. This has made it more attractive to insurance companies and funding agencies, as it is seen as a way to reduce healthcare costs. So keeping this in mind, where we land on CBT as a practice is that it’s a vital piece of our toolkit. However we are all passionate about helping our clients understand the bigger questions around their experiences such as why and how things work. Though we often begin with CBT, we aim to deliver an enriched Psychotherapy experience by also exploring your attachment history, and take your global functioning into account.