Cognitive behavioral therapy is a goal-oriented psychotherapeutic intervention that takes a hands-on approach to short-term problem-solving. This method is used to treat a wide array of issues emanating from the personal life of an individual. It is used in depression, alcohol and drug abuse, sleeping difficulties, anxiety, and relationship issues among others.
Historical Figures
Early behavioral therapy interventions utilized techniques rooted in strictly validated and clear scientific principles to reduce problematic manifestations in individuals. For example, a patient suffering from social anxiety will benefit from increased exposure or a reduction in stress during a social event. However, behavioral therapy was not immune to events occurring outside it, leading to the cognitive revolution. It happened in the 1960-1970 era, and many behavior therapists began to associate with the cognitive aspect of behavior treatment (Micallef-Trigona, 2016).
The general argument of cognition came from the fact that human beings are not mechanical. We are not wired to be automatic, but instead, we are creatures with the ability to speak and make reasoned judgments. The argument postulated that human conditioning was mediated by the verbal and cognitive skills of an individual rather than direct and automatic tendencies. Awareness, attribution, attention, linguistic representation, and expectancy were viewed as critical necessities in the learning exercise. The often-used animal conditioning models became ineffective since they did not account for the unique abilities of humans and hence had to be replaced by cognitive methods.
Cognitive measures marked the second generation of behavioral therapy which saw the abandonment of associative learning. Psychologists turned to more flexible methods that accounted for the role of internal experiences, such as feelings and thoughts, in the determination of human behavior. Humans are reasoning beings with the capability of organizing and modifying their behavior according to prevailing circumstances. The advent of cognitivism had instigated a paradigm shift in experimental psychology since its emergence in 1960. Albert Ellis came up with a treatment intervention called Rapid Emotive Intervention Therapy where he assumed that emotional distress originated from a patients thoughts about a traumatic event rather than the occurrence itself (Micallef-Trigona, 2016).
Aaron Beck, a psychiatrist, has been credited with the rise of cognitive behavioral therapy. He observed that patients tended to hold internal conversations during his analytical sessions. They were talking to themselves in their minds, yet they reported only a fraction of their thoughts to him. Beck realized the importance of the link between feelings and thoughts as well as the influence of previous experiences. He found out that people were unaware of the automatic thoughts that popped up at the back of their minds. He concluded that patients would understand and overcome their implications if they could be able to single out and identify these thoughts. He called it cognitive due to the emphasis that the theory places on the human thought process. The integration of the Ellis and Beck ideas gave rise to cognitive behavioral therapy, which is aimed at modifying behaviors, attitudes, beliefs, and expectations of the patient (Micallef-Trigona, 2016).
Key Concepts
The core hypothesis of cognitive behavioral therapy assumes that people's perceptions of events will determine their behaviors and emotions. The interpretation of a situation, rather than its actual occurrence, determines how an individual feels. For example, patients suffering from depression are considered to be negative in how they interpret events (Fenn & Byrne, 2013). Cognition, the way people think about things and the thought content, is outlined in three levels including core beliefs, dysfunctional assumptions, and negative automatic thoughts.
Core Beliefs
These are deep-seated beliefs about the world, self, and others (Fenn & Byrne, 2013). These thought systems are developed early on in an individual's life, and they are viewed as absolute since they are shaped by childhood experiences. The triad of negative beliefs affects three main areas:
Self- it considers how patients think of themselves, for example I'm worthless.'
The world/others consider thoughts like, The world is rough.'
The future considers issues like, Things will never change in my life.
Negative personal views lead people to have a skewed reality of the world. People who see themselves as worthless will assume that everyone else sees them that way. Therefore, they dont think they will amount to anything in future since everybody hates them. Core beliefs set off a pattern that influences peoples general outlook on life hence the necessity of positive thought patterns.
Dysfunctional Assumptions
These are either rigid, inflexible or lead to counterproductive tendencies (Fenn & Byrne, 2013). These are restrictive rules of existence that individuals adopt. They are sometimes unrealistic hence maladaptive. For example, a person may live with the provision that, It is better to refrain from trying than risk the prospect of failure.' Such a beliefs impacts every decision that such people make throughout their lives.
Negative Automatic Thoughts
These thoughts are activated involuntarily in specific situations. In case of depression, NATs instantly gravitate towards negative themes, uselessness, and low self-esteem. It implies that when faced with a task, such individuals will contemplate failure since they are pre-disposed to the eventuality. In the case of anxiety disorders, automatic thoughts will normally include underestimations of coping ability and overestimations of risk factors.
The cognitive model is utilized as a framework for understanding an individual's mental presenting problem. Formulation is a process that places the unique experiences of a person within a context of cognitive behavior (Fenn & Byrne, 2013). A formulation explores the precipitant causes and influences that influence an individuals problems. After understanding one's experiences, experts can aid in the mutual understanding of these difficulties and come up with solutions. According to Becks longitudinal formulation, early life experiences contribute towards the formulation of core beliefs followed by the incidence of dysfunctional assumptions. Specific critical incidents activate these assumptions leading to negative automatic thoughts and the depression symptoms.
Describe how one practices the theory
Cognitive behavioral therapy is considered an efficient depression treatment. At its core, CBT assumes that the thoughts of an individual will influence their mood. Therefore, negative, dysfunctional thoughts will affect an individuals mood, physical state, and self-behavior. The target of CBT is to enable people to learn how to recognize the negative thought patterns, evaluate them for validity, and then replace them with good ideologies (Anderson, 2014). Therapists aim to change the patients dysfunctional thoughts since they are the cause of depression. The therapists train patients to apply CBT to their cases whenever depression symptoms are present.
One practical example involves locating a problem and brainstorming on possible solutions (Anderson, 2014). Practitioners help individuals to get to the cause of their depressive symptoms. Once it is clear, people write the problem down in explicit detail then the brainstorming can begin. Loneliness is one of the hallmarks of depression, and it leads victims to think that things will never get better. Compiling a list of things you can do to ease these negative feelings will help to improve the situation. People who are battling loneliness can take strategic steps such as joining social clubs or online dating platforms.
Another application is in picking new opportunities to apply positive thinking. This approach forces the individual to revise how they view a specific aspect or object (Anderson, 2014). It is a gradual process aimed at installing a new thinking process that breeds positivity to fight depression. Individuals who see an item and think, "I hate it," could train themselves to identify three things that they immediately like about the same object. It helps them to focus on identifying the positive aspects of things rather than concentrating on negatives.
Evidence-Based Status
CBT is an effective intervention and a viable choice to antidepressant medication. Cognitive behavioral theory has shown evidence of treating depression similarly with ADM as long as it is implemented competently. The efficacy of this treatment has been proved on unipolar patients, but the evidence on bipolar studies is still wanting (Driessen & Hollon, 2010). One key advantage of cognitive behavior therapy over the medications is that it prevents against subsequent recurrence and relapses after a prolonged period of active treatment. Single studies have indicated that patients who lead antecedent lives, are unemployed, or married may display better results in cognitive behavioral therapy than via antidepressant medications. Married patients who portray low pre-treatment levels of dysfunctional attitudes are likelier to respond to CBT compared to unmarried individuals with high dysfunctional attitude levels (Driessen & Hollon, 2010).
Cultural and Gender Considerations
This global era often brings people from diverse backgrounds together. Families, individuals, nations, and communities around the world differ in histories, economies, religion, and beliefs. Mental health experts are responsible for catering to every patient regardless of their gender or cultural affiliation. Diversity and multiculturalism are some of the most prevalent topics in healthcare circles as their importance has become more apparent. 25% of Americas population consists of ethnic minorities, yet the psychologists accounting for this demographic are a paltry 5.1%. There is an acute need for culture and gender sensitive psychiatric trainers to improve communication. Cultural competency was initially a matter of choice, but now there is a trend where organizations are increasingly seeking out competent employees. This unbiased responsibility calls for an approach that is flexible enough to accommodate the diversity that is present amongst people.
Individuals from different cultural backgrounds tend to have differing views on various issues. This uniqueness impacts profoundly on CBT through its approach to addressing the thought processes of the clients (Pretzer, 2013). Cultural intelligence is critical in understanding the appropriate behavior to adopt with an individual. The backgrounds of the practitioner and client will determine their interpersonal interactions. CBT emphasizes the unique aspects of an individual, gender-wise or culturally, where therapy is tailored to meet the needs of a specific client. The broad range of CBT techniques offers the tools to enable such adaptations. Therefore, CBT paired with a multicultural approach will be highly efficient due to its personalized attention.
Secondly, cognitive behavior therapy is focused on empowering the client (Pretzer, 2013). The theory views patients as reasoning beings who can control their emotions and thoughts thus initiating the much-needed change. In line with recognizing the unique abilities of people, CBT empowers patients to make use of newly-acquired skills in an independent capacity. This level of appreciation of an individual's uniqueness means that their cultural affiliations and gender will be appreciated instead of negation. Empowering an individual to improve their lives will require a close and direct understanding of what make...
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