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What is cognitive behavioural therapy (CBT)?

Cognitive behavioural therapy (CBT) consists of a number of therapies that are designed to help solve problems in people's lives, such as anxiety, depression, or post-traumatic stress disorder (PTSD).

CBT builds upon two earlier types of psychotherapy:

1. cognitive therapy - which was designed to change people's thoughts, beliefs, attitudes, and expectations, and
2. behavioural therapy (also known as behaviourism) - which was designed to change how people acted.

Solving problems using CBT

CBT suggests that problems are often of your own making. That is, it is not the situation itself that makes you unhappy, but how you think about, and react to, the situation.

An example of how CBT can be used to solve problems is described in the following scenario.

Scenario

A woman believes that her manager secretly dislikes her and is trying to undermine her job. This makes her anxious and depressed at work, so she begins to make some mistakes.

When the woman's manager points out her mistakes, and suggests ways that she can avoid making them again, it reinforces her belief that her manager dislikes her. As she is convinced she is going to be fired, her performance drops even further. Finally, the woman's manager loses patience and does fire her.

Applying CBT

A CBT therapist would attempt to break this downward cycle by challenging the woman's negative and unhelpful thoughts and beliefs, before trying to get her to base her behaviour on more realistic thoughts and assumptions.

The CBT therapist may argue that it is highly unlikely that a manager would want to undermine an employee because it would be in the own manager's self-interest to have productive and motivated staff. And, rather than regarding the manager suggestions as a personal attack, the woman should regard them as support and encouragement.

The therapist and the woman would then discuss how she could act in the future based on these more realistic beliefs, such as asking for feedback about how she could improve, and applying for training to learn new skills.

The outcome

After several weeks of trying these new thinking and behavioural techniques, the woman's manager notices an improvement in her attitude and performance, and their relationship continues to improve. After several months, the manager recommends the woman for a promotion.

Source: NHS Direct (UK)