Cognitive-behavioural therapy (CBT) focuses on the interplay between thoughts, feelings, physical sensations, behaviors and the social context. As an example, an adverse event or the expectation of a negative experience can trigger negative thoughts about self and others (“it’s all my fault when something goes wrong”, “I’m a failure”, “others will think ill of me”, “no one will help me”); feelings of sadness, anxiety, shame or anger; stomach aches, tensions, breathing difficulties or dizziness; and withdrawal from social situations, activities and relationships.
In CBT, we initially focus on symptom-relief and the registration of negative thoughts, feelings, physical symptoms and behaviors related to these. The next step is testing, evaluating and adapting strategies and tools in order to make the desired changes. Treatment can also focus on the life experiences, assumptions, life rules, norms and values that influence the patient’s interpretations and understandings of him/herself and his/her surroundings.
CBT is a structured and usually somewhat shorter form of therapy compared to, for instance, psychoanalysis. Each session begins with setting an agenda, and specific goals for the therapy are articulated at the beginning and evaluated and revised throughout the course of therapy. Between sessions, the patient works on the issues discussed and this “homework” provides valuable data for the therapy.
The cognitive-behavioural therapist collaborates with the patient to bring about desired changes in thoughts, feelings, physical sensations and behaviors. The therapist takes on an active role and shares and discusses ideas and interpretations with the patient. Psychoeducation is an important element of CBT, where the therapist informs the patient of, for instance, relevant research on the patient’s condition or methods and techniques to change a pattern.
CBT was developed in the 1960s by the American psychologist Aaron T. Beck. Vast scientific research has established positive effect of CBT for depression, anxiety disorders (such as phobias, generalized anxiety disorder, social phobia and OCD), eating disorders, self-esteem problems, substance abuse, personality disorders and many other conditions.