CBT begins by getting to the root of faulty thinking and understanding how unhealthy coping mechanisms originated in the context of the individual's own personal history and life experiences. By appreciating how their thought and behaviour patterns developed in the first place, they come to understand how their current means of dealing with situations and interacting with the world around them may be contributing to their difficulties and actually making matters worse.
This cognitive aspect of the therapy helps the client to recognise the particular ways of thinking which lead to anxiety, depression, anger and other negative emotions, encourages them to question their formerly-held beliefs and to apply evidence and logic in such a way that they are able to replace unrealistic, unhelpful or even harmful thoughts with more balanced interpretations, predictions and assumptions.Because the focus of the treatment is on changing the cognitions and behaviours which are perpetuating a problem, however, it is not limited to talk therapy and is very much action-oriented.
Based on the clients own strengths and resources, a plan is developed which involves such things as practising different techniques, taking part in behavioural experiments and completing cognitive-monitoring diaries, all with the aim of bringing about the desired change. The behavioural aspect of the treatment is important because new thoughts generally need to be accompanied by new experiences in order for old emotional feelings and reactions to be replaced with healthier and more positive ones. Under the guidance of the therapist, the individual is able to experiment with new ways of doing things and to evaluate the outcomes.Mind and body are, of course, inseparable, and because our thinking can trigger or fuel certain unwanted and sometimes harmful physical reactions, CBT also uses various techniques which are aimed at reducing tension in the body and promoting relaxation.
There are three key reasons why CBT is such an effective and successful treatment. First of all, recovery comes from understanding the root cause of the problems that the individual has experienced in the past. Unlike using medication, therefore, it does not just deal with symptoms and it does not act as a sticking plaster.
Secondly, the treatment is not one which is imposed on sufferers, but is one in which they play an active role. Throughout the treatment, they are learning healthy and positive new methods which are relevant to their lives and which work for them.Thirdly, and perhaps most importantly, CBT provides clients with what are effectively tools for life. Their new levels of understanding allow them to spot instantly if former unhealthy thinking or behaviour starts to creep back in, but this time they are consciously aware of what is happening and they have the tools at their disposal to deal with the situation. For this reason, CBT has the power to bring real and lasting change which can improve the quality of life, literally for a lifetime. Once they have learned, it becomes very difficult to a unlearn.
CBT is designed as a brief intervention, but it can also work for longer treatments. Typically, it would be offered as a package of 10 to 20 weekly sessions of one hour duration, although the duration, frequency and format of the sessions will of course depend upon the nature of the problem as well as on other factors. Structured homework assignments are an important component of both behavioural and cognitive treatments. While the bulk of the sessions tends to concentrate on teaching, reviewing and applying new strategies, the homework assignments allow patients to practise their new skills in the outside world whilst still having the support and guidance of a trained therapist.