There are different ways to experience every situation. Our interpretations, responses, thoughts and emotions hold the key to how we approach, react and handle the events of our lives. And so the basic concept underlying cognitive behavioral therapy is that perception is far more important to how we handle everything in our lives than the reality of the experience itself. In addition, reinforcing a behavior will, over time, condition us to respond in a habitual way.

Cognitive behavioral therapy, also called cognitive behavior therapy or CBT, helps patients re-educate themselves through a variety of techniques that help change habitual ways of thinking, feeling, perceiving, and reacting to events. In this way, people learn to replace distorted or false thinking with a more realistic approach.

CBT arose in the 1950-60s as an outgrowth of two therapeutic approaches — behavioral and cognitive. The behavioral approach is evident in the classic experiments conducted by Pavlov with dogs, in which they were conditioned to respond to a stimulus they associated with food even when food was no longer supplied. Such respondent conditioning (classical/Pavlovian) and operant conditioning (behavioral modification) approaches were an accepted means to explain human behavior.

Behavioral therapy began by applying these to help people with various psychological issues. It often worked well and quickly — but it still didn’t answer all the questions researchers and therapists had about human behavior.

Meanwhile, research into cognitive processes, which involve our belief systems, recurrent thoughts, assumptions, and even fantasies, revealed how these processes played an essential role in mental disorders and personality problems. It showed that people have the potential to control their response to their environment to a large extent.

In the psychoanalytic arena two pioneers emerged. Aaron T. Beck and Albert Ellis, both former psychoanalysts, developed their theories of cognitive and rational emotive therapy respectively. These theories developed alongside earlier models of analysis that, among other things, explored the unconscious and the transference between patient and therapist, a process requiring a long investment of time. Additional studies support the effectiveness of a combined approach now known as cognitive behavioral therapy.

CBT is goal-oriented — the therapist and patient set goals together and progress is monitored throughout treatment. The issues that are dealt with are concrete problems, for example, learning to control rage, reducing anxiety or depression levels, improving relationships with others. The therapist and patient are a collaborative team, both playing an active role in the session. The therapist is the teacher and the patient a student who continues to work between sessions on the strategies he or she has learned.

Continuing research supports the effectiveness of behavioral therapy enhanced by a cognitive approach. These studies show how CBT can be effective in the treatment of depression. It also provides encouraging results for the treatment of panic attacks, obsessive-compulsive disorder and other fear and anxiety issues. And because CBT is an educational process, whereby the patient learns alternative thoughts and behaviors, treatment with CBT gives the patient tools to utilize for self-help in the future — making it effective over the long term.

Today CBT is used to treat a wide range of conditions including but not limited to depression and mood disorders, social anxiety and relationship issues, IBS, obsessive-compulsive behavior, “burn-out,” substance abuse, self-esteem issues, difficulty controlling emotions like anger, or the suppression of emotions.

Content last modified on Nov 20, 2008