In the U.S., more than 52 million adults and over 7 million children experience the effects of mental illness everyday.  No matter who you are or where you live, you will either know what it is like to struggle with mental health issues or you know someone who is currently struggling with their mental health.  Some of the most common mental health conditions troubling Americans today include anxiety disorder, affecting an estimated 48 million individuals, major depressive disorder,  affecting 21 million people, and posttraumatic stress disorder (PTSD), affecting about 9 million individuals.  Mental health issues raise many questions for nations all over the world about how to properly deal with them, and it is only in recent years that the stigma around this topic has begun to subside.  Individuals are able to feel more confident and comfortable with opening up with their struggles, and society has started to encourage our community members to ask for professional help when the weight of mental illness starts to feel too heavy. 

About 46% of U.S. adults and 50% of U.S. children received treatment for mental health disorders in 2020, meaning that over 25 million people may be familiar with the most common and widely studied forms of mental health treatments today, cognitive behavioral therapy (CBT). As more and more individuals are seeking therapeutic and medical treatments for the betterment of their mental health, CBT has certainly been one of the most employed techniques.

 

Intro to Cognitive Behavioral Therapy

As mentioned above, one of the most utilized forms of mental health treatment is cognitive behavioral therapy, more commonly referred to as CBT.  As the APA defines it, CBT is a form of psychotherapy that combines treatment techniques from cognitive and behavioral therapy to help patients change unhealthy thinking patterns and alter problematic behaviors.  CBT is considered by many to be the gold-standard of psychotherapy because it has been widely tested and empirical data has proven its effectiveness for all types of patients. 

 

The Process of CBT

In CBT, a therapist or mental health counselor will work one-on-one with a patient to tackle their emotional and behavioral issues.  It is a structured form of talk therapy that is designed to last over a limited number of sessions to help patients through their struggles in an efficient, yet highly effective manner.  Typically, sessions are 30-60 minutes long and occur on a weekly or biweekly basis.  CBT sessions are usually scheduled to continue somewhere between six weeks or six months, depending on the needs of each individual. In 2021, data from England showed that nearly 2 million CBT appointments took place, with the average number of sessions per individual being about 6.8.

As opposed to a lot of other mental health interventions that focus on dealing with past experiences, CBT hones in on current challenges that the patient is dealing with.  The goal is to address patients’ current state of mind and current patterns of thinking so that they can be dealt with in the moment.  In addition, CBT is based on core principles to help individuals tackle their problems in a digestible way that breaks down overwhelming issues into manageable tasks.  To simplify, CBT practices are founded on the idea that psychological problems are partly based on unhelpful thinking patterns and unhelpful learned behavioral patterns, but these issues can be resolved if patients learn better ways to cope with their cognitive and behavioral patterns.  When patients learn to cope better, their perspective on life begins to shift and they can begin to live more empowered lives.

 

What to expect from a CBT session

Bottom line:  CBT is meant to help people feel in control of their thoughts and emotions. Therapists typically use it as a first-line treatment against mental health disorders, and it can be used in conjunction with other modes of therapy or medication to make it more effective for patients who require multiple interventions.  

In a CBT course, therapists will begin by speaking with patients about what their current thought patterns and emotions are in the  initial sessions.  This time gives therapists fundamental insight into what patients are thinking and feeling about themselves and the world around them, and with this information they can begin to formulate a game plan for how the rest of the therapy sessions will go.  Mental health clinicians’ first goal is to assist patients in understanding how their thoughts affect their emotions, and vice versa.  Subsequently, patients are guided by their therapist to uncover what parts of their thought and emotive patterns produce unhelpful outcomes.  After this revelation, the majority of CBT is spent on working out what can be changed and how to incorporate these changes in everyday life.  Patients will learn how to cope better in stressful situations, relax their minds, practice stress management, and show more resilience.  Slowly, patients are able to apply the skills and tools they learn during treatment into their lives and interactions.  After treatment ends, the hope is that patients will be able to use their new, healthier skills and thinking patterns to successfully manage their problems.  Even if a problem were to arise in the future, they would be able to use what they learned in new situations to avoid negative impacts they might have on their mind and actions.  Essentially, patients are learning to act as their own therapists and regulate their patterns of thinking and feeling on their own.

 

Risks

Even with how effective and widely used CBT is, there are some things to consider when considering this treatment.  In order for CBT to be effective, patients must be willing to commit themselves fully to the process.  The therapist cannot force an individual to start thinking or behaving differently, but it is important to think of CBT as a collaborative team effort that helps people improve their mental health.  Patients must also be willing to face their fears instead of avoiding them.  In this process, patients will have to confront the parts of themselves that may feel uncomfortable or even painful.  Throughout CBT, patients will have to be vulnerable and put in extra work outside of sessions to cope with all the things they are learning about themselves.  If a person has very complex and difficult to treat mental disorders, CBT alone may not be very effective.  Along with this last point, CBT is an intensive process that takes up a lot of an individual’s time.  If you or a loved one is thinking about starting CBT, it may be best to start therapy when you know that there is ample time to dedicate to the process inside and outside of sessions.  Remember, all progress is good progress!

 

What does it treat?

Many studies have shown that CBT is a very effective way to treat a myriad of mental health issues.  Most notably, those with depressive and anxiety disorders can really benefit from CBT.  For example, those with depression tend to have negative and hopeless thoughts about themselves and about life.  CBT is able to help these individuals recognize how these unhealthy thoughts affect them when they ruminate on them for too long.  They may learn to stop their thoughts at an automatic level and begin to feel better when they replace negative thoughts with more positive ones.  Other disorders that CBT can address are:

  • Personality disorders
  • Eating disorders
  • Schizophrenia
  • Bipolar disorder
  • Obsessive compulsive disorder
  • attention-deficit/hyperactivity disorder (ADHD)
  • Phobias 
  • Substance use disorders
  • Sexual disorders

 

As for other mental health challenges, CBT can also help you:

  • Resolve communication issues in relationships
  • Learn how to cope with stressful situations
  • Learn to cope with medical illness
  • Manage symptoms of mental illness
  • Learn to cope with grief
  • Empower you to deal with emotional trauma and PTSD
  • Treat mental illness in conjunction with medication
  • Treat non psychological medications (like migraines or IBS)
  • Work through problems at work or with other coworkers

 

CBT is for everyone!

What’s great is that CBT is not limited to those with a mental illness.  Even if you are not clinically diagnosed with a mental health disorder, you can still seek this therapy from a therapist or mental health worker.  Those who are dealing with stressful life situations may want to learn how to cope better, and this is when skills that are taught in CBT could definitely be beneficial.  The tools and skills that individuals learn in CBT empower them to tackle new situations and changes in life with more assurance and confidence.  Considering how well studied and endorsed this treatment is by clinicians, CBT may be a therapy that you consider if you want to change your thinking patterns and behaviors for the better.

 

Results with CBT

As outlined above, CBT is a structured process, and the length of one patient’s therapy course will differ from another’s.  For this reason, when going in for the first session it is advisable to start thinking about what you want to change about your thought processes and behaviors.  The more willing someone is to commit to the process and work in collaboration with their therapist, the more efficient and more effective CBT will be.  Along this same idea, it is very important that individuals feel comfortable with the clinician or therapist that is helping them through the process.  Because CBT is a type of talk therapy, patients will be spending all of their time with their provider during the treatment.  If at any point someone feels uncomfortable with their therapist, it is in everyone’s best interest to find another one.  It is important to remember that there is no shame or pressure to stick with the first clinician you find.  In order to fully commit to the process, individuals need to feel comfortable with their therapist.   It may take a few sessions to start to see progress, but you should never feel uncomfortable because of the person you are working with.  Lastly, in order to have a successful course of CBT, it is important to stick to treatment.  As time goes on, it can be tempting to miss a session here or there, or you may feel like there isn’t anything else to learn.  Do not let the amount of work dissuade you from continuing to stay vigilant.  Give yourself your best chance at rewiring your unhealthy thinking and behavioral patterns, and show up to your therapy sessions!

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References:
“Mental Health by the Numbers.” NAMI, https://www.nami.org/mhstats. 
“Apa Dictionary of Psychology.” American Psychological Association, American Psychological Association, https://dictionary.apa.org/cognitive-behavior-therapy. 
“CBT Helping Overcome Mental Health Problems as Nearly 2 Million Appointments Take Place in 2021.” Www.rcpsych.ac.uk, Royal College of Psychiatrists, 8 Apr. 2022, https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2022/04/08/cbt-helping-overcome-mental-health-problems-as-nearly-2-million-appointments-take-place-in-2021. 
David, Daniel, et al. “Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy.” Frontiers in Psychiatry, U.S. National Library of Medicine, 29 Jan. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/. 
“Cognitive Behavioral Therapy (CBT): What It Is & Techniques.” Cleveland Clinic, https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt. 
“Cognitive Behavioral Therapy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Mar. 2019, https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610#:~:text=Cognitive%20behavioral%20therapy%20is%20used,done%20in%20a%20structured%20way. 
“Overview – Cognitive Behavioural Therapy (CBT).” NHS, NHS, https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/. 
“What Is Cognitive Behavioral Therapy?” American Psychological Association, American Psychological Association, https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral. 
“Cognitive Behavioral Therapy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Mar. 2019, https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610#:~:text=Cognitive%20behavioral%20therapy%20is%20used,done%20in%20a%20structured%20way. 
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