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What Is Cognitive Behavior Therapy?

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Michelle Craske, in her APA Theories of Psychotherapy Series Book entitled “Cognitive-Behavioral Therapy”(2010), outlines the “hallmark features of cognitive-behavioral therapy.” Dr. Craske states ”CBT is short term, problem-focused cognitive and behavioral interventions strategies that are derived from the science and theory of learning and cognition.”  The execution of treatment and evaluation is guided by empirical science.

There is a new evidence-based practice movement within the American Psychological Association. APA encourages psychologists to use the latest available research evidence for specific disorders in treatment decisions. The APA task force concluded that CBT is the most common scientifically validated treatment shown to work with specific conditions.

A Brief History of Cognitive Behavior Therapy
Behavior Therapy began as a new scientific based treatment approach in contrast to traditional training in psychoanalytic treatment methods. In 1958, Joseph Wolpe, in his ground-breaking book, “Psychotherapy by Reciprocal Inhibition,” developed a research validated approach for the treatment of anxiety disorders.  He termed this treatment procedure “systematic desensitization.”  The main principles include graduated exposure to a fear situation (e.g., a fear ladder). This graduated exposure was combined with a variety of anxiety reduction or counter conditioning techniques, applied while in the feared situation.

Aaron Beck pioneered Cognitive Therapy.  In 1963, Dr. Beck published clinical research, which showed how our interpretations, and thoughts dramatically change our feelings and behaviors.  In the mid 1990s, the merits of both Cognitive Therapy and Behavior Therapy were acknowledged and combined into Cognitive-Behavioral Treatment.

How CBT Works
Now, cognitive-behavioral specialists start with targeting problem behaviors. They then conduct a “functional analysis” of the role that behavior, emotion and thought play in the problem behavior. The patient becomes a partner and is engaged as a research participant. Behavioral assignments routinely involve tracking thoughts, feelings and behaviors to gather more detailed data and formulate intervention techniques.

Next, intervention strategies are devised and tailored to the individual and the targeted problem areas. These strategies are developed specifically to obtain desired treatment goals. The effects of the strategies are monitored to evaluate the effectiveness and continually changed to achieve the desired results.

The final stage of CBT is relapse prevention, designed to maintain improvement over the long term. Old negative habits that are strongly ingrained must be interrupted. New, weaker positive habits need to be strengthened. The strengthening process occurs through daily practice. A critical variable in successful outcome is the degree of commitment to PRACTICE.

The overall aim of CBT is internalization of new habits. The patient is trained in self-maintenance, so that he or she no longer depends on the treatment provider for positive outcome.

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