“ Cognitive Behavioral

Therapy “

NAME: BAWDIN HERA NAAZ DANIYAL

GROUP NO: 25A
HISTORY OF CBT:

• As the name cognitive behavioral therapy implies, CBT can be seen as

the integration of two separate strains of psychotherapy-that of
cognitive therapy (CT) and behavior therapy (BT).
• BT emerged first, arising in the 1950s and 1960s from an interest in
applying the principles of behaviorism to promote behavior change in
humans (Kazdin & Wilson, 1978). The modern roots of CBT can be
traced to the development of behavior therapy in the early 20th
century, the development of cognitive therapy in the 1960s, and the
subsequent merging of the two. Groundbreaking work of behaviorism
began with John B. Watson and Rosalie Rayner's studies of conditioning
in 192
• This was in contrast to the rising dominance of Freudian
psychoanalysis, an approach characterized by a focus on case studies
rather than systematic experimentation and by theories of unobservable
phenomena (e.g. the unconscious mind, repression processes, etc.)
whose existence and functioning were seen as difficult to verify at the
time.
• Aaron Beck is generally considered the founder of CT and may be
the single most influential figure in the field of CBT.

Cognitive Behavioral Therapy.

Abbreviation: CBT.

A psychotherapy method that relies on both behavioral and cognitive

modifications (e.g., through systemics desensitization and aversion
therapy) and cognitive restructuring to change disruptive thought
patterns.
Used to treat multiple disorders, including depression, generalized
anxiety disorder, PTST, panic disorder, eating disorder , eating
disorders and OCD.
Figure 18.1 illustrates the hot cross bun model of cognitive behaviour
therapy.
A typical cognitive therapy schedule consists of about 15 visits over a
three-month period. Some important techniques in CBT are:

i. Cognitive techniques such as recognising and correcting negative

automatic thoughts, teaching reattribution techniques, increasing
objectivity in perspectives, identifying and testing maladaptive
assumptions, and decentering,
ii. Behavioral techniques such as activity scheduling, homework
assignments, graded task assignment, behavioural rehearsal, role
playing, and diversion techniques, and
iii. Teaching problem-solving skills.
iv. Mindfulness, originally a Buddhist technique, can also be combined
with CBT.

INDICATIONS:

• OCD
• PHOBIAS
• Substance use disorder
• Depressive disorder
• Anxiety disorder
• Trauma related disorder
• Eating disorder
• Schizophrenia
DURATION:

• Usually for approx. 16 weeks

• Twice weekly for the first 4 weeks
• Once weekly for the remaining 12 weeks
Description:
• Focuses on changing distorted, harmful, irrational, or ineffective
beliefs, attitudes, and behavior patterns that lead to dysfunctional
behaviors
• Helps the patient to identify unhelpful and distorted thoughts
• Helps the patient develop skills and strategies to alter abnormal
behaviors and develop healthy coping mechanism.
• Aims to improve the patient's control over their emotions and
ability to deal with distress

TECHNIQUES:
combines techniques from COGNITIVE THERAPY and BEHAVIORAL
THERAPY

• Behavioral therapy:

Behavioral therapy is based on learning theory, which states that

behaviors are learned by conditioning and can similarly be unlearned by
deconditioning.

CONDITIONING:

■ Classical conditioning: A stimulus can evoke a conditioned

response.
(Example: Pavlov’s dog would salivate when hearing a bell because
the dog had learned that bells were always followed by food.)
■ Operant conditioning: Behaviors can be learned when followed by
posi tive or negative reinforcement.
(Example: Skinner box—a rat presses a lever by accident and receives
food; eventually, it learns to press the lever for food [trial-and-error
learning].)

BEHAVIORAL THERAPY TECHNIQUES (DECONDITIONING):

■ Systematic desensitization:

• The patient performs relaxation techniques while being exposed to

increasing doses of an anxiety-provoking stimulus.
Gradually, he or she learns to use relaxation skills to tolerate and cope
with the anxiety provoking stimulus.
• Commonly used to treat phobic dis orders.
• Example: A patient who has a fear of spiders is first shown a
photograph of a spider, followed by exposure to a stuffed toy spider,
then a videotape of a spider, and finally a live spider. At each step, the
patient learns to relax while exposed to an increasing dose of the
phobia.

■ Flooding and implosion:

• Through habituation, the patient is confronted with a real (flooding)

or imagined (implosion) anxiety-provoking stimulus and not allowed to
withdraw from it until he or she feels calm and in con trol.
• Relaxation exercises are used to help the patient tolerate the
stimulus. Less commonly used than systematic desensitization to treat
phobic disorders.
• Example: A patient who has a fear of flying is made to fly in an
airplane [flooding] or imagine flying [implosion].
■ Aversion therapy:

• A negative stimulus (such as an electric shock) is repeatedly paired

with a specific behavior to create an unpleasant response.
• Used to treat addictions or paraphilic disorders.
• Example: An alcoholic patient is prescribed Antabuse, which makes
him ill every time he drinks alcohol.

• Cognitive therapy:

• Cognitive therapy, pioneered by Aaron T. Beck, seeks to correct

faulty assumptions and negative feelings that exacerbate psychiatric
symptoms.
• The patient is taught to identify maladaptive thoughts and replace
them with positive ones. It is most commonly used to treat depressive
and anxiety disorders, and is usually combined with behavioral therapy
in CBT.
• May also be used for paranoid personality disorder, obsessive-
compulsive disorder, somatic symptom disorders, and eating disorders.
Cognitive therapy can be as effective as medication for some disorders.

CLINICAL EXAMPLE OF THE COGNITIVE THEORY OF DEPRESSION:

■ Cognitive distortions, also known as faulty assumptions or

automatic thoughts.
• Example: If I were smart, I would do well on tests. I must not be
smart since I received average grades this semester.

■ Negative thoughts.
• Example: I am stupid. I will never amount to anything worthwhile.
Nobody likes a worthless person.
 PROS AND CONS OF CBT:

Cognitive behavioural therapy (CBT) can be as effective as medicine in

treating some mental health problems, but it may not be successful or
suitable for everyone.

Some of the advantages of CBT include:

• it may be helpful in cases where medicine alone has not worked

• it can be completed in a relatively short period of time
compared with other talking therapies
• the highly structured nature of CBT means it can be provided in
different formats, including in groups, self-help books and online
• it teaches you useful and practical strategies that can be used in
everyday life, even after the treatment has finished.

Some of the disadvantages of CBT to consider include:

• Patient need to commit themselves to the process to get the most

from it – a therapist can help and advise, but they need co-operation.
• Attending regular CBT sessions and carrying out any extra work
between sessions can take up a lot of time.
• May not be suitable for people with more complex mental health
needs or learning difficulties, as it requires structured sessions
• Involves confronting your emotions and anxieties – patients may
experience initial periods of anxiousness or emotional discomfort.
• It focuses on the person's capacity to change themselves (their
thoughts, feelings and behaviours) – this does not address any wider
problems in systems or families that often have a significant impact on
someone's health and wellbeing.