Cognitive Behaviour Therapy (CBT)
Cognitive Behaviour Therapy (CBT) is an evidence-based, short-term therapy model designed for the treatment of anxiety, depression, Obsessive-Compulsive Disorder (OCD), post-traumatic stress disorder (PTSD), and other mental health issues. It was developed by Dr. Aaron Beck in the 1960s and it's considered the gold standard for psychotherapy treatment across a range of DSM-5 psychological disorders.
The general aim of CBT is to better understand how your interpretation of life events influences your feelings and behaviour. You'll be better equipped to make changes in your life once you understand your behaviour and develop skills for reframing cognitive distortions that perpetuate unwanted behavioural patterns. It promotes the notion that our perception of life events is interpreted through the lens of our worldview shaped by our [past] experiences.
CBT Example
Let's highlight how two different people with different biopsychosocial histories can experience the same objective event differently:
| Event | Person | Interpretation | Consequence |
|---|---|---|---|
| Person tells their partner about their day and the partner responds in a monotone voice. | Person A: Grew up in a family that was highly sensitive to emotions, expressed strong emotions in communication with one another, and had many high conflict situations. A trauma history has also developed a fear of abandonment. | Jumps to the conclusion that their partner must not care about them, finds them uninteresting, and catastrophizes that their partner will inevitably leave them. They feel fear, anger, resentment, and shame. | Attacks partner with aggressive or passive aggressive remarks about how they do not care about them. Person A avoids communicating the actual problem that they feel hurt by their partner's perceived lack of interest or care that is taken by their body language. |
| Person B: Grew up in a family that was not particularly attentive to emotional states, few conflict scenarios, and generally had secure attachment. | Thinks nothing of their partner's lack of enthusiasm in their voice and does not experience a strong emotion one way or another about this event. They might consider it rude, but do not self-blame or assume it is because of their inadequacies. | Continues the interaction without conflict. |
The idea is that by gaining insight into our behavioural patterns and 'blindspots', developing cognitive, emotional, behavioural, and interpersonal skills, and reframing our thoughts into more realistic interpretations, we can improve the way we relate to our environment and reduce the degree to which we're negatively impacted by life events.
Six Potential Modalities Used in CBT
- Journal
- Challenge beliefs
- Reframe cognitive distortions
- Mindfulness
- Behaviour experiments or 'hypothesis testing'
- Behaviour activation
"Cognitive therapy seeks to alleviate psychological stresses by correcting faulty conceptions and self-signals. By correcting erroneous beliefs we can lower excessive reactions." - Aaron T. Beck, Cognitive Therapy of DepressionÂ
References
- Rachman, S. (1997). The evolution of cognitive behaviour therapy. In D. M. Clark & C. G. Fairburn (Eds.), Science and practice of cognitive behaviour therapy (pp. 3–26). Oxford University Press.
- Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications. Sage.
Benefits:
- Effectiveness. Research shows that online therapy can be just as effective as in-person therapy for issues related to mental health.
- Accessible. Accommodates those living in rural or remote areas, people living with disabilities that prevent them from leaving the home, and eliminates transportation barriers.
- Convenience. No need to schedule time for a commute.
- Cost Effective. Eliminates cost of parking and transportation.
Considerations:
- Coverage. Some insurance companies may not cover it. We encourage you to check with yours.
- Confidentiality and Privacy. Although we use encrypted, HIPAA-compliant software and abide by telehealth guidelines, communicating over the Internet entails a greater risk for security breach compared to in-person. It also means possible Internet connectivity issues.
- Distractions. Possibilities for disruption depending on your living circumstances and others in the home.
Benefits:
- Trust and Body Language. Some people may prefer viewing the entire body language of their therapist for more effective communication.
- Severe mental health or psychiatric concerns. A more appropriate and accommodating option for people that may need crisis intervention that is better supported with in-person care.
- Participation. It is an opportunity to engage in an activity outside of your home.
Considerations:
- Time consuming. Ensuring commute time may be challenging for busy schedules.
- Expenses. Possible parking and transportation fees.
All virtual sessions are conducted using secure, HIPAA-compliant software. Research has shown that psychotherapy offered through telehealth is an effective solution for mental health treatment. The efficacy of either option depends on individual preference and comfort level.