What is CBT?
CBT is short for Cognitive Behavioral Therapy. Modern CBT represents the merging of two traditions in psychotherapy. They are Cognitive Therapy and Behavior Therapy. Cognitive therapy was first described by Aaron Beck. His original work researching and treating depression. He became frustrated with the type of therapy he had been taught derived from the work of Freud and started asking patients about what they were thinking. Beck found that depression was explained by patterns of thinking and that it could be effectively treated by helping people change these dysfunctional patterns. His work, in collaboration with many others, led to the development of what came to be called Cognitive therapy. Beck and others encouraged careful research into both the underlying theory and the effects of this type of therapy. The work began to expand to cover many other disorders.
Behavior Therapy has its roots in the psychology of learning. The first attempts at behavior therapy were derived from experimental approaches and work with animal learning models. The early behaviorists were focused specifically on changing behavior, rather than how people think. Successful treatments were developed for problems like phobias. Like the people developing Cognitive Therapy, researchers in behavior therapy were very focused on evidence that their treatments work and supporting their understanding of the underlying mechanism of change.
Over time the two traditions began to coalesce as Cognitive therapists recognized and incorporated behavioral techniques and behavior therapists recognized the importance of thinking as a form of behavior that could be changed. This merger was possible in large part because both traditions focus on a scientific approach to understanding human behavior and emphasize the importance evidence that treatment works. With time most people working in the field have begun to describe their work or approach as Cognitive Behavioral Therapy or CBT. Therapists may empathize some approaches or techniques from one tradition or the other depending on the problem they are working with or factors such as their training. CBT is constantly evolving, and efforts continue to improve results. Variations of CBT include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Meta Cognitive Therapy.
The evidence shows that CBT is as effective in treating depression as antidepressant medications and may do a better job of preventing relapse of depression. CBT has been shown to typically work better than medication in treating anxiety disorders including panic disorder, phobias, social anxiety disorder and generalized anxiety disorder. Treatment of OCD and related disorders with CBT typically works for a higher percentage of people and produces more benefit than medication. PTSD treatment with CBT has been shown to be effective and includes several specific protocols that are evidence based. CBT is effective in treating sleep problems like insomnia and is considered the first choice in most cases. CBT has been shown to be useful in treating chronic pain and managing chronic health problems. Specialized forms of CBT are useful in treating problems ranging from Borderline personality disorder to schizophrenia.
Who Can Provide CBT?
CBT may be provided by therapists from different professions including psychologists, social workers, mental health counselors, and others. Because CBT has been established as effective in treating a broad range of problems, and is often recommended by other health professionals or insurance companies it has become popular for therapists to pursue some training in CBT and offer it to their patients. The result is that a search for a therapist who offers CBT may produce a long list. Since there is no restriction on who can make this claim it can be difficult to determine if the therapist is actually well trained or is providing evidence-based treatment. This creates a situation where the buyer needs to beware. It is appropriate to ask a potential therapist about their training and to describe how they apply CBT to your concerns. It is also worth looking at what the therapist lists as their approach or how they describe orientation. Therapists who list a large number of different approaches or who include non-evidence based treatments may not be offering CBT in a form that has been tested or may be borrowing from many different approaches. This may or may not lead to effective therapy.