Cognitive-Behavioral Therapy (CBT) is considered to be one of the most rapid therapies there is when it comes to getting quick results.
CBT is both brief and time-limited in comparison to other types of therapy. Cognitive-Behavioral Therapy is based upon the idea that our thoughts, not external events like people or situations, are actually the cause of our feelings and behaviors.
What this tells us is that we have a lot more control than we think and we can change things by changing our thoughts. In light of this, we have to ask ourselves what the research says about this groundbreaking therapy.
In this article, we will examine the scientific benefits as well as the research of Cognitive-Behavioral Therapy.
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What are the Benefits of Cognitive Behavioral Therapy?
According to the National Association of Cognitive-Behavioral Therapists, CBT is based on the cognitive model of emotional response. This model tells us that our feelings and behaviors stem from our thoughts, as opposed to external stimuli. CBT is a goal-oriented and problem-focused therapy, unlike its psychoanalytical predecessors.
As a result of this, CBT focuses on the present and on the here and now, rather than on a lengthy analysis of the subject’s developmental history.
Cognitive-Behavioral Therapy is known for its quick results. Both therapists and psychologists use CBT in the treatment of certain mental disorders.
The average amount of sessions a patient receives is 15. In comparison, other kinds of therapy may take months or even years of regular sessions in order to see results.
Other advantages of CBT include the fact that it:
- Is highly engaging.
- Holds the patient accountable for the therapeutic outcome.
- Is centered on the idea that one’s emotions and thoughts are responsible for how they behave and feel.
While CBT may not work for those with severe mental disorders or those with learning difficulties, it is a great form of therapy for helping people accept and understand that they can change things by simply changing their thoughts.
This is a major advantage because it helps people understand that altering their thought processes can lead to a positive outcome. This is a much different type of therapy in comparison to more traditional therapy, which typically focuses on trying to change or re-evaluate past actions or fears.
A Look at the Research
Numerous random controlled trials have established that Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for children has many benefits.
Trauma-Focused CBT focuses on reducing both emotional and behavioral symptoms resulting from exposure to traumas. TF-CBT has been shown to decrease posttraumatic stress symptoms that may result from abuse-related fears, depression, anxiety, shame, and sexualized behavior, to name a few.
Study Number One
Preschoolers who received TF-CBT showed greater improvement when it came to internalizing and externalizing behaviors and sexual behaviors in comparison to children who received nondirective supportive therapy.
In the study, behavior problems including sexual behaviors continued to improve after the end of treatment (Cohen & Mannarino, 1997).
Study Number Two
Parental involvement in TF-CBT was associated with a decrease in child depression as well as a decrease in PTSD symptoms. Three out of four initial treatment outcomes were maintained at a two-year follow-up, with TF-CBT showing superior outcomes to standard community care.
According to research done by Turner and Swearer Napolitano (2010) at the University of Nebraska-Lincoln, CBT encompasses several different approaches that share the same theoretical underpinnings.
These therapeutic approaches include:
- Rational Emotive Therapy
- Cognitive Therapy
- Rational Behavior Therapy
- Rational Living Therapy
- Schema-Focused Therapy
- Dialectical Behavior Therapy
CBT has also been used to help those with Obsessive-Compulsive Disorder (OCD). The components of CBT used in the treatment of OCD include exposure and response prevention as well as cognitive interventions, according to Olatunji, Cisler, and Deacon (2010).
In three studies that were examined for the use of CBT in treating OCD, a large effect was found. The results were the largest effect size (1.37 or 95% CI 0.64-2.20) for CBT in any anxiety disorder.
These studies demonstrate that patients receiving CBT exhibited significantly fewer symptoms post-treatment when compared to those who received typical treatment.
The meta-analyses confirm that CBT is by far the most consistently empirically supported psychotherapeutic option when it comes to treating anxiety disorders, which makes it the gold standard treatment for those with anxiety (Olatunji, Cisler, & Deacon, 2010).
The Benefits of CBT for Anxiety
CBT is also been proven to be a good therapy for anxiety disorders. Otte (2011) examined a plethora of studies on the effectiveness of CBT for adult anxiety disorders.
According to Otte, CBT demonstrates both efficacy and effectiveness in randomized trials in naturalistic settings in the treatment of adult anxiety disorders.
Five studies reviewed the efficacy of CBT for panic disorders in a randomized placebo-controlled design. The effect size was 0.35 (95% CI 0.04-0.65), which indicates a small to medium effect.
Generalized anxiety disorder, marked by excessive and uncontrollable worry, was also studied.
CBT in the treatment of generalized anxiety disorder involves cognitive therapy, which is designed to examine the worry, and cognitive biases and relaxation to help with tension.
The controlled effect size for CBT in generalized anxiety disorder was 0.51 or 95% (CI 0.05-0.97) according to Otte.
CBT was also used in the treatment of Post-Traumatic Stress Disorder (PTSD). Cognitive Behavioral Therapy for PTSD includes:
- Psychoeducation about the nature of fear and anxiety.
- Controlled prolonged exposure to issues related to the traumatic event.
- Cognitive restructuring, processing or challenging maladaptive behaviors (Mental Health Academy, 2014).
The results of six CBT studies that were randomized and placebo-controlled for PTSD showed a controlled effect size of 0.62 or 95% which indicates a medium effect. (Otte, 2011).
These favorable effects of CBT are further corroborated by several Cochrane analyses of psychological treatments for several anxiety disorders according to the research. (Otte, 2011).
Can CBT Help with Depression?
Hofmann, Asnaani, Vonk, Sawyer, and Fang (2012) identified 269 meta-analytical studies examining the efficacy of CBT.
The research examined disorders such as:
- Substance use disorders
- Schizophrenia and other psychotic disorders
- Depression and Bipolar disorder
- Anxiety Disorders
- Somatoform disorders
- Eating disorders
- Personality Disorders
- Aggression, Anger and Criminal behaviors
- Stress in general
- Distress due to medical conditions
- Chronic pain and fatigue
- Female hormonal conditions as well as pregnancy-related distress
The strongest support was seen for the use of CBT in anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress.
Eleven studies compared the rate of response with Cognitive Behavioral Therapy and other treatments or control conditions. CBT showed a higher response rate than the comparison conditions in seven of these reviews, with only one review reporting that CBT had lower rates of response.
9 Ways to Implement These Beneficial CBT Practices
Cognitive Behavioral Therapy combines basic theories about behaviorism, or how people learn, with cognition, or how people think and how they interpret events in their lives.
CBT is a firmly established method of treatment for many mental health conditions. The research also shows that the skills people learn through CBT last long after the treatment ends (Hawton, Salkovskis, Kirk, & Clark, 1989).
In light of all this research, it’s also important to examine some basic things that can be done to mimic the results seen in CBT.
6 Common CBT Interventions
Six common CBT interventions, according to Michelle Patterson, PhD., include things like:
- Learning how to set goals that are realistic and problem-solving.
- Learning how to better manage things like stress and anxiety.
- Learning how to identify situations that you might avoid and gradually approaching feared situations.
- Doing more enjoyable activities like hobbies, social activities, and exercise.
- Learning to identify and challenge automatic negative thoughts (ANTS).
- Journaling and keeping track of your feelings, thoughts, and behaviors (Patterson, 2009).
Setting realistic goals and learning how to solve problems might involve engaging in more social activities or learning how to be more assertive.
In order to better manage stress and anxiety, you can learn relaxation techniques and deep breathing techniques. You can also use positive self-talk or use a distraction technique like taking a deep breath to calm your energy in stressful situations.
Learning to be more comfortable in situations you might normally avoid is another good technique. This might involve networking more often or simply getting comfortable walking up to and greeting strangers at a party.
There is nothing more enjoyable than doing something you love, so engaging in hobbies and social activities can go a long way to helping you heal.
Because CBT involves changing how you think, it can also be helpful to identify and challenge those automatic negative thoughts. Instead of telling yourself things never work for you, try telling yourself that life supports you in every moment.
Keeping track of those negative thoughts, feelings and behaviors might also be helpful so it’s a good reason to journal or simply record your thoughts on a regular basis.
Other CBT Common Practices include:
- Mindfulness-based cognitive therapy
- Cognitive restructuring or reframing
- Cognitive journaling
The UK National Institute of Clinical Excellence has recently endorsed Mindfulness-Based Cognitive Therapy as an effective treatment for prevention and relapse for those who are clinically depressed. However, these same techniques can also help those who aren’t clinically depressed.
Mindfulness-Based Cognitive Therapy (MBCT) combines Cognitive-Behavioral techniques with mindfulness activities and strategies to help you better understand and manage your thoughts and emotions.
MBCT was originally developed to help give patients the necessary tools to combat depressive symptoms as they arise, but it can also be helpful for those who are merely looking for ways to combat stress.
Practicing mindfulness can also help you improve your mental and physical health. Mindfulness is all about turning off the endless chatter in your mind.
You can practice mindfulness by simply living in the present moment or by breathing in and out and observing the breath.
Mindfulness involves being aware of your thoughts, but not judging them. By observing your thoughts in a detached manner, you can let go of all cares and concerns.
Mindfulness practices are also a great way to combat those automatic negative thoughts.
Cognitive restructuring or reframing is another great technique. This technique allows you to identify the filter through which you see the world and change how you view things.
When you discover a belief that is destructive or harmful, you can then begin to challenge it and reframe it. When you reframe something, you learn to look at it differently.
When properly and consistently utilized, cognitive reframing can help you eliminate negative thoughts and challenging limiting beliefs.
Cognitive reframing involves:
- Learning about basic cognitive errors.
- Developing mental awareness.
- Challenging your conclusions.
- Replacing faulty beliefs.
The truth is we all see the world a little differently. Because we see things differently, we form different conclusions about things. Learning about common mental errors like blaming or emotional reasoning, can help us develop more mental awareness.
Challenging your conclusions allows you to reframe them and see things in a new light. Once you do all of this, you can then replace those faulty beliefs.
For example, just because you believe something to be true, doesn’t necessarily mean it is so.
Let’s say you believe life is hard and friends are hard to come by. You can begin by asking yourself a series of questions like:
- Why do I believe this is true?
- Where did these “beliefs” come from?
- What is it that is holding me back or keeping me from achieving success?
- What can I do to change it?
Try listing all of those negative beliefs or thoughts and then challenging yourself to think about them in a more positive way.
Instead of saying “I am not a people person,” you can turn the statement around and say “I have some great people in my life” instead.
Rewriting your negative thoughts into positive thoughts is also a great way to start thinking differently.
Cognitive journaling is another great technique. Cognitive journaling uses something known as the “ABC Model” where you also include the letter D for Disputing.
ABC stands for:
- Activating Event – The actual event and your immediate interpretations of the event.
- Beliefs about the event – Which can be rational or irrational.
- Consequences – How you feel, what you do or other thoughts.
- Disputing – Identifying alternative beliefs that would lead to healthier consequences.
Let’s look at an activating event involving someone who constantly interrupts you or talks over you.
As a result of this, you may believe this person doesn’t like you. You may deem them rude. You may even think your thoughts aren’t important to them. These are your beliefs.
The consequences are that you feel bad. You may get anxious or nervous or even annoyed.
To dispute this, you have to look at things differently. Maybe this person is just excited to tell you something. Maybe they didn’t do it on purpose. Maybe you could simply mention the fact that this bothers you, and let it go. It’s not about YOU.
A Take-Home Message
Cognitive Behavioral Therapy is a technique that is highly engaging and a technique that offers quick results when compared to standard psychotherapy.
CBT helps us understand that we have the power to change things. CBT tells us that external situations, interactions with others’ and negative events are not actually responsible for our poor moods and problems.
The truth is that our own reactions to events and the things we tell ourselves about those events are most likely the cause.
With Cognitive Behavioral Therapy, you can learn to change the way you think, which in turn changes the way you feel. All of that then changes the way you view the world and how you handle difficult situations when they do arise.
The better you become at disrupting those negative thoughts the happier you will be.
- Hawton, K. E., Salkovskis, P. M., Kirk, J. E., & Clark, D. M. (1989). Cognitive behaviour therapy for psychiatric problems: A practical guide. New York, NY: Oxford University Press.
- Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440.
- Mental Health Academy. (2014). Treating anxiety with CBT: The evidence. AIPC. Retrieved from https://www.aipc.net.au/articles/treating-anxiety-with-cbt-the-evidence/
- Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: A review of meta-analytic findings. Psychiatric Clinics, 33(3), 557-577.
- Otte C. (2011). Cognitive-behavioral therapy in anxiety disorders: Current state of the evidence. Dialogues in Clinical Neuroscience, 13(4), 413–421.
- Patterson, M. (2009). CBT in practice: Part science, part art. Visions Journal, 6(1).
- Turner, R., & Swearer Napolitano, S. (2010). Cognitive Behavioral Therapy (CBT). In C. Clauss-Ehlers (Ed.), Encyclopedia of cross-cultural school psychology (pp. 226-229). New York, NY: Springer.