Understanding Cognitive Behavioral Therapy

A Breakdown of the Cognitive Behavioral Therapy Approach

Understanding Cognitive Behavioral Therapy

Our thoughts, which can be very powerful, drive many things in our everyday lives—from how we feel, to how we act, and everything in between. When our thoughts are negative, like "I'm so stupid," "I can't do anything right," or "I feel ugly in this outfit," they can give us a skewed perception of reality. We may end up thinking other people believe these things about us too, even if we have no factual evidence that this is true.

Because our thoughts, feelings, and behaviors are interconnected, negative self-talk and skewed perception of reality can lead to feelings of depression and anxiety, and vice versa. Cognitive Behavioral Therapy is one way to manage our emotions, change our thought patterns, and decrease symptoms of depression and anxiety.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is not new. It was developed in the early 1900s and has been around since then. CBT is an approach that helps patients learn to recognize and change thinking patterns, identify how their perceptions and their reaction impact their daily life, find ways to challenge cognitive distortions they may have, and learn to see things differently.

What can I expect during a cognitive behavioral therapy session?

During a CBT session, you will be asked to discuss the problems that brought you in. Your therapist will listen and ask questions about your thoughts and feelings and work with you to see these from a different perspective. For example, you might be afraid of making a mistake at work because you "know" everyone will focus on you, make fun of you, and think you are stupid, despite there being no evidence that this is the reality of the situation. Cognitive behavioral therapy can help you identify and change these thinking patterns and cognitive distortions.

You'll learn how your thoughts, feelings, and behaviors are connected—and how changing one can affect the others. And you'll talk to your therapist about your relationships with significant people or situations in your life and learn to reframe your behavior and the behavior of others in more helpful and constructive ways.

Next, you'll learn skills for tolerating stressful and/or difficult situations, gain insight into your own identity and abilities, and learn coping skills to help relax your mind and body. Some of the strategies might include facing your fears instead of avoiding them, role-playing potentially problematic situations with your therapist, and learning to calm your mind and relax your body.

Most therapists give homework assignments to help you become more aware of your thinking patterns and give you practice in managing them effectively. With enough practice, your new ways of thinking can become habits.

Who can benefit from cognitive behavioral therapy?

Cognitive behavioral therapy has shown to be effective for children and adults with depression, PTSD, anxiety disorders, and mood disorders, but it can also be helpful in processing other stressful life events such as a breakup, divorce, grief and loss, or situational distressing experiences.

While cognitive behavioral therapy alone has been shown to drastically improve the quality of mental health, many people choose to use medication in conjunction with a cognitive behavioral approach to maximize outcomes.

Getting Started

Here are some tips for getting the most out of cognitive behavioral therapy:

  1. Be open-minded. The first step in any form of therapy is being willing to listen and learn. That means being open-minded about what the therapist has to say. If you think they're wrong, or if they don't seem like they know what they're talking about, take a deep breath and give them a chance. You might be surprised by what happens next!
  2. Remember why it's important. Sometimes it's easy to forget why we're doing something—especially when we're learning something new or trying something that seems weird at first glance. Remind yourself why this is important for YOU right now—and then keep reminding yourself throughout the process so it stays top of mind as you go through it.
  3. Remember that you don't have to do it perfectly. This is especially important when we're learning something new and there are lots of opportunities for mistakes! Remind yourself that making mistakes doesn't mean you're doing anything wrong—it just means that you've tried something new, and now you know what not to do in the future!
  4. Remember how much better it will get with practice. It's easy to get frustrated when things aren't working right away—especially if they didn't work the first time either! But remember that every time you try something again, you'll get better at it.

Cognitive Behavioral Therapy can help you identify your thought patterns, how they make you feel, and how they impact your actions—giving you a powerful way to manage your mental health and create more healthy patterns of thinking.

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Christy Wilkie, LCSW

Christy is a Licensed Clinical Social Worker who provides therapy for children, adolescents, and young adults who have complex behavioral health issues. She combines her extensive clinical expertise with a belief in kids, and has a unique ability to find and develop their strengths. She works hard to be an ideal therapist for her clients, doing what is best to fit their needs. She earned her master’s degree in Social Work from Indiana University–Purdue University in Indianapolis, IN. She is also certified in Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS).

Dakota Family Services is a highly trusted and respected outpatient clinic providing psychology, psychiatry, and therapy in North Dakota. Our community of compassionate mental health professionals help children, adolescents, and adults improve their overall mental health and well-being through a personalized approach, trusted expertise, and unconditional presence. We offer in-office counseling in Fargo and Minot and online therapy for those who prefer to meet from the comfort of their own home. To schedule an appointment, or to learn more, call 800-201-6495.