Edmonton Psychologist | Cognitive Behavioural Therapy Strategies
What is cognitive behavioural therapy and why is this a term being thrown around a lot in the psychology industry? CBT is an effective talking therapy that helps you manage your problems by changing your thinking. Once your thinking changes your behaviour changes too.
This short-term treatment option can help you deal with many issues such as post traumatic stress disorder, insomnia, substance dependency, phobias, depression and anxiety. Many patients have overcome these issues by working with the professional who is experienced in using CBT as part of the overall therapy.
There are some common successful techniques used in CBT. These include cognitive restructuring or reframing, guided discovery, exposure therapy, journaling and thought records, activity scheduling and behaviour activation, behavioural experiments, relaxation and stress reduction techniques and role playing.
Depending on the issue you are addressing there may be some more useful than others. Some are useful in every situation. For instance journalling is helpful to capture your thoughts and figure out if they are grounded in fear and negativity or if they are a reflection of what is actually happening in your life.
Negative thought processes become so entrenched in our brain and we just keep on reinforcing them, so it is so hard to change them. This is where cognitive restructuring or reframing comes in. This technique is when you learn to recognize negative thought patterns and turn them into rational ones. This could include keeping track of your thoughts during a difficult moment, identify the distorted ones and test if they are true or false.
The goal is to capture the untrue, irrational thinking and restructure or reframe it so that it becomes true and therefore brings the stress level down in the body. Thoughts are not always true, but they are always powerful. It is important to capture them, challenge them and if needed replace them with truth. Then the healing in your body begins as the stress and anxiety levels decrease.
What the process can look like
For practicality purposes, here is what a four-step process would look like using this technique. First you calm yourself down. Next you write down the situation that is triggering negative thinking patterns. Next you will have to work hard to identify the moods you felt when you were triggered. Lastly you write down the initial thoughts that came with the moods you experienced when you were triggered.
A fitting example of how this technique could be very useful is when a patient is struggling with an eating disorder. They may experience a vicious cycle of binging and purging which brings shame and disgust but they cannot stop it. With CBT they learn to eat based on hunger cues. This adds a level of mindfulness where the patient learns to eat to live.
Guided discovery is the next effective CBT technique used in therapy. This is where the therapist works to understand the patient’s point of view. From there they help the patient become aware of assumptions they are making in their point of view and thinking. The next thing is to help the patient find new perspectives and solutions to make their thinking processes more rational. The patient’s participation is expected.
There are a lot of open ended questions to help the patient examine their own thinking patterns. An example of how this technique could be used with someone experiencing PTSD is to help patients understand the low likelihood of whatever event it is they have been traumatized by in the past of happening again.
Why exposure therapy is so important
Exposure therapy is a vital part of CBT strategies to help with working through phobias such as social anxiety. This is not a technique that should cause more anxiety. It is handled by the professional in a respectful and safe manner. The point is to bring relief and healing to help the sufferer overcome their fear and anxiety. It is important that the therapist walks the patient through step by step starting with the negative thoughts or stressful reactions in the body.
From there the patient is taught to manage the irrational fears by incorporating coping techniques. After these things are mastered in the mind, then it’s appropriate to take baby steps in real life physical situations that would cause fear. The therapist is there to guide the patient through each small step towards overcoming the fear.
Journalling and thought records are a great way to counteract negative thoughts. Once a patient has been in a situation that triggers these thoughts, it’s imperative to write down and record the triggered thoughts. Recording the automatic response that a patient has is important in challenging the thoughts that may cause depression or symptoms of it.
After a few successive months of journalling the patient will become stronger and acutely aware of the thought patterns. With the help of a therapist they can learn what coping mechanisms to use for overcoming the triggers they experience.
Plan out your day and week in advance
Activity scheduling can help productivity for the person who is depressed or a procrastinator. When things like a walk, working on a project or even engaging in a hobby are scheduled in it can reduce stress and anxiety as well as add accomplishment. All these contribute to better mental health.
Relaxation and stress reduction techniques do exactly as they indicate. These techniques range from breathing exercises to hobby induced relaxation. When you are no longer in fight or flight mode you are more relaxed and aware of your thinking. To combat stress and anxiety it is important to slow your body down and these techniques do that.
Role playing is a great and effective CBT strategy. If the patient is fearful of a certain situation, the therapist can act out the situation with them as if it is a practice run. For example, if being interviewed is triggering then it’s a productive to be able to practice being interviewed when it doesn’t matter what the outcome is. When it comes time for the real interview, the patient will have already had a run through and it brings down the anxiety level.
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