Cognitive behavioral therapy (CBT) is one of the most commonly practiced methods of psychotherapy. It combines classical behavior therapy and cognitive therapy and is one of the most researched psychotherapy methods.
What is cognitive behavioral therapy?
In Cognitive Behavioral Therapy, the client must be a very active participant and, between sessions, actively practice the behaviors worked on in therapy in his or her daily life. The term “cognitive” comes from Latin and means “to recognize.” Cognitive behavioral therapy is one of several behavioral therapy techniques. In contrast to psychoanalysis, which is concerned with deciphering a person’s motives and behavior via the subconscious, behavior therapy is based on the behaviorist approach that all of a person’s behavior patterns have been learned and can therefore also be unlearned or replaced by better behavior patterns. Even the ancient Greek philosopher Epictetus knew “It is not the things that make us unhappy, it is our view of things.” Accordingly, Cognitive Behavioral Therapy aims to identify harmful thoughts and beliefs and replace them with new behavior patterns.
Function, effect, and goals
Cognitive behavioral therapy is suitable for depression, addictive disorders, anxiety and obsessive-compulsive disorders. But also physical complaints such as chronic pain, rheumatism or tinnitus can be treated with cognitive behavioral therapy or at least help to live better with the complaints. The client must be very active in this process and, between sessions, actively practice the behaviors developed in therapy in his or her everyday life. In the case of severe depression or an anxiety problem, the client is very challenged and can sometimes reach his or her limits. Sometimes, at the beginning of the therapy, medication is necessary to alleviate the worst symptoms in order to make it possible to act at all within the framework of the behavioral therapy. Cognitive behavioral therapy is particularly suitable for dealing with very specific problems. The reasons for these are secondary in the first place. The chemistry between psychotherapist and client must be right for a trusting collaboration to succeed. In the initial consultation, the client describes his or her problems and formulates wishes and expectations for the therapy. Based on these, treatment goals are jointly defined and a therapy plan is drawn up, which can be modified as needed during the course of therapy. In order for the therapist to identify harmful thought patterns, it is important for the client to write down his or her thoughts for a while, e.g., as diary entries. The therapist and client then look together at whether the client has an appropriate, realistic assessment of things, what happens if he or she ever behaves differently than is normally the case, whether he or she is making progress, and where problems occur, if any. Relaxation exercises and problem-solving strategies are also practiced, which the client can use at home. Cognitive behavioral therapy belongs to the solution-oriented short-term methods. The duration varies from client to client. Some clients feel a significant improvement after just a few sessions, while for others it can take a few months. Health insurers usually cover 25 sessions of short-term therapy. One session lasts 50 minutes, the sessions take place once a week. At the beginning, there are 5 introductory meetings so that the psychotherapist and the client can get to know each other better. Subsequently, the application for cost coverage is submitted to the health insurance. Cognitive behavioral therapies are conducted in psychological practices, clinics and rehabilitation facilities and are offered as individual or group therapies, depending on the problem.
Risks, side effects, and dangers
In general, psychotherapy can also lead to undesirable side effects. If the client actively deals with his fears and problems, it can be very stressful for him and also his environment. This is where open discussion with the therapist can help. Cognitive behavioral therapy is one of the best-researched psychotherapy methods, and its effectiveness has been proven especially for mild and moderate depression, anxiety and obsessive-compulsive disorders. It is particularly advantageous that measurable successes can be achieved with the help of cognitive behavioral therapy after a relatively short period of time.However, certain conditions are necessary for this. This procedure requires the active cooperation of the client and does not work with clients who refuse to cooperate with the therapist and refuse to look at a situation differently. If the client sees himself more as a victim and makes his happiness dependent on someone or something providing that, behavioral therapy will not do him much good. Because cognitive behavioral therapy is a short-term method, it is less appropriate for serious mental disorders such as processing traumatic experiences. Since the client must actively cooperate, he or she needs a reasonably stable psyche, which in the case of severe disorders is usually only possible with medication. Before therapy, it is important to carefully examine the best way to treat the disorder. If medication has to be administered in order to achieve a therapeutic capability, it must also be checked whether the behavioral changes that have been worked out can continue after the medication has been discontinued. In general, it must be taken into account in behavioral therapy that a cure alone is not decisive for the success of the therapy, but that a therapeutic success can also consist in being able to better cope with one’s life with the problem in the future. Ultimately, no psychotherapy method can guarantee success because in working with people, one cannot predict what will emerge in the course of psychotherapy.
