Knowing the process of cognitive behavioral therapy is important information before receiving it. Cognitive behavioral therapy is a widely known method globally, and can be considered a fundamental approach among various psychological treatments. It is one of the psychotherapies developed during the scientific validation of psychoanalysis. For those considering cognitive behavioral therapy, this article will help you understand the process of cognitive behavioral therapy and check if it is right for you.
1. Reasons for Receiving Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) was developed by Aaron Beck, an American psychiatrist and psychoanalyst in the 1960s, as a response to the criticisms of the lack of scientific evidence supporting psychoanalysis.
Initially, it started as cognitive therapy, changing dysfunctional thinking (thoughts that are not helpful to the individual) to solve the patient’s psychiatric symptoms, and in the 1980s, it was combined with behavioral therapy, which also addressed behavioral patterns.
Cognitive behavioral therapy is suitable for treating psychiatric symptoms related to Neuroses, which involve some reality-checking ability, rather than Psychoses.
If humans are different from other animals, it is due to their ability to think, that is, the development of the neocortex. Cognitive behavioral therapy strengthens this human advantage, the Neocortex, which is why the ability to check reality is fundamentally necessary.
Those who decide to undergo cognitive behavioral therapy are likely those who dislike medication and fundamentally want to solve their mental health symptoms. If you are looking to receive treatment, it is important to find a hospital or psychological center that specializes in and is interested in cognitive behavioral therapy.
2. Process of cognitive behavioral therapy – An Overview
If you have decided where to receive cognitive behavioral therapy, you might be curious about how the process of cognitive behavioral therapy will be conducted. Let’s take a look at the overall process of cognitive behavioral therapy.
1) Current State Check
The first step in the process of cognitive behavioral therapy is to check the current state of the patient.
This involves understanding what part of their mental state they find challenging, whether they have been diagnosed, and the extent of any medications they are taking.
Additionally, this process helps determine if cognitive behavioral therapy is appropriate for the patient at this time.
2) History Investigation
After checking the current state, it investigates the patient’s past temperament, and the thought and behavior patterns they have lived with.
Process of cognitive behavioral therapy focuses on changing the patient’s dysfunctional thoughts and beliefs, so investigating their past can reveal their overall thought and behavior patterns.
3) Current Problem Resolution as a Goal
Process of cognitive behavioral therapy aims to be short-term and efficient, focusing on solving current problems.
Even if the patient’s dysfunctional thoughts and beliefs have not been completely resolved, if their intensity has diminished or the current problems have been resolved to a sufficient level, therapy can be concluded.
4) Cognitive Model Education
Just as various formulas are emphasized in famous mathematics textbook, there is an important formula in cognitive behavioral therapy. It is crucial to understand the cognitive model that reveals human thought patterns.
Patients are educated on the principles of the cognitive model and learn to identify their own thoughts, emotions, and behaviors in various situations.
5) Identifying Dysfunctional Thoughts
Although it might be misunderstood as simply changing thoughts to be more positive, cognitive behavioral therapy more accurately involves correcting distorted, dysfunctional thoughts.
Often, if thoughts are biased or too distorted, they can lead a person’s emotional and behavioral patterns in an excessive direction.
Automatic thoughts caused by cognitive errors, which arise unknowingly, are identified, and in the process of modifying these thoughts, one can discover deep-rooted core beliefs.
6) Finding Core Beliefs
Core beliefs, also known as schemas, can be considered unconscious beliefs formed unknowingly. These unconscious thoughts operate powerfully without one’s awareness.
Thoughts primarily stem from these core beliefs, and changes in these beliefs are necessary for one’s thoughts to change.
One of the goals of cognitive behavioral therapy is to change these core beliefs. Core beliefs are usually perspectives on oneself, others, and the world, learned based on one’s temperament from childhood.“
7) Practical Training
In the process of cognitive behavioral therapy, participants face moments where they must confront or deal with unwanted situations.
Often, people avoid approaching others because they feel too pathetic according to their own thoughts, or they avoid situations due to fear.
By examining distorted thoughts and training in coping strategies for difficult situations, thinking can change when faced with situations that are usually avoided.
8) Acquiring Necessary Skills
While undergoing the process of cognitive behavioral therapy, people may find it difficult when faced with unwanted tough situations. They learn techniques on how to cope during these tough moments and what efforts are necessary to maintain composure usually.
Fundamentally, through the use of dysfunctional thought records, individuals practice organizing their thoughts and correcting distorted thinking, and learn relaxation techniques to control physical responses through relaxation training.
3. Process of cognitive behavioral therapy – Individual Counseling Perspective
Let’s examine the specific process of cognitive behavioral therapy that occurs during individual counseling sessions in cognitive behavioral therapy.
1) Setting the Agenda
Cognitive behavioral therapy is a collaborative counseling process between the therapist and the patient. In some ways, it can be seen as an artistic endeavor within the relationship.
The agenda for the counseling session is set, focusing on difficult situations related to current problems. Various topics are set with the patient, and discussions are held within the allotted time.
2) Mood Assessment
Before proceeding with counseling, an assessment is made of the patient’s mood over time. Changes in the three emotions considered important in cognitive behavioral therapy (depression, anxiety, anger) can be checked.
Typically, patients are provided with a daily mood record form and are asked to check their average mood every day.
3) Recent Information Check
The counselor checks what has happened recently to the patient, and what difficult or good events have occurred. If there were positive events, these can be explored and highlighted together with the patient.
4) Reviewing Assignments
During counseling sessions in cognitive behavioral therapy, assignments (such as daily mood records, dysfunctional thought records, behavioral experiments) are given for the patient’s training.
The counselor checks if the assignments were performed well, providing a managed feel to the patient.
5) Prioritizing the Agenda
If various topics have been set at the beginning of the counseling, priorities are then set for discussion.
Counseling sessions usually last about 40 to 60 minutes, and prioritizing the agenda is necessary to conduct efficient counseling within the limited time.
6) Working on Specific Problems & Educating on Cognitive Behavioral Therapy Techniques
During counseling on prioritized agendas, if the patient shows distorted thinking and inefficient behavior patterns, skills related to cognitive behavioral therapy for change can be taught.
Typically, through guided discovery (using Socratic questioning to recognize one’s thoughts), the patient’s distorted thinking can be reviewed, and alternative approaches can be found.
Other necessary skills (such as relaxation techniques, assertiveness training) can also be taught to the patient.
7) Setting Tasks Related to the Agenda
Tasks can be set to change distorted thinking and behavior related to the topics set by the patient. At the beginning of counseling, dysfunctional thought records can be written daily to explore and differentiate one’s thoughts and emotions.
8) Providing a Summary
The therapist can summarize all the content discussed during the day’s counseling and explain it to the patient, who can also try summarizing it themselves.
9) Reviewing New Tasks
Besides the tasks related to the agenda, other necessary tasks for the patient can be reviewed.
10) Feedback
After counseling, the therapist can receive feedback from the patient on how the shared counseling session went, allowing both to tune their approaches.
The author personally thinks that learning the cognitive model proposed in cognitive behavioral therapy and being able to distinguish one’s thoughts, emotions, and core beliefs through the dysfunctional thought record gives one a great tool in life!
Even if you do not receive cognitive behavioral therapy counseling, it is recommended to learn the writing method of thought records and the concept of the cognitive model!
4. Conclusion and Q&A
We have looked at the process of cognitive behavioral therapy. The therapist can check the patient’s history and current state to assess suitability for cognitive behavioral therapy.
During counseling, efforts are made to change dysfunctional thoughts and beliefs and inefficient behavior patterns, and necessary skills are trained to the patient.
Below, we will explore frequently asked questions and key points related to the Process of cognitive behavioral therapy
1) What is the process of cognitive behavioral therapy?
Confirming suitability → Reviewing past history → Checking the patient’s dysfunctional thoughts and beliefs, behavior patterns → Educating skills for change, practicing facing avoided situations → Changing core beliefs, etc.
2) How long does the process of cognitive behavioral therapy counseling take?
Since cognitive behavioral therapy aims for short-term and efficient treatment, it typically can be conducted between 5 to 20 sessions. However, the duration can be adjusted depending on the patient’s state.
If you are curious about the types of cognitive behavioral therapy or the advantages and disadvantages of cognitive behavioral therapy, please refer to the link below for more articles!
► Information source and reference materials
Chapter 5, ‘The Structure of the First Therapy Session’ – Judith S. Beck / Hana Publishing House
Chapter 4, ‘Structuring and Educating’ – J. H. Wright, M. R. Basco, M. E. Thase / Hakjisa
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