Cognitive and Behavioural Therapies

Information about cognitive and behavioural therapies:

Behavioural Therapy

Behavioural Therapy is effective for individuals who require treatment for some sort of behaviour change, such as addictions, phobias and anxiety disorders. Based on the principle that behaviour is learnt, and can therefore be unlearnt, or reconditioned, Behavioural Therapy concentrates on the 'here and now' without focusing on the past to find a reason for the behaviour.
The most famous examples of conditioning are those of Ivan Pavlov and B.F Skinner.
An experiment conducted by Pavlov demonstrated how ringing a bell close to dinner time caused dogs to associate the ringing of the bell with the expectation of food, which made them salivate even if no food appeared. The importance of this experiment is that the conditioned response (the dogs salivating) decreased in intensity the more times the conditioned stimulus (ringing of the bell) occurred without the appearance of food.

A similar technique can be used to treat phobias, for example, where an individual can gradually be exposed to the stimuli that triggers the phobia, and recondition their behavioural response to it.
B.F Skinner conducted an experiment that associated reconditioning with rewards. The experiment involved feeding a rat via an automatic dispenser until the rat leant to associate the noise of the dispenser with the arrival of food. Once the rat had learnt this behaviour, a lever in the wall was raised so that when the rat touched it (accidently) with its paw, the food was dispensed. The rat then learnt to associate the lever with the arrival of food and continually pressed it.
A similar technique can be applied to individuals by reinforcing desired behaviour, or not reinforcing undesired behaviour.

Cognitive Therapy

Cognitive Therapy involves learning how to identify and replace distorted thoughts and beliefs, ultimately changing the associated habitual behaviour towards them. It is usually focused on the present and is a problem-solving orientated treatment. Cognitive Therapy is based on the principle that the way we perceive situations influences how we feel about them.
When individuals are distressed they often can't recognise that their thoughts are distorted, so Cognitive Therapy helps them to identify these thoughts and reassess them. For example, if an individual makes a small mistake they may think “I'm useless, I can't do anything right”. Strongly believing this may cause them to avoid the activity where they made a mistake and confirm this belief deeper. Addressing these thoughts, and reassessing them can lead to more flexible ways of thinking, allowing the individual to feel more positive, be less likely to avoid situations and be able to challenge their negative belief.
Cognitive Therapy was first developed in the 20th century by American psychiatrist Aaron Beck who realised what usually held his clients back most were negative thoughts and beliefs such as “I'm stupid” or “I can't do that”. Beck initially focused on depression and developed a 'list of errors' in thinking, that he believed could maintain depression. The list included errors such as magnification (of negatives), minimisation (of positives) and over-generalisation.
Albert Ellis, another therapist, came to similar conclusions about his clients' negative beliefs and their tendencies to 'catastrophise' or 'awfulise'. Ellis's work also became known as a form of Cognitive Therapy, now referred to as Rational Emotive Behaviour Therapy (REBT).
The cognitive approach came into conflict with the behavioural approach at the time, which focused solely on assessing stimuli and behavioural responses to it. However, during the 1970's behavioural techniques and cognitive techniques joined forces to create Cognitive Behavioural Therapy.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) combines cognitive and behavioural therapies, and involves changing the way you think (cognitive) and how you respond to these thoughts (behaviour). CBT focuses on the 'here and now' instead of focusing on the cause of the issue, and breaks overwhelming problems into smaller parts to make them easier to deal with. These smaller parts can be described as thoughts, emotions, physical feelings and actions. Each of these has the ability to affect the other, e.g. the way you think about things can affect how you feel emotionally and physically, and ultimately how you behave.
CBT is based on the principle that individuals learn unhelpful ways of thinking and behaving over a long period of time. However, identifying these thoughts and how they can be problematic to feelings and behaviours can enable individuals to challenge negative ways of thinking, leading to positive feelings and behavioural changes. It is possible for the therapy to take place on a one-to-one basis, with family members or even as a group depending on the issue and how the individual feels most comfortable.
CBT can be useful for dealing with issues such as:

anger
anxiety
depression
drug or alcohol problems
eating disorders
obsessive-compulsive disorder
phobias
post-traumatic stress disorder
Sexual and relationship problems

The emphasis on cognitive or behaviour aspects of therapy can vary depending on the issue. For example, the emphasis may be more towards cognitive therapy when treating depression, or the emphasis may be more towards behaviour therapy when treating obsessive compulsive disorder.
CBT is a practical therapy, which is likely to work best treating a specific issue as it focuses on particular problems and how to overcome them.
CBT sessions may consist of a number of activities, including: