What Makes Cognitive Therapy Different

For any therapy to be effective, the client must have a good relationship with the therapist. They will want to feel they are working with someone who is non-judgmental, compassionate, and effective. There also must be certain boundaries in place, such as ensuring that the relationship is focused on the client. The client must feel like they are able to fully be themselves and talk about the most difficult parts of their lives. But there are some features that are unique to Cognitive Behavioral Therapy (CBT).  

One difference is that a CBT therapist aims to be very collaborative with the client. The client is an active participant in the therapy process. In addition, CBT sessions are structured in a way that makes them more efficient. The CBT model aims for a shorter therapeutic process than other types of therapy. A key goal is for the client to learn to become their own therapist. The model removes the power dynamic of the therapist as an expert and the client as a passive recipient. Instead, the ideal is the two to function as partners in facilitating change. Clients report that they like the structure, shared decision making and inclusion in the process.

Another way that CBT can be different is that there are clear, collaboratively created goals. The client and therapist set an agreed upon agenda for each session. Sessions build on what was learned from previous sessions in order to work on larger problems and patterns. Another unusual feature of Cognitive Therapy is that the client and therapist work together to formulate specific plans for the client to practice their new skills between sessions.

Cognitive Behavioral Therapy is based on the idea that how you think influences how you feel and what you ultimately do. The model differs from the premise in other therapeutic techniques. It has ample research behind it and is effective with a range of problems including anxiety, depression, OCD, relationships, and eating disorders. It is a more pragmatic approach than other therapies. In CBT, the concern is not just what happens to the client but the meaning that they make of that event.  For example:, if a client were to lose their job, the therapist would then help the client find the most effective mindset to approach finding a new job. In addition, a CBT therapist would work with them to address long-standing negative beliefs that are activated as a result of the job loss. 

A last difference is that in CBT there is a primary focus on the present. It is not that CBT ignores the past. It instead looks at how the past informs the present through the client’s thoughts, feelings, and behaviors. It asks how past events created a belief system for the client and helps the client evaluate how those beliefs are working for them in the present.

Overall, CBT will help the client to understand  thought patterns that are limiting them.  It helps them to understand that the way they see themselves may not be how others see them. It can also help clients to figure out when to take other people’s actions less personally. Cognitive Behavioral Therapy can make problems seem smaller and help clients to gain a more balanced perspective.

Cognitive Behavioral Therapy leads to measurable changes in participants’ brains. People who go through CBT often have a reduced threat response in an area of the brain called the amygdala. That enables them to be less reactive in certain situations and respond more thoughtfully.

There are a few problems and situations that are not served best by cognitive therapy, including certain types of diagnosed personality disorders and some severe developmental delays.

There are criticisms of CBT. Some critics argue that CBT is a “cookbook therapy” or that manualized therapy reduces the human component of therapy. Others are concerned that CBT does not attend enough to people’s emotional lives. However, a skilled therapist will take care to use this set of techniques in a way that is tailored to the individual client and be sure to attend to their emotions.

Clients will know CBT is working when they think, feel, and act differently in challenging situations. Their thoughts may not be as immediately negative, worried, or hopeless. Their emotional reactions may be less intense, less frequent, or last for a shorter period of time. Lastly there are usually changes to behavior. Clients may begin to participate in activities or take on tasks that they previously avoided.