Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that focuses on how individuals think about themselves, the world, other people, and how the individual’s actions will affect their thoughts and feelings. CBT was founded by Dr. Aaron Beck in the 1960’s. Trained in psychoanalysis, Dr. Beck was researching whether this method was beneficial in the treatment of depression. Through his research he discovered that analysis was not a suitable form of therapy in the treatment of depression, so he began to research alternative methods for treatment. He began to see that client’s thoughts about themselves had a direct relationship to their emotional state. Since Dr. Beck’s initial theory, CBT has been studied more than 500 times, showing its efficiency in treating various psychological problems.
Cognitive Behavioral Therapy is beneficial to almost all individuals that are seeking psychotherapy. CBT is an approved treatment modality by most insurance companies, because when practiced correctly, it can be a short-term evidence-approved modality. Individuals can quickly learn ways to identify their rational and irrational beliefs, and can learn to see how their beliefs are affecting their thoughts and behaviors. For instance, in the event that somebody you know passes you in the street without recognizing you, you can translate it a few ways. You may think they would prefer not to know you in light of the fact that nobody likes you (which may lead you to feel discouraged). Alternatively, you may believe they don’t stop to converse with you on the grounds that they assume you won’t know what to say and think you’re exhausting and dumb (tension). Finally, you may think they’re deliberately being nasty (prompting outrage). A healthier reaction is to think that they simply didn’t see you. Unlike other talk therapies, CBT focuses on the “here and now.” The treatment is not intended to diminish past experiences, but instead focus on what is affecting you today.
I have found CBT to be extremely helpful with two populations that I counsel. I specialize in dealing with clients who have some form of addiction (i.e., substances, gambling, sex, food, etc.) and males who are going through or have been through difficult martial/divorce/child custody cases.
In addressing addictions, we often talk about the need for people to stop their addiction and develop ways to avoid relapse. This is often easier said than done. If someone could stop and simply step away from destructive behaviors, wouldn’t they? When discussing relapse prevention, we talk about avoiding people, places and things. We talk about how you have to change your lifestyle and anything associated with your addiction. In the case of alcohol, it is everywhere, no matter where you live or work. Why is it that on some days liquor stores or bars don’t concern an alcoholic, but then suddenly, on another day, an alcoholic becomes weak and relapses?
CBT looks at the individual and what he or she is dealing with—or in many cases, not dealing with in the moment—rather than people, places and things. For the addict, it is important to avoid places that could lead to a relapse; however, it is more important to look at what they were thinking and feeling at the moment of their relapse. If CBT is used early in the treatment process of recovery, it can significantly aid in educating the addict to what is really behind the cravings and urges, which are the thoughts and feelings. Almost every addict will talk about not wanting to feel or think a certain way. CBT allows us to teach them that those thoughts and feelings are always within us; however, we don’t always have to react the same way by turning to the addiction. In this process, we aid the client in implementing the skills and tools needed to sustain long-term recovery.
Similarly, no matter what stage of the divorce process you are in, the common emotions that an individual will experience are guilt, grief, fear, anger, doubt and regret. All of these are very common and uncomfortable emotions for most people. As individuals go through divorce it is not uncommon to hear phrases about what the spouse is trying to do to the client: how parenting time is being taken away; how the spouse wants more money; how the court system is unfair; etc. The list goes on. The techniques of CBT can help an individual change their negative beliefs and focus on being more optimistic.
Clients can begin to experience a calmer and clearer view of their situation using CBT. In matters of divorce and child custody issues, people are often placed—due to their circumstances or the motives of another—into positions of vulnerability and extreme feelings of loss. When a person is taught the skills and techniques of CBT, they then can redirect their energy to themselves and what it is they are afraid of handling (typically an emotion). As clients begin to express how they are feeling and what thoughts are going through their heads, they can start to say to themselves: “I am ok. This is an unpleasant situation, but I am ok and will be ok when this is over.” They learn to talk about the emotions they are experiencing, and with the assistance of a therapist, they look at the reasons driving their feelings and learn to reframe thoughts and actions. The goal is for the individual to address situations appropriately.
There are many therapy modalities that are available to therapists who treat various mental health issues. Cognitive Behavioral Therapy can aid in breaking the debilitating cycles of negative thinking, feelings and behavior. When an individual can identify the cycle clearly, they can change the elements and then alter the way they are feeling. The goal of CBT is to establish a “muscle memory” of this process, therefore enabling the client to address future issues on his or her own.
Gerald Opthof, Psy.D, LPC, LCADC, is a member of the American Counseling Association, as well as a cognitive behavioral forensic psychotherapist who is licensed to practice in New Jersey. In his clinical experience, he has counseled individuals with addictive disorders such as alcohol, drugs, gambling, sexual, and computer addictions.