Depression / Anxiety / Panic disorder / Obsessive Compulsive Disorder / Phobia / Social Anxiety / Eating Disorder / ADHD etc.
Scientific Evidence and Benefits
Cognitive Behavior Therapy started with the depression studies of Dr. Aaron Beck in the early 1960s. Dr. Albert Ellis and behaviorists like Dr. Bandura further contributed to the development of cognitive behavior therapy.
It has been known as one of the most effective evidence-based treatments that has been applied to reduce anxiety, anger and stress through cognitive modification and skills training. It has a systematic structure with initial, middle and final treatment phases. The typical treatment takes about three to six months and 70% to 90% of treatment participants show improvement in their symptoms with low relapse rate.
At the beginning of the treatment, clinicians assist clients to analyze the biological, cognitive, psychological, and behavioral factors of each symptom, understand the scientific and theoretical background of cognitive behavior therapy, and learn how to record their symptomatic behaviors in an objective and scientific way. The clients will be able to identify their own cognitive processes and behaviors that aggravate the symptoms and create a strategy to modify their problematic issues effectively.
In the middle of the treatment, clinicians will look into clients’ emotions, behaviors, thoughts, and belief patterns and identify cognitive distortions they may have. Through this process they will recognize their symptomatic and negative behaviors and replace them with positive behaviors. The clients will learn various cognitive behavior skills to regulate their emotions relating to the symptoms. They will learn to solve prompting events that trigger symptoms and replace them with effective coping skills.
During the final phase of the treatment, clients will identify their remaining symptoms and its causality thoroughly and continue practicing various behavior skills, building effective coping strategies to prevent relapse.
Relentless pain and suffering,
Only you, only with your effort, can you get out of suffering
Changing your thoughts and behaviors;
they are the core principles of Cognitive Behavior Therapy
Cognitive Behavior Therapy for Depression Treatment
Cognitive Behavioral Therapy developed by Aaron Beck has been known to be one of the best treatments for depression. Its effectiveness is known to be equivalent to antidepressants and a combination of medication and CBT further lowers the relapse rate.
Clients will first learn skills to identify triggering factors of depression. They will learn about mood dependent and negative thinking patterns, depressed mood, self-isolating behaviors and how these components connect to each other. Clinicians will help the clients build systematic behavioral plans to change their life by applying problem–solving approaches. This will help clients to identify their thoughts and daily routines and help to deal with their symptoms more effectively.
Cognitive Behavior Therapy for Anxiety Treatment
Cognitive Behavior Therapy for Generalized Anxiety Disorder
Cognitive Behavior Therapy for treating general anxiety disorder was initially developed by the Center for Stress and Anxiety Disorders in Albany, New York and further developed by Dr. Barlow of the Center for Anxiety and Related Disorders at Boston University and Dr. Craske at University of California.
Based on the research 70% of clients who participated in this treatment program showed improvements in physical symptoms, worry thoughts, and finding pleasure in daily life and maintained treatment efficacy in the long-term.
The duration of the treatment program is 10-12 weeks. In the beginning phase of the treatment, clients are expected to understand the rationale of anxiety disorder as well as the functions of anxiety and learn how to record and observe their symptoms.
With progressive relaxation training, clients will manage their muscle pain, sleep disorder, reduced attention span, restlessness, and annoyance triggered by excessive worries and physical tension. It will also help the clients understand and change their cognitive pattern that leads to negative thinking.
Clinicians will then encourage clients to face their fear-related thoughts and situations through exposure. During the final phase of the treatment, clients will practice coping skills to deal with their daily stress and build strategies to prevent relapse.
Cognitive Behavior Therapy for Social Anxiety Disorder
Cognitive Behavior Therapy for treating social anxiety disorder was developed by Dr. Richard Heimberg in the early 1980s. The studies indicated that 75% of the CBT treatment participants showed significant improvement with social anxiety symptoms and the treatment efficacy has maintained after six months from the termination of the treatment. And a follow-up study of the effect of the treatment showed that the efficacy was maintained after five years from the termination. Further world-wide studies showed that 80% of participants in most countries reported a significant improvement in their clinical condition.
This CBT treatment, as a systematic treatment program, starts with identifying clients’ fear in a social situation and help them understand the rationale of their social anxiety by looking into the interrelationship between their behaviors and thoughts that persists the symptoms. The clients will then learn to analyze their symptoms and identify specific factors that contributed to the symptoms.
In the middle of the treatment, clients will learn how to restructure their cognition and practice systematic training to find problematic thoughts to understand and manage their social situation. This scientific approach provides the basis to challenge and change one’s behavior. Through this systematic approach, clients will be able to face their anxiety-provoking situation, which they have been avoiding, and overcome negative thoughts, beliefs, and difficult situations such as presentation, conversation, hand tremor etc. During the final phase of treatment, positive changes clients experience will be reinforced and strengthened, preventing the possibility of relapse.
Cognitive Behavior Therapy for Panic Disorder
Efficacy studies of Cognitive Behavior Therapy for treating panic disorder show that 70–90% of treatment participants no longer experience panic disorder. Approximately 60–80% of agoraphobia participants also show a significant improvement in their condition. Dr. Craske and Dr. Barlow implemented 2 years a 2-year follow-up study of panic disorder treatment in 1991 and the National Institute of Mental Health (NIMH) recommended Cognitive Behavior Therapy, medication treatment or a combination of the two treatments as the first line treatment of panic disorders.
At the beginning of treatment, clients will learn the symptoms of panic disorder, rational of the treatment, and how to record subjective distress of anxiety and phobia. Then, they will set the hierarchy of phobia triggering situations and learn breathing techniques and other coping skills.
In the middle phase of exposure–based treatment, clinicians help them expose to fear-inducing physical symptoms and situations with desensitization process. Although there are some individual differences, it is the most effective short-term treatment with minimal relapse rate.
Cognitive Behavior Therapy for Obsessive-Compulsive Disorder
Cognitive Behavior Therapy for treating obsessive-compulsive disorder was first introduced in 1970s and has been known as the most effective treatment. Medication is also effective for treating OCD by changing serotonin metabolism; however, it has some limitations such as the discontinuation of medication increases the rate of relapse.
To compensate for this relapse problem, CBT is the most preferred treatment that sustains its treatment effectiveness. Based on recent research, the effectiveness of CBT is comparable to medication treatment and is superior to medication in relapse prevention and sustaining treatment efficacy. And it has better treatment results if CBT and medication treatment are combined.
At the beginning of treatment clients will learn to understand the rationale of OCD symptoms, types of OCD and the severity of OCD. Clinicians will help modify the negatively formed thoughts with cognitive restructuring techniques. Then, clients will learn skills to experience the changes of their cognitions and behaviors systematically with the exposure and reaction prevention strategy and build strategies to utilize the learned behavioral skills for relapse prevention.
Cognitive Behavior Therapy for Phobia
Cognitive Behavior Therapy for treating Phobia is an evidence-based psychotherapy treatment that reduces phobic symptoms with systematic exposure techniques. It adopted the concepts of systematic desensitization of Dr. Joseph Wolpe. This treatment method is later developed to exposure therapy that facilitates clients to face fearful stimuli repetitively. It has proven its effectiveness; and a single intensive exposure therapy session can reduce the symptoms of specific phobia significantly.
The first step of this treatment is to help clients understand the causes and the process of experiencing phobia. Then clients will learn about the irrational thoughts related to the phobia and replace them with more rational and adaptive thoughts.
In the later part of treatment, clinicians help clients face phobia-inducing stimuli by understanding their avoidance behaviors. Recent studies show that the combination of this kind of behavioral approach and cognitive restructuring technique is very effective in treating phobia. Recently, virtual reality technology has been utilized in exposure therapy when exposure is difficult to apply in a real-life situation such as fear of height or flying the airplane.
Cognitive Behavior Therapy for Eating Disorder
Cognitive Behavior Therapy for eating disorders consists of about 20 sessions during a six–month period. In treatment, clients will first learn about appropriate and healthy eating behaviors. It is crucial for them to build healthy, balanced eating behaviors because repetitive dieting and purging make their central nervous system that regulate appetite and metabolism become unstable. It is likely that the central nervous system sends inaccurate signals to the clients’ bodies.
Fear of repetitive
Eating disorder treatment,
you should learn scientifically
what your body consumes
Combined treatment of emotion dysregulation
and eating issues could lead to resolve the
repetitive cycle of eating related suffering
Clients will identify the psychological and environmental factors that instigate eating disorders and investigate their problems objectively by studying the progression of eating disorders. Then they will learn their problematic eating patterns, start observing healthy balanced meals and measure their weight appropriately. Clinicians modify their problematic behaviors by applying cognitive behavior therapy model safely and effectively.
In the middle of treatment, clinicians will review clients’ achievements, strengthen healthy eating habits and let them challenge food that they are avoiding with exposure procedures. Clients will be challenged with their perspectives on weight, body shape and food restriction; learn problem solving skills to deal with negative emotions, bloating feelings, interpersonal problems that often trigger inappropriate eating behaviors.
The latter part of treatment focuses on reviewing the clients’ positive changes helping them solve problems for other eating disorder behaviors and making alternative plans to prevent relapses.
Eating disorder often covaries with other symptoms such as emotion regulation and impulse control issues. More specialized treatment such as Dialectical Behavior Therapy, DBT, can be recommended if those symptoms are prevalent during the CBT eating disorder treatment.
Cognitive Behavior Therapy for Adult ADHD treatment
Cognitive Behavior Therapy for ADHD was developed at Massachusetts General Hospital and Harvard University. Many researchers continue doing research to develop better CBT treatment. The studies show that ADHD can be benefited from medication; however, it does not fully treat ADHD symptoms. This initiated CBT research to analyze clients’ problematic behaviors and to develop relevant strategies to reduce the symptoms. Recent studies with ADHD clients show that the combination of CBT and medication treatment is more effective than the medication only treatment.
During the initial phase of treatment, clients will learn biological, cognitive, and behavioral factors of ADHD symptoms. Clinicians help them understand their problems objectively. Various behavioral skills and strategies to reduce attention and hyperactivity will be introduced such as organizing and planning skills at work or activity settings. Then the clinicians help the clients form adaptive thinking to apply behavioral skills and reduce procrastination and avoiding behaviors.