Cognitive Behavioural Therapy (CBT)

Understanding Behaviourism Approach to Therapy

 

Understanding a little of the behaviourism field is important when trying to understand CBT. Behaviourism takes the view that a persons behaviour is in response to environmental stimuli.  The response can be objectively and scientifically measured by focusing on external factors and ignoring internal factors such as emotions and thoughts.

Any internal responses, such as thoughts are encouraged to be explained as behavioural issues or disregarded.

The chances of the behaviour reoccurring again can be influenced by positive and negative reinforcement or punishment. Behaviour is, therefore, an indication of learning taking place by the person.

 When learning a new behaviour, it is said to be achieved through classical or operant conditioning which is collectively known as 'learning theory'.

 

What is Cognitive Behaviour Therapy

 

1. Cbt is based on an ever-evolving formulation of the client and their problems in cognitive terms.

• Current thinking: continually evaluating how the client evolves during the program

• Problematic behaviours

• Precipitating factors: specific event or trigger to the onset of the current problem. 

• Developmental events

• Patterns of interpreting events

1. Cbt requires a good therapeutic relationship emphasising the core conditions. This is regarded as a relationship of equals between the client and therapist.

2. It emphasises collaboration and active participation working together to achieve a common goal in the therapeutic relationship.

3. Is goal-oriented and problem-focused aimed at changing behaviours and cognitive patterns to change the problem.

4. Initially it emphasises the present

5. Is usually time-limited but not exclusively

6. Is educational in its aim to teach the patient to be their own therapist and emphasises relapse prevention. This is achieved through worksheets and techniques.

7. Sessions are structured

8. Teaches clients to identify, evaluate and respond to dysfunctional thoughts and beliefs

9. Uses various techniques to change thinking mood and behaviour

 

How CBT works with a client to identify, challenge and change unhelpful thinking

 

CBT works with the client a collaborative to identify unhelpful patterns of thinking and behaviour. This may be achieved by bringing an awareness to the client who may only notice the negative things that maybe happen to them or around them while ignoring the positive things.  Or in identifying the unhelpful behaviours behind the symptoms.

Exercises are then used to support the client in challenging and changing these unhelpful thoughts and behaviours. This may involve focusing more on thoughts or sometimes focusing more on behaviours.

Assessment and case formulation

Cognitive-behavioural assessments follow basic principles with aims that are clearly defined. One of the main principles is the idea that an individuals behaviour is determined by situations and the client's interpretation. This would form the main focus of the assessment, emphasising the specific details of their presenting problem (or maintaining factors).

The main aim of the assessment is to formulate a preliminary case formulation which is then used to form the basis of their future treatment plan. This initial formulation is said to have an organic quality and will be tested during subsequent sessions or through homework assignments.