Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. It is based on the theory that an individual’s emotions are directly linked to his/her thoughts. CBT helps individuals identify thoughts that may be distorted/inaccurate and/or unhelpful, particularly if those thoughts are increasing negative emotions. For example, the thought “I am going to fail this test,” will likely lead a student to feel increased anxiety prior to taking the test. CBT teaches individuals skills to change patterns of thinking or behavior that are contributing to their difficulties. As a result of changing thoughts and/or behavior, and feelings or emotions often change as well. If the student modifies his/her original thought to be “I have studied for the test and will do the best I can, and I can still pass the class even if I do not do well on the test,” the resulting anxiety is likely to drop. CBT works by teaching individuals to how to identify, analyze, and change their attitudes and their behavior by focusing on their thoughts, images, beliefs and attitudes, especially as related or contributing to emotional problems.
Exposure therapy is a type of cognitive-behavioral therapy that is often used to treat anxiety disorders (e.g., phobias, social anxiety, panic disorder, obsessive-compulsive disorder). In phobias, exposure therapy is used in conjunction with relaxation exercises and/or imagery. For OCD, a type of exposure called Exposure and Response Prevention is often employed. In this protocol, clients make a ranked list of activities that trigger obsessions and learn skills to systematically confront the items on the list without engaging in the desired compulsions. This helps clients learn to manage their anxiety without perpetuating the cycle among obsession and compulsions. Similar protocols are used for other types of anxiety. Common to all methods of exposure therapy, in conjunction with teaching clients how to bring about a relaxed state at-will, this technique gradually exposes them to what frightens them and helps them cope with and reduce their fears.
Cognitive Processing Therapy
Cognitive Processing Therapy (CPT) is another gold standard treatment for PTSD. It based on cognitive behavior therapy and the assumption that thoughts and emotions directly affect one another. CPT theorizes that an individual’s thoughts can change dramatically following exposure to trauma in a way that is unhelpful and perpetuates PTSD symptoms. For example, one might believe that the world is a relatively safe place where most people can be trusted to some degree prior to trauma exposure and shift to beliefs that the world is completely dangerous 100% of the time and absolutely no one can be trusted. These new beliefs contribute to maintenance of hypervigilance, detachment from others, and avoidance of trauma triggers seen in PTSD. CPT involves helping clients identify their beliefs that have shifted and are keeping them stuck with PTSD and it teaches them skills to evaluate and modify these beliefs to make them less extreme. CPT has significant research supporting its effectiveness at reducing PTSD symptoms.