Cognitive Behaviour Therapy (CBT)
Our thoughts are incredibly powerful and are the driving force behind our behaviour. For example, if someone experiences a stressful event, such as receiving negative feedback at work, their thought patterns might lead to feelings of anxiety or depression. A person who thinks, "I'm terrible at my job, and everyone will think I'm incompetent," may experience heightened distress. On the other hand, someone with a more balanced perspective might think, "This feedback is an opportunity to improve," leading to more adaptive emotions and actions.
In other words, it is not external events (such as situations or people) that directly cause emotional distress, but rather our interpretations of those events. This is the basis of Cognitive Behaviour Therapy (CBT), a focused therapy that helps individuals manage their thoughts, feelings and behaviour to influence their quality of life. Through guided techniques, a CBT therapist supports individuals in addressing their symptoms, and challenging their automatic negative thoughts and beliefs.
What is Cognitive Behavioral Therapy (CBT)?
Unlike other therapies, which may delve deeply into past experiences or unconscious processes, CBT is centered on the present moment. It is a short-term, goal-oriented modality that focuses on helping individuals recognise how their thoughts influence their emotions and behaviors, and it offers practical strategies to address and change unhelpful patterns.
A fundamental concept in CBT is the identification of cognitive distortions—biased or irrational ways of thinking that contribute to emotional distress. These distortions often lead individuals to perceive situations in a distorted or unhelpful way. Common examples include:
All-or-nothing thinking: Viewing situations in black-and-white terms without acknowledging any gray areas (e.g., "If I don’t succeed perfectly, I’ve failed completely").
Catastrophising: Expecting the worst possible outcome, no matter how unlikely it is (e.g., "If I make a mistake at work, I’ll get fired").
Overgeneralisation: Making broad conclusions based on a single event (e.g., "I failed this exam, so I’ll never succeed at anything").
Personalisation: Taking responsibility for events outside your control (e.g., "My friend is upset, it must be my fault").
During the therapy, the individual is educated on identifying these negative thought patterns and behaviours, interrupting them and replacing them with positive thought patterns. At the same time, a CBT therapist also addresses the development of problem-solving skills, which can be especially helpful in managing stress. By approaching problems in a structured and systematic way, individuals can feel more in control and less overwhelmed. This might involve breaking down larger issues into smaller, manageable steps and brainstorming potential solutions.
Techniques Used in CBT
During the therapy the counsellor explores the origin of the negative thought to help the client rationalise the issue and change the impact it has on their life. The goal is not to eliminate all negative thoughts, but rather to evaluate them objectively and reduce their impact on emotions. It usually involves practical homework which follows specific techniques personally tailored to the individual. There are two dimensions to CBT
Part I: Awareness
Journaling: A journal is a tool used to track automatic thoughts and associated emotions. Clients are asked to write down specific thoughts related to a situation, rate their level of distress, and then work with the therapist to reframe those thoughts. This helps clients develop a more accurate understanding of their thought patterns.
Mindfulness: While traditional CBT focuses heavily on cognitive restructuring, newer approaches like Mindfulness-Based Cognitive Therapy (MBCT) combine mindfulness practices with CBT. Mindfulness teaches individuals to observe their thoughts and emotions in the present moment without judgment, which can be particularly helpful for managing rumination and anxiety.
Exposure Therapy: Exposure therapy, a technique commonly used for anxiety and phobias, involves gradually and systematically exposing the individual to feared situations in a controlled and safe environment. The goal is to reduce the emotional response associated with these situations over time. This is a step-by-step approach to confronting fears, starting with less anxiety-provoking situations and gradually working up to more challenging ones. For example, someone with a fear of public speaking might begin by talking in front of a small group of friends before progressing to larger audiences.
Behavioral Experiments: This technique refers to testing the validity of negative beliefs by conducting experiments in real life. For example, a person who believes "If I express my opinion, people will dislike me" might test this belief by voicing their opinion in a safe, low-risk situation and observing the outcome.
Activity Scheduling and Planning: CBT helps individuals engage in positive activities that can improve their mood and reduce negative thinking patterns. This might include setting up daily or weekly schedules with enjoyable or meaningful activities, such as exercise, socialising, or pursuing a hobby.
Part II: Problem Solving
Problem-solving is approached in a methodic, structural way, often broken down into a few small steps:
Defining the problem. This often involves answering a series of questions to ensure the problem is fully understood. In some cases, the client can define the problem clearly on their own, while in other cases, a discussion may be necessary to clarify the issue.
Brainstorming potential solutions. At this stage the individual’s creativity is encouraged, and it is key do this without judgment. It's vital to generate ideas freely at this stage, as people often dismiss possible solutions prematurely, either out of self-doubt or concern about their feasibility. Additionally, this judgment-free approach allows for a wider range of ideas. Sometimes “thinking outside the box” may ultimately prove useful.
Analysing the solutions. This step involves carefully evaluating the pros and cons of each solution. At this point, it's time to use an analytical approach to assess which solutions are most viable based on their advantages and disadvantages, while also considering their “cost”, e.g. what needs to be done to get there.
Taking action. The fourth step is for the client to select the most practical solution, one that seems most likely to succeed, and put it into action. But this step does not end here and assessing the outcome becomes necessary as well. If the chosen solution doesn't work, the process may need to return to the brainstorming or evaluation stages, until a better alternative is found.
How Effective is CBT?
One of the major strengths of CBT is its strong evidence base. Numerous studies have demonstrated that CBT can be highly effective for a range of mental health conditions, such as:
Depression
Insomnia
Relationship Problems
Substance abuse
Eating Disorders
Child Behavioural Issues
CBT is a practical, solution-oriented, and skill-building approach, which makes it a versatile and empowering form of therapy. Once the client has achieved their goals or made significant progress, the therapist will work with them to prepare for the end of treatment. The therapist may provide resources for continued self-help or suggest follow-up sessions if necessary.
Finding the right CBT therapist
Seek out a licensed and experienced therapist, social worker, counsellor, or other mental health professional who has received additional training in Cognitive Behaviour Therapy (CBT), often offered by relevant professional bodies in Australia. Equally important is finding a therapist with whom you feel at ease.
If you or your loved one is experiencing mental health distress and are ready to get support, contact our psychology clinic in Tweed Heads, where counselling is available for children, teens, adults, couples and families. Often the first step is the hardest, but Brain Care is here to support you through the rest of your journey.