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Cognitive Behavioral Therapy: CBT Techniques for Anxiety & Depression

Cognitive Behavioral Therapy Techniques

CBT techniques, or ‘cognitive behavioral therapy techniques’, refer to the various methods used to redirect or change human behavior. Two of the conditions cognitive therapists often treat are anxiety and depression. The ultimate goal of the cognitive therapist is to destroy bad thoughts and replace them with good thoughts, affirming thoughts – because what a person thinks is believed to determine how a person acts.

Cognitive behavioral therapy (CBT) entered medical history because of Dr. Aaron Beck at the University of Pennsylvania, who discovered it in depression treatments. CBT treatment has since extended to anxiety.


In addition to depression or anxiety disorders, the following issues are treated by cognitive behavioral therapy:
  • bipolar disorder
  • borderline personality disorder
  • eating disorders
  • obsessive compulsive disorder (OCD)
  • panic disorder
  • phobias
  • post-traumatic stress disorder (PTSD)
  • psychosis
  • schizophrenia
  • Sleep Problems and Sleep Disorders
  • problems related to alcohol misuse
  • (sometimes) long-term health conditions, such as irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), fibromyalgia

CBT Worksheets

CBT worksheets are what cognitive therapists use to assess their patients’ experiences. The worksheets ask questions such as “What do I do when I feel anxious?” or “What negative thoughts occur in my head most?”

For young children who battle bipolar disorder, the cognitive worksheets are used to help bipolar children express an experience they had, their thoughts at the time the event took place, as well as how the child interpreted the event. The goal of the worksheet is to help the child see that, when certain things take place, he or she thinks certain thoughts. If the child can see the connection between events and thoughts in worksheets, then maybe they can realize the problem and turn their thoughts in a different direction the next time the same event happens. Cognitive therapists give children a diary that accompanies the cognitive worksheets.

CBT Techniques for Anxiety

What are the best cognitive behavioral therapy techniques for using anxiety?

Cognitive Restructuring And Exposure Therapy

The best CBT techniques for anxiety are cognitive restructuring and exposure therapy.

Cognitive restructuring is self-explanatory: the cognitive therapist uses this technique to ground the patient’s thoughts in something that corresponds to reality.

A patient may walk into a cognitive therapist’s office, worried about a big speech or presentation he or she has to give in a week or so. He or she may feel worried about how the presentation will go, or have sweaty palms and overwhelming fear of the event’s outcome. The cognitive therapist will enact the scene with his patient, trying to help the patient place himself or herself in the actual event – though it is still a future event. The goal is to get the patient in a position to see his reaction, discuss why he has the reaction he does, and discuss times in which the exact opposite happened.

In the case of the business employee, the cognitive therapist will try to help the patient recall times in which he or she expressed confidence in speeches and presentations. The goal of such discussion is to help the patient see that to presume he or she will fail in their presentation is a false assumption – and why assume the worst when things could go well? Placing the patient in times of success can help to reduce the sweaty palms, stammered voice, and frightened appearance in public – all symptomatic of cognitive distortions.

The next cognitive behavioral therapy technique for anxiety is exposure therapy. The term ‘exposure’ therapy is self-evident: this therapy ‘exposes’ the patient to face fear head-on.

For example, if a patient has a fear of heights, the cognitive therapist may take the patient to the top of the therapy clinic and walk him near the edge of the building. The therapist may do this repeatedly until the individual can walk on the top of the building without clamming up, getting sweaty palms, and panicking so quickly.

If the patient has a fear of snakes, the therapist may take the patient to a snake owner’s estate and allow him or her to walk around and see the various snakes in aquariums or cages – to convince the individual that there is no reason to fear snakes. The cognitive therapist will do this until the patient no longer fears snakes as much.

CBT Techniques for Depression

There are two CBT techniques for depression  (1) rational emotive behavioral therapy and (2) dialectical behavior therapy.

Rational Emotive Behavioral Therapy

Rational emotive behavioral therapy is a cognitive method whereby patients are taught to think and place their emotions in check.

A good example of this strategy on display is a patient who has been seeing his therapist about his hurt and grief over his girlfriend ending their relationship. For the last two years, the man has been licking his wounds, hurting over her, unable to date or see someone else. After two years, he still visits his therapist about the situation. How does the cognitive therapist respond?

He begins to talk about how the patient’s old girlfriend has moved on with her life – while he sits on the sidelines and will not even date. The therapist does this to help jolt the patient and remind him that, while he pines away for his former girlfriend, he is missing a valuable opportunity to date and eventually meet that special someone that he will marry. In one meeting, the patient finally gets what his therapist has been saying – and the goal of rational emotive behavioral therapy has been achieved.

Dialectic Behavioral Therapy (DBT)

Dialectic behavioral therapy (DBT) is a therapy system that treats people with borderline personality disorder (BPD). While dialectical therapy involves cognitive behavioral techniques, it also includes some elements of Buddhist meditation, one of which is mind awareness.

DBT was first discovered by Marsha M. Linehan, a researcher in psychology at the University of Washington. Linehan found that dialectics were a positive form of dialogue exchange between therapist and patient. She learned, through discussions with her patients (who seemed to have personality disorders or something close to them), that she could help patients by showing them moments in which their judgments accurately reflected reality.

In each session, Marsha would show patients that some of their views rightly reflected reality, while others were distorted or twisted. Through an affirmation of ‘stay and change’ with her clients, she was able to reach many who were on the verge of losing themselves – and helped bring them back to reality (with their co-operation and self-determination).


Conclusion

When someone is undergoing CBT techniques, the goal of the cognitive therapist is to move the patient into a more positive direction. CBT techniques are used for the sole purpose of helping redirect the thought processes of scared, frightened, or mentally disoriented individuals whose view of reality differs from reality’s true form. Patients often go to therapists believing that the cure is in the mind of the therapist; surprisingly, therapists are showing patients that the cure is within. With a little encouragement, patients have all they need to face their reality – as it is.

 

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