Cognitive-behavioral therapy (CBT), developed by Aaron Beck in the 1960s, is a type of psychosocial intervention—meaning that it primarily consists of “activities, techniques, and strategies that target a combination of biological, behavioral, cognitive, social, and environmental factors with the aim of developing personal coping strategies that will help to solve current problems and change unhealthy patterns of behavior and emotional regulation” (England, 2015). It is based on the belief that maladaptive thought patterns and behaviors contribute to the development and maintenance of psychological disorders, and as such, symptoms and related distress can be reduced by learning new patterns and behaviors (Field, Benson, & Jones, 2015). While it was originally used to treat depression, CBT is now commonly used to treat a range of problems such as anxiety, post-traumatic stress disorder (PTSD), eating disorders, phobias, and substance abuse. Modern forms of CBT include exposure therapy, commonly used for phobias; cognitive emotional behavioral therapy (CEBT), used for a range of problems and aims to improve understanding and tolerance of emotion; and the more recent mindfulness-based therapy. In cognitive-behavioral therapy, the role of the therapist is to “assist the client in finding and practicing effective techniques and strategies to meet identified goals and decrease symptoms of their disorder” (“Cognitive Behavioral Therapy”, 2010). Unlike other forms of therapy, cognitive-behavioral therapy is incredibly action- and goal-oriented for both the therapist and client and relies heavily on a therapeutic alliance between the two.
While cognitive-behavioral therapy requires initiative and participation from both parties, CBT therapists help clients to “identify their strengths and use them to teach clients “how” to do, as opposed to telling them “what” to do” (“Cognitive Behavioral Therapy”, 2010). In the treatment of most disorders, common treatment interventions in CBT include “setting realistic goals and learning how to solve problems; learning how to manage stress and anxiety; identifying situations that are often avoided and gradually approaching them (exposure therapy); identifying and challenging negative thoughts; identifying and engaging in enjoyable activities; and keeping track of feelings, thoughts, and behaviors to become aware of symptoms and make it easier to change negative patterns” (Patterson, 2009). In addressing specific problems such as substance abuse, common interventions may include “exploring the consequences of continued substance abuse, self-monitoring for cravings, identifying high-risk situations for substance abuse, and developing strategies to cope with and avoid high-risk situations and the desire to use” (Patterson, 2009). After completing the Theoretical Evaluation Self Test and scoring highest in the subcategories of cognitive and ecosystems, I began to research cognitive-behavioral theory and greatly identified with this approach. However, while I do believe that maladaptive patterns of thinking and behavior contribute to the development and maintenance of psychological disorders and that learning new patterns can lead to a better quality of life, I also strongly agree with the fundamentals of the psychodynamic approach to therapy. Through personal experience and observation, I have learned that many maladaptive patterns of behavior and thinking are developed and acquired through defense mechanisms used during childhood and/or other past traumatic experiences.
For this reason, in my own future practice, I hope to implement a balance of techniques from both the psychodynamic and cognitive-behavioral approaches to allow for the possibility of clients to learn to change maladaptive patterns in addition to understanding where those patterns were acquired.