Cognitive behavioural therapy (CBT) is a structured and time-limited type of psychotherapy where clients and therapist work collaboratively to help gain control of their problematic behaviours and alleviate their distress so they can feel more hopeful and equipped to address future events.
Clients and therapists focus on the present, while at the same time identifying the starting place of the clients’ distress and symptoms. There is also a focus on how clients view themselves, the world, and the future, as well as learning emotional consequences to events are mostly created by the clients’ belief system and the emotional disturbances are caused by clients’ unfounded irrational beliefs. When clients identify such beliefs, they can learn to dispute them by challenging them rationally.
In CBT, clients learn cognitive techniques to identify and modify their negative thoughts and cognitive distortions. These techniques can include examining the evidence, reframing, relaxation techniques, graded task assignments, exposure, guided discovery, and generating alternatives. The clients learn various self-monitoring tools and complete homework between sessions to solidify the skills learned in sessions. Through CBT, clients learn to change how they think (cognition) and what they do (behavioural), and this has an impact on how they feel.
Clients can participate in CBT individually or in groups with a therapist, through self-help books, or on computer based programs. Therapy is not “done to” the clients and does not prove client wrong and therapist right. There are no unhelpful debates, but it is instead a skilfull collaboration between clients and therapist where clients discover healthy and adaptive alternatives.
CBT is probably most famous for its positive effect in the treatment of anxiety disorders, depressive disorders, substance abuse, and addictive behaviours. CBT is very popular because it is simple, effective, and can produce results in a relatively short time. It can be used as an alternative to medication, or as an addition to medication. CBT is client-centered in that the therapists provide clients with the tools they need to make effective change in their lives. The treatment can be adapted to clients’ unique problems. Clients with addiction problems have found CBT to help them cope with their difficulties.
Dialectical behavioural therapy is a psychotherapy method that combines elements of behaviour therapy, cognitive therapy, motivational interviewing, client-centered, gestalt, paradoxical, and strategic approaches with Eastern philosophy and mindfulness meditation practices.
According to DBT theory, there is an interaction between clients’ emotional vulnerability and their invalidating environment. Some of the underlying assumptions of DBT include that everything is connected to everything else and change is constant and inevitable. Others include that clients’ lives are unpleasant and potentially life threatening, clients are doing the best they can, they want to improve, need to do better, try harder, and be more motivated to change, and they have to solve the problems in their life even though they may not have caused them all. The therapists, clients and families need to work as a team to best serve the clients.
The main components of DBT are: weekly skills training group, weekly individual therapy, between-session coaching, and team consultation. In DBT, clients learn to identify the emotions, thoughts, sensations, behaviours, and urges linked to their problematic behaviours, all antecedents and precipitating factors. They learn adaptive solutions to the behavioural problems. With DBT, clients gain knowledge of how to identify what they can change and accept what cannot be changed, which is why clients with addiction problems can benefit from learning DBT skills.
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