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At the end of last year, I started to see a cognitive behavioral therapist. My executive function, the set of mental processes that help order the day-to-day like organization, working memory, time management and focus was in shambles. In my intake interview, the therapist asked when I noticed that my focus had gotten worse, and I said that I’d been diagnosed with ADD when I was in my mid-40s, but added that I was also possibly in menopause.My ex-husband and co-parent had recently died, and I was now the single mother of a grieving teen.……Continue reading….
By: Andi Zeisler
Source: Salon
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Critics:
Cognitive behavioral therapy (CBT) is a form of psychotherapy that combines basic principles from cognitive psychology and behaviorism.[1] It aims to reduce symptoms of various mental health conditions by challenging and adjusting convictions and assumptions, while helping patients learn better-adapted behavior by trying and training new behaviours. While CBT has philosophical precursors in Stoicism, it developed in three waves in the 20th century.
Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Among psychotherapeutic approaches for major depressive disorder, cognitive behavioral therapy and interpersonal psychotherapy are recommended by clinical practice guidelines including The American Psychiatric Association Practice (APA) Guidelines (April 2000), and the APA endorsed Veteran Affairs clinical practice guideline.
CBT has been shown to be effective in the treatment of adults with anxiety disorders.[147] There is also evidence that using CBT to treat children and adolescents with anxiety disorders was probably more effective (in the short term) than wait list or no treatment and more effective than attention control treatment approaches. Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression.
A 2013 meta-analysis suggested that CBT, interpersonal therapy, and problem-solving therapy outperformed psychodynamic psychotherapy and behavioral activation in the treatment of depression. According to a 2004 review by INSERM of three methods, cognitive behavioral therapy was either proven or presumed to be an effective therapy on several mental disorders. This included depression, panic disorder, post-traumatic stress, and other anxiety disorders.
The first wave consisted of the development of behaviorism in the 1920s and behavioral therapy in the 1950s and 1960s. The second wave focused on the importance of cognitions in the therapeutic process, resulting in the development of cognitive therapy by psychoanalyst Aaron Beck in the 1950s and the establishment of classical CBT, when cognitive and behavioral approaches were combined.
The third wave took place in the 1980s and 1990s, when principles originating from Buddhism, especially mindfulness and acceptance, significantly contributed to the development of various new forms of CBT. Over time, cognitive behavior therapy became an umbrella term for all cognitive-based psychotherapies. CBT is a “problem-focused” and “action-oriented” form of therapy. The therapist’s role is to assist the client in finding and practicing effective cognitive and behavioral strategies to address identified obstacles and alleviate symptoms of the disorder.
CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of many psychological disorders. CBT focuses on challenging and changing these cognitive distortions (thoughts, beliefs, and attitudes) and their associated behaviors to improve emotional regulation and help the individual develop coping strategies to address problems. CBT includes a number of cognitive and behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
These therapies include, but are not limited to, rational emotive behavior therapy (REBT), cognitive therapy, metacognitive therapy, metacognitive training, reality therapy/choice theory, cognitive processing therapy, eye movement desensitization and reprocessing (EMDR), and multimodal therapy. New forms of CBT specifically influenced by mindfulness approaches include dialectical behavior therapy, mindfulness-based cognitive therapy, acceptance and commitment therapy, and compassion-focused therapy.
Though originally designed to treat depression, CBT is often prescribed as an evidence-informed treatment for many mental health and medical conditions. These include obsessive–compulsive disorder generalized anxiety disorder, substance use disorders, marital problems, attention deficit hyperactivity disorder, and eating disorders. Along with interpersonal psychotherapy (IPT), CBT is recommended in treatment guidelines as a psychosocial treatment of choice.
It is recommended by the American Psychiatric Association, the American Psychological Association, and the British National Health Service. CBT is also recommended as the first line of treatment for the majority of psychological disorders in children and adolescents, including aggression and conduct disorder. Criticism of the therapy has focused on its lack of double-blind tested research, relatively high drop-out rates, and tendency to target symptoms rather than the underlying condition.
CBT may be delivered in conjunction with a variety of diverse but related techniques such as exposure therapy, stress inoculation, cognitive processing therapy, cognitive therapy, metacognitive therapy, metacognitive training, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy. Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.
CBT is used to help people of all ages, but the therapy should be adjusted based on the age of the patient with whom the therapist is dealing. Older individuals in particular have certain characteristics that need to be acknowledged and the therapy altered to account for these differences thanks to age. Of the small number of studies examining CBT for the management of depression in older people, there is currently no strong support.
A typical CBT program would consist of face-to-face sessions between patient and therapist, made up of 6–18 sessions of around an hour each with a gap of 1–3 weeks between sessions. This initial program might be followed by some booster sessions, for instance after one month and three months. CBT has also been found to be effective if patient and therapist type in real time to each other over computer links.
Cognitive-behavioral therapy is most closely allied with the scientist–practitioner model in which clinical practice and research are informed by a scientific perspective, clear operationalization of the problem, and an emphasis on measurement, including measuring changes in cognition and behavior and the attainment of goals.
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