Cognitive Behaviour Therapy - Process

Cognitive-behavioral therapy is an action-oriented form of psychosocial therapy that assumes that maladaptive, or faulty, thinking patterns cause maladaptive behavior...

Discuss the process of cognitive behaviour therapies.

Cognitive-behavioral therapy is an action-oriented form of psychosocial therapy that assumes that maladaptive, or faulty, thinking patterns cause maladaptive behavior and 'negative' emotions. The treatment focuses on changing an individual's thoughts (cognitive patterns) in order to change his or her behavior and emotional state.

The process of CBT is as follows:

  1. Rapport formation and Client engagement:  Build a relationship with the client by using the core human elements of empathy, warmth and respect. Look out for any negative impacters such as interview related anxiety. Thereafter, build confidence in them that change is possible using CBT. Knowing that CBT will help them will engage them into the treatment.
  2. Assessment: This step focuses on assessment of three things - the problem, the person, and the situation. Some of the most common areas that are assessed include
    1. Symptoms - Severity of the problem
    2. Predisposing factors - Client’s personal and social history, Relevant personality factors
    3. Precipitating factors - Non-psychological causative factors
    4. Triggers - Presence of any related clinical disorders
    5. Beliefs and assumptions - Client’s view of the problem
    6. Maintenance processes - Secondary disturbances
  3. Preparation: After the assessment, the client is prepared for the therapy. The preparation involves helping the client understand the treatment goals, assessing client’s motivation levels for therapy and increasing client’s knowledge about CBT. This is followed by discussing approaches to be used and the implications of treatment. Once the discussion has happened a contract is developed.
  4. Implementation: In this phase the treatment program that is found most suitable based on the above steps is implemented. The treatment program involves using activities such as Socratic questioning, identifying cognitive errors, experimentation, changing self-talk from negative to positive, homework tasks and thought recording/rational analysis. 
Supplementary strategies & techniques may include : relaxation training, interpersonal skills training, etc.
  1. Evaluation: After the implementation phase an evaluation is conducted to assess whether improvement is due to significant changes in the client’s thinking, or due to an improvement in their external circumstances.
  2. Termination: Finally, the client is prepared for the termination of therapy, so that if they slip back and discover their old problems are still present to some degree, they don’t despair and continue their self-help work. Clients should be warned about possibility of relapse and apprised of appropriate next steps. They should also be coached on seeking help again in case of relapse.

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In Cognitive Behavior Therapy the more the client knows about how the problem works and about the techniques to manage and overcome the problem, the more the client can become their own therapist. The CBT process is designed to help achieve this goal and involves the following steps: rapport formation and client engagement, assessment, preparation, implementation, evaluation, and termination.


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