Cognitive Behaviour Psychotherapy considers the way in which the individual’s pattern of thoughts, feelings and behavior contribute to depression and anxiety states.
In 1976 Aaron Beck published this triad model in ‘Cognitive Therapy and the Emotional Disorders’ in order to propose a method for changing the patterns of interactions and thus finding solutions in therapy.
Over time, through the 19th and 20th Centuries, therapists have developed this original model to incorporate numerous treatment methods including Mindfulness, Acceptance and Commitment Therapy (ACT), Compassion-Focused Therapy (CFT) and Body-focused Therapies.
The first stage in Cognitive Behavioural Psychotherapy is an Assessment which considers the ways in which the person’s beliefs and thinking (cognitions) impact on the way they feel, leading the person to behave in certain ways which become habits over time (behaviour). Any of the three components of thoughts, feelings and behaviour can drive the cycle.
Through the assessment meeting the therapist is gaining an understanding of the individual’s experiences and the patterns of their experience. At the end of the assessment the therapist and client discuss the Formulation, which is an understanding of the patterns of thoughts, feelings and behavior that the individual has developed over time and also whether these patterns may indicate a depression or anxiety state.
This looks at the ways in which people’s thoughts and beliefs (cognitions) can affect their mood and feelings and therefore their behaviour. Cognitions can be automatic thoughts [either positive or negative], assumptions or core beliefs. If our actions or feelings go against our values, beliefs or assumptions about life then the distress generated may lead to anxiety and/or depression.
In therapy the person is encouraged to examine the evidence for and against their beliefs about themselves and others, their negative automatic thoughts, catastrophic thinking and negative predictions. Acceptance and Commitment Therapy encourages people to accept their experience and commit to moving forward in a new direction that incorporates acceptance of things that cannot be changed.
People tend to repeat cycles of behaviour even if they know that they are not helpful. This may be because we all feel more comfortable with what/where/who we already know, especially when we feel anxious or low in mood and vulnerable.
Behaviour therapy is based upon the ABC model: Antecedents to behaviour, the Behaviour and the Consequences.
The model understands that Behaviour will be repeated if it is reinforced, that is rewarded in some way. CBP also looks at the way in which unhelpful behaviours may unwittingly bring rewards. Methods such as carrying out a cost-benefit analysis help the client to identify why unhelpful behaviours are repeated.
A young person’s capacity for complexity of thought develops with age, so research has demonstrated that behaviour therapy is more appropriate for children.
Our body and brain are one system. Feelings and emotions are experienced in our body although signs of discord, such as dizziness and headaches, are apparent in our head.
In therapy the client will be encouraged to notice their feeling responses to thoughts, to events, actions and to relationships. Therapy enables the person to listen to and appreciate their feelings and therefore themselves. The person is encouraged to notice and feel comfortable with all feelings. Our feelings are telling us something that we need to know, such as ‘I am enjoying this and should do this more’; ‘This person is making me feel uneasy’ or ‘I am feeling sad about this but that is ok’