Cognitive Behavior Therapy examines how the patients’ feelings affect their behavior. Therapist will examine what the patients stressors are and what feeling they experience; depression, anxiety, anger, or fear. Cognitive Therapy has been proven to be extremely effect with the treatment of depression and anxiety. This type of therapy is relatively short in duration. The typical number of sessions are about 14 sessions unless the stressors are extreme and complex that last about 45-90 minutes. The reason this type of therapy is short, is because the therapist focuses on educating the patient and making use of homework assignments. They help the patient understand that their thoughts that lead to irrational reactions or emotions (Leahy, 1996).
There are 10 principles of Cognitive Therapy; 1) Cognitive Therapy is based on an ever-evolving formation of patients’ problems, 2) Cognitive Therapy requires a sounds therapeutic alliance, 3) Cognitive Therapy emphasizes active participation, 4) Cognitive Therapy is goal oriented and problem focused, 5) Cognitive Therapy initially emphasizes the present, 6) Cognitive Therapy is educative to the patient, 7) Cognitive Therapy aims to be time limited, 8) Cognitive Therapy is structured, 9) Cognitive Therapy teaches patients to identify and evaluate their dysfunctional thoughts, and 10) Cognitive Therapy uses a variety of techniques to change thinking and behavior (Beck, 2011). This paper will discuss 2 of these principles; principle # 4 Cognitive Therapy is goal oriented and principle #9 Cognitive sessions are structured, these two principles go hand and hand with each other. During the structured sessions, goals are revealed and focused on. Goals are important for people to have because they allow the patient to actually “see” the therapy working and help prevent relapse. Another advantage of using Cognitive Behavior Therapy is the use of structured sessions by having the sessions stay on topic, getting to the root of the cause of the problem and also emphasizes relapse prevention (Beck, 2006).
Cognitive Behavior Therapy consist of very structured therapy sessions. Before the session starts, the therapist will perform an evaluation of the patient with a diagnostic interview. This is important for the therapist to understand what a typical day is for the potential patient. The 1st session consist of building an initial positive rapport and educating the patient about Cognitive Therapy. Educating the patient about Cognitive Therapy is performed by socializing the patient to treatment, explaining the cognitive model, and setting specific goals. This session is know as the “assessment period”, patients may meet alone or with a spouse or caregiver. It is also important for the patient to describe to the therapist that their expectations are for therapy (Wexbrook, 2011).
During each session, the therapist will perform a mood check with the patient that looks at what the patient’s current symptoms are and if any have improved since the previous session. If the patient is on any medication, the therapist will ask if there has been any side effects or significant changes that the patient has noticed. Next, the agenda is set. The therapist will ask what the patient’s current problems are. They will also talk to the patient to see if they see any other pressing problems that the patient is not aware of. This is then followed by prioritizing the agenda. This keeps each session stay on track of the problems at hand. The issue is examined and discussed in detail, making sure the patient is aware of what thoughts are evoked when the patient describes the stressor and if those thoughts are irrational. After this, homework is assigned. Homework will reassure the patient of the Cognitive Therapy process and help to prevent relapses. At the end of the session, the therapist will summarize the session and ask for feedback. This is crucial for the patient to hear what happened in the session and make sure that nothing was left out. By asking for feedback, the patient will feel like they have control over their session and the agenda (Wexbrook, 2011).
During the next 8-10 sessions, knows as the treatment period, the therapist and patient will work on specific problems and solutions/goals. There are 3 different effective types of strategies that are used during these sessions; cognitive, behavioral, and physical strategies. Cognitive strategies are used to help the patient learn to notice their own thoughts and to understand that their feeling will impact their behavior. It is important for patients to identify irrational thoughts and emotions so they can see the clearer picture. Behavioral strategies help the patients to learn to solve problems, make decisions, confront situations, and work toward goals. Patients need to be able to set goals in order to make a strategic plan on accomplishing them. Physical strategies are used to counteract unpleasant physical symptoms associated with their emotions. These strategies include breathing exercises and meditation (Wexbrook, 2011).
Also in these sessions the client could have individual, group, family, couples, and or parent therapy. Individual therapy will help patients to identify their goals, reduce their problematic symptoms, learn various strategies, and monitor their treatment. Group therapy is where a selected group of patients that share similar problems will meet with a specific therapist. This type of therapy will help patients learn to cope with their emotions, communication skills, and social connections. Family therapy examines the relationship among the patient and their immediate family. This type of therapy will focus on increasing family communication and assisting the various family members with the patients problems. Parent therapy focuses on helping the parents or caregivers with behavior issues of the patient. This type of therapy will help parents goal setting and decreasing the frequency of the problematic behavior. Couples therapy assist partners resolve conflicts within their own relationship. This therapy will help couples identify problematic behaviors and set resolution goals. Each type of therapy all similar structured sessions and goals (Williams, 2007).
The final phase is the maintenance phase. This phase is known as relapse prevention. The patient and the therapist have agreed that their goals have been met and the sessions will gradually taper off. The patient has learned of their emotions and how they affect their behavior; they have identified stressors; and they have developed long term goals to deal with these particular stressors. Many times, therapist will suggest having a refresher session to prevent relapse (Williams, 2007).
In conclusion, there are 10 principles of Cognitive Therapy. This paper discussed 2 of those principles; Cognitive Therapy is goal oriented and there sessions are structured. The paper discussed a typical session length and what is expected in each session as well as various types of strategies and therapy types. Cognitive Therapy has been shown to be very effective with the treatment of depression and anxiety. The sessions are relatively short in duration, if the problem is more complicated, the therapy will need more sessions. Goals are identified in this type of therapy through the assignment of “homework”. Homework is an assignment that the therapist will give the patient(s) to complete prior to the next session. By completing and reviewing the homework, patients are being more educated in the therapy process and seeing their goals workout on paper. The structured sessions are what really make this type of therapy unique. The sessions are structured so that the patient feels in control of their session, they are educated about cognitive therapy, goals are given, the agenda is met, and feedback is given. Overall, each principle demonstrates the effectiveness of Cognitive Behavior Therapy.
References
Beck, J.S. (2006, 01 05). Interview by Norman Sussman, MD [Interview]. In session with Judith S. Beck, PhD: Cognitive-Behavioral Therapy. Primary Psychiatry, Philadelphia. (Beck, 2006)
Beck, J. S. (2011). Cognitive Behavior Therapy:Basics and Beyond. (2nd ed). New York and London: The Gulford Press. (Beck, 2011)
Leahy, L. Cognitive Therapy: Basic Principles and Applications. Jason Aronson Publishing Co., 1996. (Leahy, 1996)
Wexbrook, D.E. (2011). An introduction to cognitive behavior therapy: skills and applications (2nd ed). Los Angeles: SAGE.
Williams, M. (2007). Peaceful Mind: Using mindfulness and cognitive behavioral psychology to overcome depression. New Harbinger. (Williams, 2007)
