Cognitive-Behavioural Therapy (CBT)
Extensive clinical research dating back to the 1960’s has found strong evidence supporting the effectiveness of Cognitive Behavioural Therapy (CBT) in treating a wide range of mental health issues including mood disorders such as depression and anxiety. As CBT became the mainstream psychological treatment of choice throughout the 1980’s and 1990’s, another psychological treatment emerged in the form of mindfulness and mindfulness-based interventions. Similar to CBT, strong support has been found for the effectiveness of mindfulness as a treatment approach for mental health issues. Today, both cognitive-behavioural and mindfulness-based approaches are utilised to treat a whole spectrum of mental health conditions including depression, anxiety, bipolar disorder, adjustment difficulties, anger management issues, addiction, eating disorders, and issues around trauma and personality. Some psychologists employ either CBT or mindfulness – whilst others combine the approaches. In treating depression and anxiety, Dr Coleiro works flexibly within these approaches – bringing in the components of each perspective in response to the needs of individual clients.
The main components of CBT are spelled out in its name:
Cognitive = Thoughts. CBT seeks to change or restructure the way we think
Behavioural = Behaviours or actions. CBT seeks to change our behaviour.
Therapy = Thoughts and behaviours are explored and targeted. This is part of a therapeutic relationship with a therapist such as a psychologist or other allied health clinician.
The client and therapist work together to set up a series of treatment goals aiming to reduce symptoms of depression and anxiety whilst enhancing quality of life and well-being. Working towards these goals involves using therapy sessions to explore how behaviours and thoughts impact on mood. Homework tasks are set for the client to complete in between sessions – these tasks are important for the treatment to be effective.
In a CBT framework, the client is encouraged to change behaviours in order to improve mood and well-being. For example, clients might be encouraged to improve self-care, increase social support, or expand pleasurable activities. In addition, clients are supported to change or restructure patterns of thinking by challenging their thoughts in a process called cognitive restructuring. Skills are taught for identifying thoughts and changing thinking patterns. This process is depicted visually in Figure 1 below. In cognitive restructuring, rigid and negative thoughts are restructured into alternative ways of thinking. Often the restructured thoughts are more flexible, realistic, and accurate – and these thoughts lead to improvements in depression and anxiety.
Recent trends in psychotherapy have seen a shift towards more developed forms of CBT such as Schema Therapy. Schema therapy involves identifying and managing deeply held core beliefs that can lead to emotional dysreguation and unhelpful behaviours.
For more information about CBT or schema therapy please contact Dr Chris Coleiro.