Cognitive Behavioral Therapy states that in situations where emotional or behavioral difficulties are experienced, the relationship established between thought, emotion and behavior leads to some false beliefs and forces the individual to be conditioned in this direction. The individual may think that he/she is not loved, valued or is a failure due to these beliefs. Someone who thinks in this direction may feel more unpleasant emotions emotionally and may withdraw into himself/herself.
Cognitive Behavioral Therapy aims to show the person how this belief system is reflected in emotions and behaviors by recognizing the negative conditioning and the belief system that develops in relation to it. As the most basic principle in the therapy process, dysfunctional and unfavorable thoughts are replaced with alternative/realistic thoughts . It states that the change created at the level of thought will also positively affect emotions and thus the desired behavioral change will be observed. Various coping methods are taught to the individual through the methods used in the therapy process. In this way, the aim is to positively change unfavorable thought and behavior patterns.
Use of Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is the most commonly used type of psychotherapy today. It is an evidence-based practice that provides effective results in many disorders such as depression, anxiety disorder, phobias, and obsessive-compulsive disorder.
In Cognitive Behavioral Therapy, the psychologist/psychotherapist and the client work actively ; the client is not in a position where he/she is waiting for suggestions or receiving information about what to do. On the contrary, the details about the difficulty experienced are addressed by working as a team .
For example, when an individual who has difficulty speaking in a group, has difficulty adjusting the tone of his voice, or is shy about greeting people encounters such situations, certain thoughts cross his mind: “Nobody will hear me, I will not be able to speak again, I will be embarrassed if I say a word wrong, nobody will like my presentation, they are already very bored, nobody wants to be close friends with me, etc.” When these thoughts occur, the person may experience intense anxiety; this anxiety is often accompanied by physiological symptoms: dry mouth, sweating, rapid heartbeat, palpitations, rapid breathing, blushing, etc. When these symptoms and emotional state are combined with the above thoughts, the picture that emerges may be exactly as the person has in mind: Due to intense anxiety, he may rush, slip his tongue, get tangled up, or exhibit avoidance behavior in order not to experience these, may not want to do such a task (such as a presentation), and may stay away. Eventually, he may avoid entering social environments altogether and lock himself in the house. He may lose his functionality to a great extent.
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The above incident is an example of social phobia evaluated within an anxiety disorder. Cognitive Behavioral Therapy states that the trigger for the process is the way of thinking . The thoughts that pass through the individual’s mind affect their emotions and ultimately their behavior. One of the main goals of Cognitive Behavioral Therapy is to establish a connection between event-thought-emotion-behavior and replace dysfunctional thoughts with more realistic ones. It is thought that not only the change in thought but also in behavior will eliminate the symptoms that occur in the individual.
The aim of the therapy process is to make the person aware of the stereotyped thought patterns that disrupt their functionality. How these beliefs are formed and how they can be changed are discussed. Various exercises are performed to get rid of the faulty/dysfunctional way of thinking. In essence, what is taught to the person is the thinking pattern that they can use after the therapy process.
Various homework assignments are given to adapt what is learned during the therapy process to daily life. The aim is for the person to replace their old dysfunctional thinking and behavioral style with functional behavioral patterns. At the end of the therapy process, the person is expected to develop realistic beliefs about themselves and completely abandon the beliefs and behavioral patterns that make them unhappy.
How Long Does Cognitive Behavioral Therapy Last?
Cognitive Behavioral Therapy is a relatively short-term, solution-focused therapy. Factors such as the individual’s reason for application, the intensity of the symptoms, the type of psychopathology, the way it manifests itself, ongoing stress factors at that time, and the individual’s insight (awareness of the problem) change the duration of the treatment. For example, the duration of intervention for a mild anxiety disorder differs from the duration of intervention for a client with obsessive-compulsive symptoms.
Visible changes occur within an average of 8-16 sessions, and symptoms are significantly relieved or eliminated. What is important here is not the number of sessions of psychotherapy, but the well-being that the person reports and observes from the outside. Many clients tend to end the therapy process when the symptoms have subsided. However, ending therapy, like starting therapy, has more positive results when it is done with the mutual consent of both the psychologist and the client.
The main purpose of psychotherapy is to eliminate the symptoms as well as to help the person achieve permanent behavioral changes and to be able to recognize dysfunctional thought patterns related to their belief system. When the relevant symptoms reappear (depression or anxiety symptoms), the aim is for the person to recognize these symptoms and to re-adapt the skills they have gained during the therapy process to their life.
Medication Use During Cognitive Behavioral Therapy
The individual’s condition, level of awareness, severity of symptoms and the extent to which the person’s functionality in life is impaired are determined after a detailed clinical evaluation. In this context, medical treatment and Cognitive Behavioral Therapy can be used together for some clients. In this regard, it is very important to get the opinion of a mental health specialist (psychiatrist) and to follow the process regularly.
After a comprehensive evaluation, a personalized intervention plan is created and a decision is made whether or not medical treatment will be included in the therapy process. In some cases, therapy alone may be continued, or medical treatment may be used throughout therapy, depending on the severity of the symptoms.
