CBT Cognitive Behavioral Therapy: Techniques, Triangle for Anxiety and Insomnia

Cognitive behavioral therapy (CBT) is a type of psychotherapy aimed at changing cognitive and behavioral patterns for people with depression, anxiety, drug and alcohol disorders, eating disorders, marital problems, and other mental illnesses. 

Typically, CBT takes a problem-solving, goal-oriented approach to help people identify challenges, find solutions, and reach their desired end goal. In addition, CBT aims to identify, understand, and change unhealthy thoughts, behavior, and patterns. 

While CBT is empirically supported, some criticisms of traditional CBT mention that it requires an enormous amount of work from the patient. This is because problem-solving strategies only work if the patient actively implements the techniques daily.

Traditional CBT also identifies negative thoughts and patterns as the problem, which many criticize since the treatment fails to provide room to accept them.

For specific mental health disorders, like phobias and generalized anxiety disorder, research by Ruhmland M. and J. Margraf found that cognitive behavioral therapy cbt techniques were highly efficient in treating generalized anxiety disorder. 

Moreover, a meta-analysis by Kim K, Uchiyama M, and Okawa M showed the effectiveness and prevention of relapse in treating insomnia with CBT. 

What Are The Types Of Cognitive Behavioral Therapy?

Here are four common types of CBT.

What Are The Types Of Cognitive Behavioral Therapy
What Are the Types of Cognitive Behavioral Therapy?
  1. Cognitive Therapy (CT): Cognitive Therapy (CT) is the first variation of CBT, invented by psychiatrist Aaron Beck, relating to changing an individual’s dysfunctional cognitive thinking.
  2. Acceptance and Commitment Therapy (ACT): Acceptance and Commitment Therapy (ACT) encourages people to accept their dysfunctional thinking and feelings instead of CBT to modify and eliminate unhealthy thoughts and patterns. 
  3. Dialectical Behavior Therapy (DBT): Dialectical Behavior Therapy (DBT) is unique to traditional CBT but similar to ACT’s philosophy of balancing acceptance and changing dysfunctional thinking and behavior. However, DBT uses mindfulness techniques to help individuals focus on the present. 
  4. Trauma-focused cognitive behavioral therapy (TF-CBT): Trauma-focused cognitive behavioral therapy (TF-CBT) incorporates family-focused, gentle techniques for children and adolescents affected by trauma. TF-CBT helps improve children’s emotional problems that stem from traumatic events.

What Are The Principles of CBT?

According to the American Psychological Association (APA), here are the three principles of cognitive-behavioral therapy (CBT).

  1. Part of psychological disorders are caused by unsound or unhelpful thinking
  2. Part of psychological disorders are caused by habitual patterns or unhelpful behavior
  3. Relieve symptoms of psychological disorder through effective problem-solving processes to promote a better quality of life

What Are The Benefits Of CBT?

These are the benefits of CBT, according to the APA.

What Are The Benefits Of CBT
What Are the Benefits of CBT?
  1. Helps patients recognize unhealthy thinking and reevaluate based on rational evidence
  2. Less illogical thinking by perceiving themselves, the world, and other people rationally
  3. Develop problem-solving skills to eliminate or modify identified problems
  4. Gain more confidence in their potential 

How To Use Cognitive Behavioral Therapy For Anxiety?

Cognitive-behavioral therapy is the favored choice in treating generalized anxiety. Unlike severe anxiety, generalized anxiety includes these symptoms occurring for at least six months.

  1. unmanageable worrying
  2. restlessness
  3. fatigue 
  4. difficulty concentrating 
  5. irritability 
  6. muscle tension
  7. sleep disturbance

Treating social anxiety with CBT can help relieve symptoms immediately. CBT also has long-term benefits through exposure, restructuring, and social skills training for social anxiety. 

The following are the general CBT-based techniques to treat generalized anxiety.

  1. Identifying triggers
  2. Exposure therapy – stimulates situations or real-world situations that cause emotionally triggering thinking and responses. Includes imagining things, situations, and emotionally unhelpful people 
  3. Modifying thoughts causing anxiety with verbal modifications from a therapist to change a patient’s beliefs 
  4. Applied relaxation – helps individuals enter a relaxed state in real-life anxiety triggering situations

How To Use Cognitive Behavioral Therapy For Insomnia?

Using cognitive-behavioral therapy (CBT) for individuals experiencing insomnia works to help patients modify or eliminate negative thoughts that cause difficulty sleeping. The following are common CBT techniques.

  1. Conditioning a patient’s mind to consider their bed for one purpose – conditions the mind and body to associate the object with sleep
  2. Applied relaxation – teach a patient to calm their mind and body
  3. Modifying and eliminating worries through exercises – help individuals recognize unhelpful thoughts that keep them awake
  4. Medications for immediate relief

Does CBD Help For Performance Anxiety?

Yes, CBD can provide immediate relief for individuals experiencing performance anxiety. For example, according to the NCBI, patients with generalized social anxiety saw a significant reduction in their symptoms with one dose of CBD. In addition, CBD helped relieve anxiety symptoms, like cognitive impairment, and lessening the fear of public speaking.

What Are The Risks Of The CBT?

If an individual is experiencing dysfunctional thoughts and behaviors, then cognitive behavioral therapy may help them identify and solve these issues. However, the main risk of CBT is feeling uncomfortable during a therapy session since it requires patients to talk about their unhealthy thoughts and patterns.

What Are The Steps Of CBT?

The first step of cognitive behavioral therapy is finding a therapist with which patients can establish a positive, collaborative relationship. 

Here are the steps of CBT.

  1. Initial Assessment: The beginning of CBT involves therapists taking an active role by outlining principles and sharing information with the patient about this type of psychotherapy. During this stage, the patient works to identify their problems with guidance from the therapist. The goal of the assessment is for therapists to determine a patient’s core beliefs that lead them to their maladaptive and instinctual thoughts. 
  2. Identifying Problems: The patient and the therapist work together to identify the primary problem.
  3. Define Goals: After identifying the problem, with guidance from the therapist, the patient sets goals, and the therapist should outline concrete factors based on the observation that indicate improvement.
  4. Awareness: The therapist guides the patient to become aware of the reasons for their problems. The main benefit of cognitive behavioral therapy is to change the way a person perceives and reacts to emotionally triggering situations. A therapist will often have the patient identify their maladaptive and instinctual thoughts by observing the evidence behind these thoughts. Maladaptive thoughts are assumptions individuals have about themselves and the world with no concrete evidence behind these assumptions – they are irrational. While instinctual thoughts are also irrational, they usually occur in specific situations where an individual feels threatened. 
  5. Treating Problems: Once patients identify the reasons for their thinking, assumptions, and patterns, the therapist encourages them to eliminate and modify these problems. This happens through different approaches that vary depending on the patient’s goals and needs. Typically, CBT involves the therapist giving the patient homework to work towards their goals in real-life.

What Is The Length of CBT?

Cognitive-behavioral therapy is a short-term therapy, with the length of CBT typically ranging from 10-20 sessions. Patients accomplish the first four steps within the first couple of sessions of CBT.

For some, CBT provides patients relief after a few sessions, while others need several sessions to meet their goals. The length of CBT depends on a couple of factors.

  1. The severity of the patient’s mental illness
  2. The personality of the patient
  3. Level of support

What Is The Confidentiality Level Of Cognitive Behavioral Therapy?

Therapists understand how important confidentiality is in therapy, so the level of confidence in cognitive behavioral therapy (CBT) is firm. In addition, federal privacy laws under HIPAA entail the minimum level of confidentiality that therapists and psychologists have to follow. 

Specific exceptions are when medical professionals can disclose a patient’s personal information.

  1. If a patient informs them of their plan to commit suicide or induce harm to another
  2. Ongoing domestic abuse and negligence of children, elderly, and people with disabilities
  3. If a patient’s mental health is in question during legal proceedings

How To Prepare Yourself For Cognitive Behavioral Therapy?

While there is no one way to prepare for cognitive behavioral therapy, here are some ways to get the most out of the first session. 

How To Prepare Yourself For Cognitive Behavioral Therapy
How to Prepare Yourself for Cognitive Behavioral Therapy?
  1. Reserve some time to think about what you want out of CBT
  2. Write down fears, questions, and concerns about the CBT process
  3. Think about situations that typically cause you to react or think about recent problems that made you feel a certain way, and write them down

What Are The Factors For Cognitive Behavioral Therapy Success?

These are the factors for CBT success.

  1. Openness
  2. Willingness to participate and share
  3. Make time to practice outside of sessions

What Are The CBT Techniques?

Cognitive-behavioral therapy (cbt) techniques include the following strategies.

  1. The goal-oriented, problem-solving approach
  2. Collaboration through the engagement of patient and therapist
  3. Identifying, evaluating, and modifying irrational thoughts through adaptive thinking
  4. Behavioral experiments to observe, test, and correct distortions
  5. Other techniques depend on the patient. For example, a common method for people with an aversion to blood and needles is applied tension (when someone tenses their muscles in exposure situations) 

Who Invented Cognitive Behavioral Therapy?

Psychiatrist Aaron Beck invented cognitive behavioral therapy (CBT) in 1976. Specifically, Beck’s version of therapy was called cognitive therapy. According to the NCBI, Beck formed this new type of therapy, leading to its empirical support and overall support, by exploring the possibility of changing a patient’s unhelpful cognitions.

What Is The Relationship Between Cognitive Behavioral Therapy And Cognitive Triangle?

The cognitive in CBT cognitive behavioral therapy suggests that this psychological treatment stresses changing an individual’s thought processes. The cognitive triangle outlines these processes by explaining people’s thoughts of an event as a repetitive process of thinking, feeling, and doing.

The cognitive triangle helps explain how dysfunctional thinking leads to unhealthy behaviors through repeated unhelpful thoughts that lead to irrational feelings and, ultimately, lead to negative actions. 

These unhealthy patterns and thoughts are when the role of effective CBT treatment comes in. CBT helps individuals understand their maladaptive and automatic thoughts and perceive situations rationally with the cognitive triangle. Moreover, the cognitive triangle helps to slow a patient’s thought process through introspective questioning. 

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