Cognitive-Behavioral Therapy: what is it and what principles is it based on?

We explain what CBT, a type of psychotherapy, consists of.

The cognitive-behavioral therapy is one of the most important concepts in applied psychology, as it allows us to address a Wide range of problems by applying techniques that have scientific backing.

This is a form of intervention inherited from the theoretical and practical principles of behavioral psychology, to which methods and objectives of cognitive therapy are added. In this article we will see what it consists of and why it is so used among psychologists.

What is Cognitive-Behavioral Therapy?

Within the fields of psychological intervention and clinical psychology there is a large number of proposals that are offered to many types of patients and problems. The offer is very varied, and it is easy to get lost in the jungle of labels, names and descriptions of therapeutic approaches..

However, one of these types of therapy receives special attention nowadays, both in practices and clinics and in psychology faculties.

This is cognitive-behavioral therapy, a therapeutic orientation with a scientifically proven efficacy. scientifically proven efficacy in different types of in different types of intervention. In addition, one of the most characteristic aspects of this therapy is that it adapts to a wide variety of needs and problems to be addressed in the treatment of patients.

Modifying behaviors and thoughts

If you have ever stopped to think about the conventional idea of what a "psychological problem" is, you may have realized that there are two sides to this type of problem.

On the one hand, a material and objective side, which is recognizable by many people and can be measured on the basis of specific scales. On the other hand, a side that responds to subjective states of consciousness, i.e., aspects of the mental and private life of the person with the problem, which often translate into emotional terms.

Cognitive-behavioral therapy responds to the need to intervene in these two areas. And it does so by leveraging thanks to the synergies that are established between the part of the intervention focused on mental processes and that which is oriented towards actions and changes in the patient's material environment. In other words, this therapeutic orientation that acts on acts as well as on thoughts.

The foundations of this form of psychological intervention

It is considered that cognitive-behavioral therapy was born from the fusion of behavioral therapies and those derived from cognitive psychology..

On the one hand, behaviorism (and especially the radical behaviorism of B. F. Skinner) serves as an example of an exhaustive methodology, very close to the precepts of the scientific method, which allows to objectively assess the progress made during the therapy. allows for an objective assessment of the progress made during therapy..

On the other hand, Cognitive Therapy emphasizes the need not to renounce the consideration of directly unobservable mental processes, since a large part of the usefulness of a therapy lies in the subjective well-being of the patients and this factor does not necessarily have to be recorded through pure behavioral analysis.

However, and although within cognitive-behavioral therapy in any of its forms, we work with constructs that refer to the "mental world" that is not directly observable, efforts are made to ensure that the mental elements that come into play in the diagnosis and intervention respond to well-defined and translatable categories to quantitative variables in order to be able to exhaustively monitor the changes made at the subjective level.

Thus, all kinds of esoteric and ambiguous formulations about the person's way of thinking are avoided and systems of categories are created in which recurrent ideas are classified one within the other in classifications that respond to a single criterion.

Deepening in the differences with behaviorism

Cognitive-behavioral therapy is heir to certain fundamentals of Behavioral Psychologysuch as the emphasis on practical learning processes and the idea that association is a central concept in therapy. However, it incorporates the need to act not only on behavior, but also on the person's thoughts. Mainly, the intervention on the "mental" part focuses on the cognitive schemas and conceptual categories from which the person interprets reality.

Non-adaptive beliefs are also explored, once these have been located, in order to train the client in his ability to locate facts in his daily life that contradict these assumptions. Thus, if the person has self-esteem problems, he/she can be taught to pay attention to the signs of admiration from friends and family, which are a type of stimulus easily ignored when the self-image is very damaged.

In short, any type of cognitive-behavioral therapy is based on the idea that emotions and behavioral styles do not depend only on the physical stimuli that reach us from the environment but also on the thoughts that shape the way we perceive both those stimuli and our own mental processes.

How does this type of therapy intervene?

Cognitive-behavioral therapy works by teaching how to recognize the thinking styles that predispose the patient to reach conclusions that are not very useful for him/her, or dysfunctional thoughts. For this it is necessary to train the person to be able to reflect on his or her own way of thinking and to consider which points are conflictive and which are not. In this way, the client is expected to be more capable of questioning the categories with which he/she works. (e.g., "success and failure") and to detect typical patterns of thinking that cause problems.

The process by which the patient recognizes the cognitive aspects that cause him/her discomfort and can act on them is based on a model of action inspired in the Socratic dialogue. This implies that during part of the cognitive-behavioral therapy sessions, the professional will be giving the patient back the feedback necessary for the patient to detect by himself the contradictions or undesired conclusions to which his thinking styles and cognitive schemes lead him.

The therapist does not guide the patient in this process, but rather asks questions and highlights assertions and highlights assertions that the client himself has made so that the latter can go deeper into the study of his own thinking.

The second part of cognitive-behavioral therapy involves intervening on the cognitive and material foci that have been detected. This involves, on the one hand, setting specific objectives to be met, and on the other hand, training the patient to be able to determine from his or her own criteria the strategies that bring him or her closer to the problem, training the patient to be able to determine from his or her own criteria the strategies that bring him or her closer to or further away from these goals.. Moreover, since the objectives have been defined in such a way that it is possible to check impartially whether they have been met or not, it is easy to measure the progress being made and the pace at which it is happening in order to take note of it and, if necessary, make changes in the intervention program.

Meeting objectives when going through a program of sessions with cognitive-behavioral therapy can mean, for example, significantly minimizing the effects of a phobia phobia, ending an addiction or abandoning an obsessive thinking style. In short, problems with a material side and a subjective or emotional side.

In which cases is it used?

Cognitive-behavioral therapy can be applied in practically all ages. in all agesand in a great variety of problems.. For example, it is used to intervene in anxiety disorders and phobias, dysthymia, bipolar disorders, depression, etc. It can also be used as an aid in cases of neurological disorders in which it is necessary to provide support to know how to manage symptoms in the best possible way, and even in psychotic disorders related to schizophrenia.

In some disorders, however, behavioral therapy has been shown to be almost as effective as cognitive-behavioral therapy, without the need to perform tasks to modify beliefs and thought patterns. For example, it is common for psychologists to resort to behavioral therapy, rather than cognitive-behavioral therapy, when dealing with very young children, since they do not yet have good control over abstract thinking and the articulation of concepts through language.

The effectiveness of this type of psychotherapy

Cognitive-behavioral therapy is currently considered to be the only type of psychotherapy the only type of psychotherapy whose results have been validated through the scientific method.. This means that its efficacy is supported by empirical observations in which many groups of patients who have undergone treatment with Cognitive Behavioral Therapy have improved significantly more than would be expected if they had not attended therapy or had followed a placebo effect program.

When it is said that cognitive-behavioral therapy has been shown to be effective through the application of the scientific method, this means that there are strong reasons to believe that the improvement experienced by people who have tried this type of therapy is caused by the use of these psychological interventions, and not by other variables. This does not imply that 100% of the people who go to Cognitive Behavioral Therapy sessions will improve, but a very significant portion of them will. of them.

Moreover, this improvement can be translated into objective and observable criteria, such as success or not in quitting smoking. This is a characteristic that distinguishes cognitive-behavioral therapy from other forms of intervention, many of which, since they do not set measurable objectives under well-defined criteria, can hardly be subjected to empirical examination to determine their efficacy through the scientific method.

On the other hand, it must be taken into account that the degree of efficacy of each type of therapy depends on the disorder to be treated; taking this into account, cognitive-behavioral therapy is the one that has been shown to be effective in a greater number of psychological disorders.