Usage of Cognitive Behavioral Therapy in Research Studies on Mental Health

In our society today we are taught that medications are an “easy and short-term fix” to a mental illness, resulting in many people falling towards this rather than therapy. Cognitive-behavioral theory is a form of short-term therapy, that works in the present (rather than issues from the past) and is “one of the most popular intervention models used by social workers and other mental health professionals.” (Early, 2017) Cognitive behavioral therapy also known as CBT, is a combination of two types of therapy, cognitive therapy and behavioral therapy. Cognitive theory provides the foundation for CBT, “the hypothesis behind cognitive therapy is that thoughts shape feelings and thereby behavior, so that by changing thought patterns, behavior can be changed as well.” (Filges, 2015)

CBT was established by Dr. Aaron T. Beck in the 1960’s, who studied and practiced psychoanalysis realized that he had an interest in the concept of depression, which was what CBT was originally formulated to treat. “He found that depressed patients experienced streams of negative thoughts that seemed to arise spontaneously. He called these cognitions “automatic thoughts.” He then started helping clients through exercises become aware of these automatic thoughts, and found by doing this, the clients were able to think more realistically. “As a result, they felt better emotionally and were able to behave more functionally. When patients changed their underlying beliefs about themselves, their world and other people, therapy resulted in long-lasting change.” (Beck)

CBT “is often the preferred type of psychotherapy (talk therapy) because it can quickly help you identify and cope with specific challenges. It generally requires fewer sessions than other types of therapy and is done in a structured way.” (Mayo Clinic, 2019) CBT teaches the client how to live a healthier, improved lifestyle. This is done by the therapist helping the client understand their flawed thoughts that is behind their problem(s), following with the arrangement of goals to change their thinking. CBT challenges individuals to develop different ways of thinking about situations, attitudes and problems, which in turn motivates emotional and behavioral changes. Clients are instructed to practice what they learn after sessions to reinforce change.

According to Mayo Clinic, CBT can be a very helpful tool ― either alone or in combination with other types of therapies ― in treating mental health disorders such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. CBT can be an effective tool to help anyone learn how to better manage stressful life situations.” With eating disorders such as anorexia, “CBT therapist put special emphasis on behavior change leading to establishing regular eating, and thoughts and beliefs supporting an over-valuation of body shape and weight, control and clinical perfectionism.” Interventions for depression typically start with the main focus on having the client become more engaged in activities they value, that they may have given up since becoming depressed. Additionally, it helps clients look at and analyze negative thoughts and beliefs that they have about themselves and the world. Depending on the age of the client the main focus can differ. For adults it could be helping the client maintain a social life, analyze beliefs about aging and how cope with aging and changes in health. (Beck)

A 2015 study’s main goal was to develop a model of the experiences of adults undergoing combined treatment with antidepressant medication and (CBT) for depression. Participants started first with an interview about their experiences. What was found was that their choice of medication was an initial aid to surviving a crisis. Participants on medication long term felt caught in a “drug loop.” From their research they were able to conclude that “antidepressant medication and CBT are perceived and experienced differently, with CBT often being seen as an alternative to medication, or even as a means to discontinue medication. Service users’ experiences and beliefs about medication may thus affect their engagement and goals in CBT, and it may be important for therapists to consider this.” (Figles, 2015) CBT can do anything medications can do except through treatment and without the side effects, but people with more severe symptoms may benefit from adding medications. For less severe disorders CBT is as strong medication and for some disorders it is even stronger. (MUJIK)

A 2015 study found that CBT didn’t have much effect as a treatment for young people ages 13-21 who misused drugs, such as cannabis, amphetamines, ecstasy and cocaine. The main objective of this study “was to evaluate the current evidence on the effect of CBT on abstinence and drug use reduction for young people in outpatient treatment for non-opioid drug use.” A typical session for this particular study starts with the therapist guiding the client through the process of listing the advantages and disadvantages of drug uses. Followed by skills training that involves coping and problem- solving strategies. The third part of the session is dedicated to planning the week ahead and discussing how new skills will be implemented in their life outside of the session.

The results of this study was that they did not find a significant effect of CBT compared to other interventions. But the CBT study did perform very well. (Filges, 2015) In treating substance use disorders, Beck talked about how CBT can be beneficial if done right. The CBT therapist should encourage clients to continue with support groups and sponsors as part of their recovery team. During therapy the therapist should provide client with the right tools and resources to prevent relapse, teach them how to observe their urges, and prepare client to recover if they do have a lapse, in order to prevent a full-fledged relapse.

A 2016 study focused on bringing more of a positive approach to the cognitive behavioral theory. By doing this and as well as mindfulness techniques it can be assumed that it adds to the evidenced-based effectiveness of CBT. Their findings were that “although cognitive modification plays a central role in CBT, little attention has been given to the role of positive thinking patterns in anxiety, depression, and other disorders. Adding positive interventions builds on the established effectiveness of CBT.” (Mothersill, K, 2016) When using CBT it is easy to get caught up in having the client think about bad thoughts in order to reconstruct them into positive thoughts and it is often forgotten that positive interventions are necessary. Adding positive interventions such as, learning relaxation techniques, coping self-talk, journaling, and coping worksheets builds on the effectiveness of CBT.

Judith S. Beck, award winner for Significant and Enduring Contributions to Cognitive Behavior Therapy Academy of Cognitive Therapy, is best known for her work in cognitive therapy and CBT. Her father is Aaron Beck, MD, who is the founder of cognitive therapy. “Judith provides the vision and leadership to further our mission: to improve lives worldwide through excellence in Cognitive Behavior Therapy.. . Dr. Beck has written over 100 articles and chapters on different aspects of cognitive therapy. She is the author of the primary text in the field, Cognitive Behavior Therapy: Basics and Beyond (2nd ed.), which has been translated into 20 languages, as well as books and workshops. Today Dr. Beck continues to create courses for therapists, educating clinicians around the world on the essentials of CBT, CBT for depression, anxiety, and personality disorders. To date, her courses have been taken in 112 countries.” (Beck)

According to Beck, CBT has been shown to be effective in over 2,000 research studies. It helps individuals identify goals that are important to them and overcome issues that are in the way of living their ideal lifestyle. CBT helps people get better and stay better. The most important part to remember about CBT is to help the clients figure out what they want out of the sessions so they can move on and achieve what they want in life. Through CBC clients will learn certain skills to change their thinking ultimately changing their behavior in order to achieve lasting improvement in problems and sense of well-being.