Basic principles of cognitive behavioral therapy. Cognitive behavioral therapy

When studying the world, we look at it through the prism of the knowledge we have already acquired. But sometimes it may turn out that our own thoughts and feelings can distort what is happening and traumatize us. Such stereotypical thoughts, cognitions, arise unconsciously, showing a reaction to what is happening. However, despite their unintentional appearance and seeming harmlessness, they interfere with living in harmony with oneself. You need to get rid of such thoughts with the help of cognitive behavioral therapy.

History of therapy

Cognitive behavioral therapy (CBT), also called cognitive-behavioral therapy behavior therapy, originated in the 50-60s of the twentieth century. The founders of cognitive behavioral therapy are A. Back, A. Ellis and D. Kelly. Scientists have studied human perception various situations, his mental activity and further behavior. This was the innovation - the merging of the principles and methods of cognitive psychology with behaviorist ones. Behaviorism is a branch of psychology that specializes in the study of human and animal behavior. However, the discovery of CBT did not mean that similar methods have never been used in psychology. Some psychotherapists used the cognitive abilities of their patients, thus diluting and supplementing behavioral psychotherapy.

It is no coincidence that the cognitive-behavioral direction in psychotherapy began to develop in the United States. At that time, behavioral psychotherapy was popular in the United States - a positive concept that believes that a person can create himself, while in Europe, on the contrary, psychoanalysis, which was pessimistic in this regard, dominated. Cognitive behavioral psychotherapy was based on the idea that a person chooses behavior based on own ideas about reality.

A person perceives himself and other people based on his own type of thinking, which, in turn, is obtained through learning. Thus, the incorrect, pessimistic, negative thinking that a person has learned carries with it incorrect and negative ideas about reality, which leads to inappropriate and destructive behavior.

What is cognitive behavioral therapy and what does it involve? The basis of cognitive behavioral therapy are elements of cognitive and behavioral therapy aimed at correcting a person’s actions, thoughts and emotions in problematic situations. It can be expressed in the form of a unique formula: situation – thoughts – emotions – actions. In order to understand the current situation and understand your own actions, you need to find answers to the questions - what did you think and feel when this happened. After all, in the end it turns out that the reaction is predetermined not so much by the current situation as by your own thoughts on this matter, from which your opinion is formed. It is these thoughts, sometimes even unconscious, that lead to problems - fears, anxieties and others. painful sensations. It is in them that the key to solving many people's problems lies.

The main task of the psychotherapist is to identify erroneous, inadequate and inapplicable thinking that needs to be corrected or completely changed, instilling in the patient acceptable thoughts and patterns of behavior.

For this, therapy is carried out in three stages:
logical analysis;
empirical analysis;

pragmatic analysis.

At the first stage, the psychotherapist helps the patient analyze emerging thoughts and feelings, finds errors that need to be corrected or removed. The second stage is characterized by teaching the patient to accept the most objective model of reality and compare the perceived information with reality. At the third stage, the patient is offered new, adequate life attitudes, based on which he must learn to respond to events.

Cognitive errors The behavioral approach considers inappropriate, painful and negatively directed thoughts as cognitive errors. Such errors are quite typical and can occur in different people V different situations . These include, for example, arbitrary conclusions. In this case, a person draws conclusions without having evidence or even in the presence of facts contradicting these conclusions. There is also overgeneralization - generalization based on several incidents, implying the selection actions. However, what is abnormal here is that such overgeneralization is also applied in situations in which it should not be done. The next mistake is selective abstraction, in which certain information is selectively ignored, and information is also taken out of context. Most often this happens with negative information to the detriment of positive information.

Cognitive errors also include inadequate perception of the significance of an event. As part of this error, both exaggeration and understatement can occur, which, in any case, is not true. Such a deviation as personalization also does not bring anything positive. People who are prone to personalization perceive the actions, words or emotions of other people as related to them, when in fact they had nothing to do with them. Maximalism, also called black and white thinking, is also considered abnormal. With it, a person differentiates what happened into completely black or completely white, which makes it difficult to see the essence of the actions.

Basic principles of therapy

If you want to get rid of negative attitudes, you should remember and understand some of the rules on which CBT is based. The most important thing is that your negative feelings are primarily caused by your assessment of what is happening around you, as well as yourself and everyone around you. The significance of the situation should not be exaggerated; you need to look inside yourself, in an effort to understand the processes driving you. Assessing reality is usually subjective, so in most situations you can radically change your attitude from negative to positive.

It is important to recognize this subjectivity even when you are confident in the veracity and correctness of your conclusions. This common occurrence discrepancies between internal attitudes and reality disturb your peace of mind, so it is better to try to get rid of them.

It is also very important for you to understand that all this - incorrect thinking, inadequate attitudes - can be changed. Typical thinking, developed by you, can be corrected in case of minor problems, and in case of serious ones, it can be completely corrected.

Training in new thinking is carried out with a psychotherapist in sessions and independent studies, which subsequently ensures the patient’s ability to adequately respond to emerging events.

Therapy methods

Most important element CBT in psychological counseling is to teach the patient to think correctly, that is, to critically assess what is happening, use available facts (and search for them), understand probability and analyze the collected data. This analysis is also called pilot testing. The patient carries out this check independently. For example, if a person thinks that everyone is constantly turning to look at him on the street, he should just take it and count how many people will actually do this? This simple check allows you to achieve serious results, but only if you do it and do it responsibly.

Therapy for mental disorders involves the use of other techniques by psychotherapists, for example, reappraisal techniques. When using it, the patient checks for the likelihood of a given event occurring due to other reasons. Carried out as much as possible full analysis sets possible reasons and their influence, which helps to soberly assess what happened as a whole. Depersonalization is used in cognitive behavioral therapy for those patients who feel constantly in the center of attention and suffer from this.

With the help of tasks, they understand that those around them are most often passionate about their own affairs and thoughts, and not about the patient. An important area is also the elimination of fears, for which conscious introspection and decatastrophizing are used. Using these methods, the specialist gets the patient to understand that all bad events come to an end, and that we tend to exaggerate their consequences. Another behavioral approach involves repetition desired result in practice, its permanent consolidation.

Treatment of neuroses with therapy

Cognitive behavioral therapy is used to treat a variety of diseases, the list of which is extensive and vast. In general, using her methods, they treat fears and phobias, neuroses, depression, psychological trauma, panic attacks and other psychosomatics.

There are many methods of cognitive behavioral therapy, and their choice depends on the individual and his thoughts. For example, there is a technique - reframing, in which the psychotherapist helps the patient get rid of the rigid framework into which he has driven himself. In order to better understand themselves, the patient may be asked to keep a kind of diary in which feelings and thoughts are recorded. Such a diary will also be useful for the doctor, since he will be able to select a more suitable program in this way. A psychologist can teach his patient, replacing the formed negative picture of the world. The behavioral approach has interesting way– a change of roles, in which the patient looks at the problem from the outside, as if it were happening to another person, and tries to give advice.

Behavioral psychotherapy uses implosion therapy to treat phobias or panic attacks. This is the so-called immersion, when the patient is deliberately forced to remember what happened, as if to relive it.

Systematic desensitization is also used, which differs in that the patient is first taught relaxation methods. Such procedures are aimed at eliminating unpleasant and traumatic emotions.

Treatment of depression

Depression is common mental disorder, one of the key symptoms of which is impaired thinking. Therefore, the need to use CBT in the treatment of depression is undeniable.

Three typical patterns have been found in the thinking of people suffering from depression:

thoughts about the loss of loved ones, the destruction of love relationships, loss of self-esteem;
negatively directed thoughts about oneself, the expected future, others;
an uncompromising attitude towards oneself, imposing unreasonably strict requirements and boundaries.

Behavioral psychotherapy should help in solving problems caused by such thoughts. For example, stress inoculation techniques are used to treat depression. For this purpose, the patient is taught to be aware of what is happening and deal with stress wisely. The doctor teaches the patient, and then consolidates the result with independent studies, so-called homework.

But with the help of the reattribution technique, you can show the patient the inconsistency of his negative thoughts and judgments and give new logical guidelines. CBT methods such as the stop technique, in which the patient learns to stop negative thoughts, are also used to treat depression. At the moment when a person begins to return to such thoughts, it is necessary to erect a conditional barrier to negativity that will not allow them. Having brought the technique to automaticity, you can be sure that such thoughts will no longer bother you.

Depression, anxiety, phobias and others mental disorders quite difficult to cure traditional methods forever.

Drug treatment only relieves symptoms, not allowing a person to become completely mentally healthy. Psychoanalysis may be effective, but it will take years (from 5 to 10) to obtain a sustainable result.

Cognitive-behavioral direction in therapy is young, but really working for healing with a form of psychotherapy. It allows people to a short time(up to 1 year) get rid of despondency and stress by replacing destructive patterns of thinking and behavior with constructive ones.

What is human cognitive development? Find out about this from ours.

Concept

Cognitive methods in psychotherapy work with the patient's thinking model.

The goal of cognitive therapy is awareness and correction of destructive patterns (mental schemes).

The result of treatment is a complete or partial (at the request of the patient) personal and social adaptation of a person.

People faced with unusual or painful events in different periods life, often react negatively, creating tension in the body and brain centers responsible for receiving and processing information. This releases hormones into the blood that cause suffering and mental pain.

In the future, such a thinking pattern is reinforced by repetition of situations, which leads to. A person ceases to live in peace with himself and the world around him, creating your own hell.

Cognitive therapy teaches you to react more calmly and relaxed to inevitable changes in life, turning them into a positive direction with creative and calm thoughts.

Advantage of the method- work in the present tense, without focusing on:

events in the past;
influence of parents and other close people;
feelings of guilt and regret about lost opportunities.

Cognitive therapy allows take fate into your own hands, freeing yourself from harmful addictions and unwanted influence of others.

For successful treatment It is advisable to combine this method with behavioral, that is, behavioral.

What's happened cognitive therapy and how does it work? Find out about it in the video:

Cognitive-behavioral approach

Cognitive behavioral therapy works with the patient in a comprehensive manner, combining the creation of constructive mental attitudes with new behaviors and habits.

This means that every new mental attitude must be supported by specific action.

This approach also allows us to identify destructive patterns of behavior, replacing them with healthy or safe for the body.

Cognitive, behavioral and combination therapy can be used both under the supervision of a specialist and independently. But still, at the very beginning of the journey, it is advisable to consult with a professional to develop the right strategy treatment.

Areas of application

The cognitive approach can be applied to all people who feel unhappy, unsuccessful, unattractive, unsure of themselves etc.

An attack of self-torture can happen to anyone. Cognitive therapy in this case can reveal the thinking pattern that served as the trigger for creating bad mood, replacing it with a healthy one.

This approach is also used for the treatment of the following mental disorders:

Cognitive therapy can remove difficulties in relationships with family and friends, as well as teach how to establish and maintain new connections, including with the opposite sex.

What does cognitive science study? find out right now.

Aaron Beck's opinion

American psychotherapist Aaron Temkin Beck (Professor of Psychiatry at the University of Pennsylvania) is the author of cognitive psychotherapy. He specializes in treating depressive states, including with suicidal tendencies.

The basis of the approach of A.T. Beck took the term (the process of processing information by consciousness).

The decisive factor in cognitive therapy is the correct processing of information, as a result of which an adequate behavioral program is consolidated in a person.

Patient undergoing treatment according to Beck must change the way I look at myself, your life situation and tasks. In this case, you need to go through three stages:

admit your right to make mistakes;
abandon erroneous ideas and worldviews;
correct thought patterns (replace inadequate ones with adequate ones).

A.T. Beck believes that only correcting erroneous thinking patterns can create life with more high level self-realization.

The creator of cognitive therapy himself effectively applied its techniques to himself when, after successfully curing patients, his income level significantly decreased.

The patients recovered quickly without relapses, getting back to health and happy life , which adversely affected the doctor’s bank account.

After analyzing thinking and correcting it, the situation changed for the better. Cognitive therapy suddenly became fashionable, and its creator was asked to write a series of books for a wide range of users.

Aaron Beck: goals and objectives of cognitive psychotherapy. Practical examples in this video:

Cognitive behavioral psychotherapy

After this work, methods, techniques and exercises of cognitive behavioral therapy are used that cause positive changes in a person's life.

Methods

Methods in psychotherapy are ways to achieve a goal.

In the cognitive behavioral approach these include:

Removing (erasing) thoughts that destroy fate(“I won’t succeed”, “I’m a loser”, etc.).
Creating an adequate worldview(“I’ll do it. If it doesn’t work out, it’s not the end of the world,” etc.).

When creating new thought forms it is necessary look at problems realistically. This means that they may not resolve as planned. This fact should also be calmly accepted in advance.

Reviewing painful past experiences and assessing the adequacy of their perception.
Consolidating new thought forms with actions (practice of communicating with people for a sociopath, good nutrition- for anorexic, etc.).

The methods of this type of therapy are used to solve real problems in present time. An excursion into the past is only necessary to create adequate assessment situations with a view to creation healthy model thinking and behavior.

More details about the methods of cognitive behavioral therapy can be found in the book by E. Chesser, V. Meyer, “Methods of Behavioral Therapy.”

Technicians

A distinctive feature of cognitive behavioral therapy is the need active patient participation in your healing.

The patient must understand that his suffering is created by wrong thoughts and behavioral reactions. It is possible to become happy by replacing them with adequate thought forms. To do this, you need to perform the following series of techniques.

You can learn about what the cognitive sphere of personality is from ours.

Diary

This technique will allow you to track the most frequently repeated phrases that create problems in your life.

Identifying and recording destructive thoughts when solving any problem or task.
Checking a destructive attitude with a specific action.

For example, if the patient claims that “he won’t succeed,” then he should do what he can and write it down in a diary. Next day recommended perform a more complex action.

Why keep a diary? Find out from the video:

Catharsis

In this case, the patient needs to allow himself to express feelings that he previously forbade himself, considering them bad or unworthy.

For example, cry, express aggression(in relation to a pillow, mattress), etc.

Visualization

Imagine that the problem has already been solved and remember emotions, which appeared at the same time.

The techniques of the described approach are discussed in detail in the books:

Judith Beck, Cognitive Therapy. Complete Guide"
Ryan McMullin "Cognitive Therapy Workshop"

Methods of cognitive behavioral psychotherapy:

Cognitive dissonance - what is it? in simple words? is on our website.

Exercises to do on your own

To correct your thinking, behavior and solve problems that seem insoluble, you don’t have to immediately turn to a professional. You can try the following exercises first:

The exercises are discussed in great detail in the book. S. Kharitonova"Manual of Cognitive Behavioral Therapy."

Also, when treating depression and other mental disorders, it is advisable to master several relaxation exercises, using auto-training techniques and breathing exercises.

additional literature

Cognitive behavioral therapy - young and very interesting approach not only for the treatment of mental disorders, but also for creating a happy life at any age, regardless of the level of well-being and social success. For more in-depth study or self-study, the following books are recommended:

Cognitive behavioral therapy is based on worldview correction, which is a series of beliefs (thoughts). For successful treatment, it is important to recognize the incorrectness of the formed thinking model and replace it with a more adequate one.

Today, correction of any psychological problems is carried out using the most different methods. One of the most progressive and effective is cognitive behavioral psychotherapy (CBT). Let's figure out how this technique works, what it consists of, and in what cases it is most effective.

The cognitive approach is based on the assumption that all psychological problems are caused by the thoughts and beliefs of the person himself.

Cognitive-behavioral psychotherapy is a direction that originates in the middle of the 20th century and today is only being improved every day. The basis of CBT is the opinion that it is human nature to make mistakes when passing life path. That is why any information can cause certain changes in a person’s mental or behavioral activity. The situation gives rise to thoughts, which in turn contribute to the development of certain feelings, and these already become the basis of behavior in a particular case. The behavior then creates a new situation and the cycle repeats.

A striking example would be a situation in which a person is confident in his insolvency and powerlessness. In each difficult situation he experiences these feelings, becomes nervous and despairs, and, as a result, tries to avoid making a decision and cannot realize his desires. Often the cause of neuroses and other similar problems becomes an intrapersonal conflict. Cognitive-behavioral psychotherapy helps to determine the original source of the current situation, the patient’s depression and experiences, and then resolve the problem. The skill of changing one’s negative behavior and thinking pattern becomes available to a person, which has a positive effect on emotional condition, and to the physical.

Intrapersonal conflict is one of the common reasons occurrence of psychological problems

CBT has several goals:

stop and permanently get rid of the symptoms of a neuropsychiatric disorder;
achieve a minimum probability of recurrence of the disease;
help improve the effectiveness of prescribed medications;
eliminate negative and erroneous stereotypes of thinking and behavior, attitudes;
resolve problems of interpersonal interaction.

Cognitive behavioral psychotherapy is effective for a wide variety of disorders and psychological problems. But most often it is used when the patient needs to receive quick help and short-term treatment.

For example, CBT is used for deviations eating behavior, problems with drugs and alcohol, inability to restrain and experience emotions, depression, increased anxiety, various phobias and fears.

Contraindications to the use of cognitive behavioral psychotherapy can only be severe mental disorders, which require the use of medications and other regulatory actions, and seriously threaten the life and health of the patient, as well as his loved ones and others.

Experts cannot say exactly at what age cognitive-behavioral psychotherapy is used, since depending on the situation and the methods of working with the patient selected by the doctor, this parameter will be different. However, if necessary, such sessions and diagnostics are possible in both childhood and adolescence.

Use of CBT for severe mental disorders unacceptable, special drugs are used for this

The following factors are considered the main principles of cognitive behavioral psychotherapy:

A person's awareness of the problem.
Formation of an alternative pattern of actions and actions.
Consolidating new stereotypes of thinking and testing them in everyday life.

It is important to remember that both parties are responsible for the result of such therapy: the doctor and the patient. It is their well-coordinated work that will allow us to achieve maximum effect and significantly improve a person’s life, taking it to a new level.

Advantages of the technique

The main advantage of cognitive behavioral psychotherapy can be considered a visible result that affects all areas of the patient’s life. The specialist finds out exactly what attitudes and thoughts negatively affect a person’s feelings, emotions and behavior, helps to critically perceive and analyze them, and then learn to replace negative stereotypes with positive ones.

Based on the skills developed, the patient creates a new way of thinking, which corrects the response to specific situations and the patient’s perception of them, and changes behavior. Cognitive behavioral therapy helps to get rid of many problems that cause discomfort and suffering to the person himself and his loved ones. For example, in this way you can cope with alcohol and drug addiction, some phobias, fears, and part with shyness and indecisiveness. The duration of the course is most often not very long - about 3-4 months. Sometimes it may take much longer, but in each specific case this issue is resolved individually.

Cognitive behavioral therapy helps to cope with a person’s anxieties and fears

It is only important to remember that cognitive behavioral therapy has a positive effect only when the patient himself has decided to change and is ready to trust and work with a specialist. In other situations, as well as in particularly difficult mental illness, for example, in schizophrenia, this technique is not used.

Types of therapy

Methods of cognitive behavioral psychotherapy depend on specific situation and the patient's problems have a specific purpose. The main thing for a specialist is to get to the root of the patient’s problem, teach the person positive thinking and ways to behave in such a case. The most commonly used methods of cognitive behavioral psychotherapy are the following:

Cognitive psychotherapy, in which a person experiences uncertainty and fear, perceives life as a series of failures. In this case, the specialist helps the patient develop positive attitude to yourself, will help you accept yourself with all your shortcomings, gain strength and hope.
Reciprocal inhibition. All negative emotions and during the session the feelings are replaced by other more positive ones. Therefore, they cease to have such a negative impact on human behavior and life. For example, fear and anger are replaced by relaxation.
Rational-emotive psychotherapy. At the same time, a specialist helps a person realize the fact that all thoughts and actions must be reconciled with the realities of life. And unrealizable dreams are the path to depression and neurosis.
Self-control. When working with this technique, a person’s reactions and behavior in certain situations are reinforced. This method works for unmotivated outbursts of aggression and other inappropriate reactions.
“Stop tap” technique and anxiety control. At the same time, the person himself says “Stop” to his negative thoughts and actions.
Relaxation. This technique is often used in combination with others to completely relax the patient, create a trusting relationship with a specialist, and more productive work.
Self-instructions. This technique consists in creating a series of tasks for oneself and independently solving them in a positive way.
Introspection. At the same time, a diary can be kept, which will help in tracking the source of the problem and negative emotions.
Research and analysis of threatening consequences. A person with negative thoughts changes them to positive ones, based on the expected results of the development of the situation.
A method for finding advantages and disadvantages. The patient himself or in pairs with a specialist analyzes the situation and his emotions in it, analyzes all the advantages and disadvantages, draws positive conclusions or looks for ways to solve the problem.
Paradoxical intention. This technique was developed by the Austrian psychiatrist Viktor Frankl and consists in the fact that the patient is asked to experience a frightening or problematic situation over and over again in his feelings and does the opposite. For example, if he is afraid to fall asleep, then the doctor advises not to try to do this, but to stay awake as much as possible. In this case, after a while a person stops experiencing negative emotions associated with sleep.

Some of these types of cognitive-behavioral psychotherapy can be carried out independently or act as a homework» after a specialist session. And when working with other methods, you cannot do without the help and presence of a doctor.

Self-observation is considered a type of cognitive behavioral psychotherapy

Cognitive Behavioral Psychotherapy Techniques

Cognitive behavioral psychotherapy techniques can be varied. Here are the most commonly used ones:

keeping a diary where the patient will write down his thoughts, emotions and situations preceding them, as well as everything exciting during the day;
reframing, in which, by asking leading questions, the doctor helps to change positive side patient stereotypes;
examples from literature, when the doctor talks and gives specific examples of literary characters and their actions in the current situation;
the empirical path, when a specialist offers a person several ways to try certain solutions in life and leads him to positive thinking;
a change of roles, when a person is invited to stand “on the other side of the barricades” and feel like the one with whom he has a conflict situation;
evoked emotions, such as anger, fear, laughter;
positive imagination and analysis of the consequences of a person’s choice.

Psychotherapy by Aaron Beck

Aaron Beck- American psychotherapist who examined and observed people suffering from neurotic depression, and concluded that depression and various neuroses develop in such people:

having a negative view of everything that happens in the present, even if it can bring positive emotions;
having a feeling of powerlessness to change something and hopelessness, when when imagining the future a person pictures only negative events;
suffering from low self-esteem and decreased self-esteem.

Aaron Beck used the most different methods. All of them were aimed at identifying a specific problem both from the specialist and from the patient, and then a solution to these problems was sought without correcting the specific qualities of the person.

Aaron Beck - an outstanding American psychotherapist, creator of cognitive psychotherapy

In Beck's cognitive behavioral therapy for personality disorders and other problems, the patient and therapist collaborate in experimental testing of the patient's negative judgments and stereotypes, and the session itself is a series of questions and answers to them. Each of the questions is aimed at promoting the patient to understand and understand the problem, and find ways to solve it. A person also begins to understand where his destructive behavior and mental messages are leading, together with a doctor or independently collecting the necessary information and testing it in practice. In a word, cognitive behavioral psychotherapy according to Aaron Beck is a training or structured training that allows you to detect negative thoughts in time, find all the pros and cons, and change your behavior pattern to one that will give positive results.

What happens during the session

Choice plays a huge role in the outcome of therapy. suitable specialist. The doctor must have a diploma and documents permitting his activity. Then a contract is concluded between the two parties, which specifies all the main points, including details of the sessions, their duration and quantity, conditions and time of meetings.

The therapy session must be conducted by a licensed professional

This document also prescribes the main goals of cognitive behavioral therapy, and, if possible, the desired result. The course of therapy itself can be short-term (15 one-hour sessions) or longer (more than 40 one-hour sessions). After completing the diagnosis and getting to know the patient, the doctor draws up individual plan work with him and the timing of consultation meetings.

As you can see, the main task of a specialist in the cognitive-behavioral direction of psychotherapy is considered to be not only monitoring the patient and finding out the origins of the problem, but also explaining your opinion on the current situation to the person himself, helping him to understand and build new mental and behavioral stereotypes. To increase the effect of such psychotherapy and consolidate the result, the doctor can give the patient special exercises and “homework”, use various techniques, which can help the patient to further act and develop in a positive direction independently.

People's experiences often include themes of hopelessness, a gloomy perception of the world, and dissatisfaction with oneself. Cognitive psychotherapy helps to identify established stereotypes by working with thinking and replacing “automatic” negative thoughts with positive ones. The patient is an active participant in the therapy process.

Cognitive therapy - what is it?

Aaron Beck, an American psychotherapist, one of the founders of the movement in 1954, studying depression within the framework of psychoanalysis, did not receive any encouraging reliable results. Thus, a new direction of psychotherapeutic assistance appeared in panic attacks, depression, various addictions. Cognitive therapy is a short-term method aimed at recognizing negative thought patterns that lead a person to suffering and replacing them with constructive thoughts. The client learns new perceptions, begins to believe in himself and think positively.

Methods of cognitive psychotherapy

The psychotherapist initially negotiates and establishes a collaborative relationship with the patient. A list of target problems is formed in the order of importance of elaboration for the patient, and automatic negative thoughts are identified. Cognitive behavioral therapy methods that produce positive changes at a fairly deep level include:

struggle with negative thoughts (“this is pointless”, “this is useless”, “nothing good will come of this”, “I don’t deserve to be happy”);
alternative paths perception of the problem;
rethinking or living through a traumatic experience from the past, which affects the present and does not allow the patient to adequately assess reality.

Cognitive psychotherapy techniques

The psychotherapist encourages the patient to actively participate fully in therapy. The therapist’s goal is to convey to the client that he is unhappy with his old beliefs; there is an alternative to start thinking in a new way, to take responsibility for his thoughts, state, and behavior. Homework is required. Cognitive therapy for personality disorders contains a number of techniques:

Tracking and recording negative thoughts and attitudes when you need to take some important action. The patient writes down on paper in order of priority the thoughts that come to him while making a decision.
Journaling. During the day, the thoughts that arise most often in the patient are recorded. A diary helps you track thoughts that affect your well-being.
Testing negative attitudes in action. If the patient claims that “he is not capable of anything,” the therapist encourages him to first take small successful actions, then complicates the tasks.
Catharsis. A technique for experiencing emotions from a state. If the patient is sad or in self-disagreement, the therapist suggests expressing sadness, for example, by crying.
Imagination. The patient is afraid or unsure of his abilities to take action. The therapist encourages you to imagine and try.
Three Column Method. The patient writes in the columns: situation-negative thought-corrective (positive) thought. The technique is useful for learning the skill of replacing a negative thought with a positive one.
Recording the day's events. The patient may believe that people are aggressive towards him. The therapist suggests keeping a list of observations, where to put “+” “-”, throughout the day with each interaction with people.

Cognitive therapy - exercises

Lasting results and success in therapy are ensured by the consolidation of new constructive attitudes and thoughts. The client completes homework and exercises that the therapist will prescribe: relaxation, tracking pleasant events, learning new behavior and self-change skills. Cognitive psychotherapy and self-confidence exercises are necessary for patients with high anxiety and depression from dissatisfaction with themselves. In the course of developing the desired “self-image,” a person tries on and tries different variants behavior.

Cognitive therapy for social phobia

Fear and high, unreasonable anxiety prevent a person from performing his or her duties normally. social functions. Social phobia is a fairly common disorder. Cognitive psychotherapy for social phobia helps to identify the “benefits” of such thinking. Exercises are selected for the patient’s specific problems: fear of leaving the house, and so on.

Cognitive therapy for addictions

Alcoholism and drug addiction are diseases caused by a genetic factor; sometimes it is a pattern of behavior of people who do not know how to solve problems and see stress relief in the use of psychoactive substances without solving the problems themselves. Cognitive behavioral psychotherapy for addictions is aimed at identifying triggers (situations, people, thoughts) that trigger the mechanism of use. Cognitive therapy successfully helps a person cope with bad habits through awareness of thoughts, working through situations and changing behavior.

Cognitive behavioral therapy - the best books

People cannot always turn to a specialist for help. Techniques and methods of well-known psychotherapists can help you independently move towards solving some problems, but they will not replace the psychotherapist himself. Cognitive behavioral therapy books:

“Cognitive therapy for depression” A. Beck, Arthur Freeman.
“Cognitive psychotherapy for personality disorders” A. Beck.
“Psychotraining according to the Albert Ellis method” A. Ellis.
“The practice of rational-emotional behavioral psychotherapy” A. Ellis.
“Methods of behavioral therapy” V. Meyer, E. Chesser.
“Guide to cognitive behavioral therapy” by S. Kharitonov.

This method of psychotherapy addresses the conscious mind and helps to free ourselves from stereotypes and preconceived ideas that deprive us of freedom of choice and push us to act according to a pattern. The method allows, if necessary, to correct the patient’s unconscious, “automatic” conclusions. He perceives them as truth, but in reality they can greatly distort real events. These thoughts often become a source of painful emotions, inappropriate behavior, depression, anxiety disorders and other diseases.

Operating principle

Therapy is based on working together therapist and patient. The therapist does not teach the patient how to think correctly, but together with him he understands whether the habitual type of thinking helps him or hinders him. The key to success is the active participation of the patient, who will not only have to work during the sessions, but also do homework.

If at the beginning therapy focuses only on the patient’s symptoms and complaints, then gradually it begins to affect unconscious areas of thinking - deep-seated beliefs, as well as childhood events that influenced their formation. The principle of feedback is important - the therapist constantly checks how the patient understands what is happening in therapy and discusses possible errors with him.

Progress

The patient, together with the psychotherapist, finds out under what circumstances the problem manifests itself: how “automatic thoughts” arise and how they affect his ideas, experiences and behavior. In the first session, the therapist only listens carefully to the patient, and in the next they discuss in detail the patient's thoughts and behavior in numerous everyday situations: what does he think about when he wakes up? And at breakfast? The goal is to make a list of moments and situations alarming.

The therapist and patient then outline a program of work. It includes tasks that must be completed in places or circumstances that cause anxiety - riding an elevator, having dinner at public place… These exercises allow you to reinforce new skills and gradually change behavior. A person learns to be less rigid and categorical, to see different facets of a problem situation.

The therapist constantly asks questions and explains points that will help the patient understand the problem. Each session is different from the previous one, because each time the patient moves forward a little and gets used to living in accordance with new, more flexible views without the support of a therapist.

Instead of “reading” other people’s thoughts, a person learns to distinguish between his own, begins to behave differently, and as a result, his emotional state changes. He calms down, feels more alive and free. He begins to be friends with himself and stops judging himself and other people.

In what cases is this necessary?

Cognitive therapy is effective in treating depression, panic attacks, social anxiety, obsessive-compulsive disorder and eating disorders. This method is also used to treat alcoholism, drug addiction and even schizophrenia (as a supportive method). At the same time, cognitive therapy is also suitable for working with low self-esteem, relationship difficulties, perfectionism and procrastination.

It can be used both in individual work and in working with families. But it is not suitable for those patients who are not ready to take an active part in the work and expect the therapist to give advice or simply interpret what is happening.

How long should therapy last? How much does it cost?

The number of meetings depends on the client’s willingness to work, the complexity of the problem and his living conditions. Each session lasts 50 minutes. The course of therapy ranges from 5–10 sessions 1–2 times a week. In some cases, therapy may last longer than six months. A consultation with a cognitive psychologist costs from 2,000 to 4,000 rubles.

History of the method

1913. American psychologist John Watson publishes his first articles on behaviorism. He encourages his colleagues to focus exclusively on studying human behavior, on studying the connection between “external stimulus and external reaction (behavior).”

1960s The founder of rational-emotive psychotherapy, American psychologist Albert Ellis, states the importance of the intermediate link in this chain - our thoughts and ideas (cognitions). His colleague Aaron Beck begins to study the field of cognition. Having assessed the results various methods therapy, he came to the conclusion that our emotions and our behavior depend on the style of our thinking. Aaron Beck became the founder of cognitive behavioral (or simply cognitive) psychotherapy.