Cognitive Behavior Therapy

Cognitive therapy, also know as cognitive behavior therapy, is a uniquely effective treatment for both anxiety disorders and depression. It is also highly effective as a treatment for sexual dysfunctions and eating disorders and can be beneficial for anyone who wants to improve their overall sense of emotional well-being. It is clearly the treatment of choice for anxiety disorders with numerous treatment outcome studies showing it to provide the greatest improvement with the most lasting results. Most people can be helped with short-term therapy usually from 5-15 sessions.

Cognitive behavior therapy combines two great therapeutic traditions those of cognitive therapy and behavior therapy.

Cognitive therapy, developed by Aaron Beck M.D., focuses on changing dysfunctional thinking patterns and is based on the fact that there is a very close relationship between emotional distress and irrational thinking. Each negative emotional state has a specific pattern of distorted thinking which is the key factor in perpetuating it. For example, when people have panic attacks they typically have thoughts such as:

• "What if I go crazy or lose control?"
• "What if I have a heart attack or stop breathing?"
• "What if I faint?"

When people get depressed they typically have distorted negative thoughts about their self-worth, the world, and the future.

Cognitive therapy teaches you how to recognize and free yourself from such distorted thinking which results in relief from emotional suffering. Cognitive therapy also helps you to give up underlying irrational beliefs such as the idea that you need everyone’s approval or that you should be perfect or should always be in control of things.

Behavior therapy, developed by Joseph Wolpe M.D., sees anxiety disorders as the result of maladaptive anxiety acquired through experience most often by means of conditioning, and it focuses on desensitizing anxiety through corrective learning. This is most often achieved through exposure therapy which means exposure to the situations that are feared. Exposure therapy is the single most effective treatment for phobias with very dramatic and lasting results often achieved in a very short time. It is also the treatment of choice for agoraphobia and in fact is the only way that agoraphobia can be overcome. Behavior therapy also includes such helpful techniques as assertive training, social skills training, and exposure through imagery.

Many if not most people today are treated with medication alone for anxiety disorders and depression. In the case of anxiety disorders this is clearly not the best treatment and is much less likely to result in a lasting resolution of the problem. Treatment outcomes studies with anxiety disorders clearly show that cognitive behavior therapy gets the best long-term results and can lead to full resolution of symptoms with short-term therapy. 

While medication sometimes results in significant symptom relief, relapse rates are high when medication is discontinued in contrast to CBT where therapeutic gains are lasting with very low relapse rates. 

Unfortunately, many people who might have fully overcome an anxiety problem with CBT end up taking medication for years or even for life. With CBT the idea is to help people overcome their problem with no further therapy needed and not to keep them indefinitely in treatment. 

In the case of depression, some people do well with medication alone, but a common finding is that with cognitive therapy the results may be more enduring and without the side effects and potential risks of drugs.