The Father of CBT:

Aaron Beck was a psychologist who wanted to help his patients with their mental illnesses. He is known as the Father of Cognitive Behavioral Therapy. He grew up in Providence, Rhode Island and he attended Yale and Brown, and later was hired at the University of Pennsylvania. He has helped to impact mental health positively in his lifetime and passionately helped publish 25 books and 600 articles. Before he passed away he had earned many awards such as the Albert Lasker Award for Clinical Medical Research and the Gustave O. Lienhard Award from the Institute of Medicine among many others. He passed away on November 1st, 2021.

KEY TERMS:

Cognitive Behavioral Therapy (CBT): Psycho-social intervention that aims to reduce symptoms of various mental health conditions.

Psycho-social: Relating to the interrelation of social factors and an individual’s thoughts and behavior.

Co-Occurance: An event or situation that happens at the same time as or in connection with another.

Automatic Thoughts: Maladaptive thoughts that appear to arise reflexively, without conscious deliberation.

Cognitive Behavioral Modification: Approach to CBT that focuses on changing negative self-talk and life narrative to positive self-talk.

Cognitive Distortion/Errors: An exaggerated or irrational thought pattern involved in the onset or perpetuation of psychopathological states.

Arbitrary Inferences: Forming an interpretation of a situation, event, or experience when there is no factual evidence to support the conclusion or when the conclusion is contrary to the evidence.

STRATEGIES TO APPLY CBT:

• Cognitive Restructuring:

• This is a technique that CBT uses to replace negative thoughts and beliefs with more positive thoughts. It aims to help people think more positively and more realistically. It often is used to reevaluate relationships, self-esteem, depressed and anxious thoughts, insomnia, and other stress. There are no specific steps for this strategy, however, many techniques can be applied to target thoughts and replace those that are negative with a more positive mindset. This technique can be helpful for those that may catastrophize, “all or nothing”, overgeneralize, or magnify situations, relationships, or even thoughts.

• Relaxation:

• Relaxation is a good strategy that helps to change a patient's stress levels as well as even help with substance abuse. You can use various relaxation methods to help with stress such as breathing deeply, suggestive (autographic) relaxation, Progressive Relaxation, and Guided Imagery Relaxation. For Breathing Relaxation, focusing on breathing deeply and in a relaxed way helps people to be able to focus their mind and body on things that they can control. In Suggestive/Autographic Relaxation there can be verbal cues given to relax the body. In Progressive Relaxation the mind tells the body to relax one body part at a time. Lastly, Guided Imagery Relaxation has people visually relaxing situations or places within their minds.

• Goal Setting:

• Goals Setting is helpful for individuals who are dealing this any mental health issues that prevent them from having positive thoughts regarding the future. The

• re are 4 steps for creating goals in CBT. They are: 1) Identify your goal, 2) Identify your start point, 3) Identify the steps, and 4) Begin! As you attend sessions of cognitive behavioral therapy, it can be helpful to reflect on your goal setting, make adjustments, and even create more goals for various areas of the patient's life.

• Journaling/Efficacy Journalling:

  • Efficacy Journaling can also be a portion of the journal entries. Efficacy Journaling is when an individual writes openly and honestly, without the fear of judgment. For Journaling to be effective in CBT patients need to use an efficacy journaling mentality as they record daily thoughts/actions.

• Journaling is often used in CBT as a way of reflecting on circumstances and thought patterns. It can be used as a way to track things like behavior, emotions, thoughts, etc. When keeping the journal, patients are asked to think about their automatic negative thoughts and how to improve them in future entries. It aids patients in seeing their thoughts through a new perspective and in becoming more socially aware of their actions.

• Role Play:

• Patients will work with their therapist and role-play various scenarios that trigger the patient’s mental health. Practicing role-playing helps to track negative thoughts in a safe and controlled environment that can target those thoughts and behaviors that are negatively affecting the mental health of the patient. Patients can focus on specific scenarios, and after the therapist is to give specific feedback to the patient on how to better thought patterns and behaviors.

• ABC Analysis:

• The ABC Model uses a good strategy for patients who struggle with mindset and thoughts and beliefs that are harmful to increasing positive mental health. The ABC Model stands for A- Adversity or activating event, B- Beliefs about the events, and obvious and underlying thoughts about situations, yourself, and others, C- Consequences as well as the behavioral and emotional response of the patient. The overall goal is to target and change irrational thoughts and to create better responses to those.

• Thought Recording/ Identifying Negative Thoughts:

  • What happened? (the situation)

  • How did this make you feel at first? (the emotions)

  • What are some unhelpful thoughts I had? (Thought/Mindset)

  • What fueled these unhelpful thoughts? (Evidence)

  • What makes these unhelpful thoughts a lie? (Counter-Evidence)

  • What thoughts can I use to replace these thoughts? (Better Mindset)

  • How have feelings and thoughts since changed? (Changed Mindset)

• For thought recording, various prompts can be used. These prompts include:

• These prompts can be reflected on and referred to in future sessions to see growth and patterns in negative thought processes.

• Exposure Therapy:

• Exposure Therapy is often used in counseling to also help manage emotions while in a situation. It can be especially helpful for those with phobias and OCD. First, you start with items, behaviors, or situations that cause emotions that are uncomfortable, but that you are able to manage. You then can focus on time and frequency to increase exposure and handling emotions. By starting with something that is controllable and then shifting to something more difficult you can work on targeting specific areas.

STUDIES DONE ON IT:

“The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses”

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/ 

• This is a Review of 269 Meta-Analysis that studied the effectiveness of CBT for various mental health issues. These studies also contained various size samples, methodology, and limitations. Some of the more notable results showed the following:

1. Those struggling with substance abuse benefited from more sessions of CBT rather than just one. It also was more effective depending on the substance that was being abused.

2. A positive, medium effect size was found regarding Schizophrenia and CBT sessions.

3. For depression, it was found that CBT had an equal effect as other kinds of therapy.

4. For Biopolar patients, the effect of CBT was small to medium effect size and often decreased at follow-up inquiries.

5. Anxiety disorders had significant positive effects from CBT sessions. It had medium to large effect sizes. Even post-CBT sessions showed even more improvement.

“Effect of a Cognitive-Behavioral Prevention Program on Depression 6 Years After Implementation Among At-Risk Adolescents”

Source:https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2443408 

• This was a Randomized Clinical Trial that wanted to see if CBT was an effective treatment for depressed patients. They used 4 different trial groups. Some of the main findings were:

1. During the trial, it took 75 months to gather data from 316 teenagers.

2. 4 separate test areas

3. Part of this study focuses on how the participant's parent's depression may affect the participant and if CBT can reverse that.

4. They tried to attempt a zero-skewed data sample collection.

“Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: Acute Outcomes”

Source:https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2015.14101293 

• This was a study that was conducted to see if CBT was more effective than light therapy for seasonal-affected disorder (SAD).

1. They used a Randomized Clinical Trial and the law of large numbers, and this study has been successfully replicated.

2. It was found that both Light Therapy and CBT were effective choices for SAD and could both be effective for those struggling.

3. It was found that those remission rates were not affected by CBT or Light Therapy respectively. Therefore, neither affected the participants negatively.

4. After the 6 week study, there were no significant differences found in the compared benefits of CBT versus Light Therapy. Therefore, both were found to be plausible options for those suffering from SAD.

5. However, some of the limitations found in the study were a racially homogeneous sample, some elements may lead to a regression of patients, but this study is only concerned about the newest data after the study, so no long-term effects are taken into account.

ADDITIONAL RESOURCES (PAPERS, WEBSITES, VIDEOS):

• This video breaks down CBT and gives a good overview and example of CBT: https://youtu.be/Jz55Uk9EH6U?feature=shared 

• Here is another short explanation video: https://youtu.be/bMI0riMVhJg?feature=shared 

• Here is a video that role-plays what a CBT therapy session would look like: https://youtu.be/8-2WQF3SWwo?feature=shared 

• This video is a real example of a CBT session for a patient with depression: https://youtu.be/7LD8iC4NqXM?feature=shared 

• This video is a CBT session for a patient with Social Anxiety: https://youtu.be/XH2tF8oB3cw?feature=shared 

• Here is a video about how/why CBT works: https://youtu.be/0ViaCs0k2jM?feature=shared 

HOW CBT APPLIES TO TEACHING:

• CBT techniques can be implemented into teaching and problem-solving in the classroom. (This does NOT mean giving therapy to students!) For example, in an article titled, “CBT in the classroom. CBT in an Educational setting” they suggest teachers use, “. . .explicit teaching, modeling, role-play, feedback, reinforcement, and also cognitive aspects like cognitive modeling.” These can help our students to implement better communication, emotional responses, and problem-solving skills as they work on assignments. Students can use these skills in social and academic settings. The article also notes that the results of CBT techniques implemented in the classroom include, “self-regulation, less maladjusted reactions/behaviors such as aggression, anxiety, and emotional well-being.”
  

Podcast Episodes to check out:

“MyCBT with Dr. Julie Osborn: Labeling Yourself & CBT:”

https://open.spotify.com/episode/0ADLOPxSUZnluYfRgcb1XO?si=Cf8X-5cSTlqsxqSuGg9hSg 

This one talks about how we label ourselves and why we do that with our Mental Health but not medical symptoms. She discusses how to change that mindset using CBT tools. She gives various tips and tools during the podcast that you can try in real time!

The Brain People Podcast: 011 How to Change Your Thoughts- CBT Basics: https://open.spotify.com/episode/5SnxUQftn5yn3wE15FB2jL?si=fz7jD_ujRs6_hIHwnWNQxw 

This podcast gives a brief explanation of the history of CBT, what it is, and how it can be used. They discuss how important it is to think about the thoughts that lead to behaviors and emotions. They discussed some of the strategies and tools that people can use in CBT.

**If you liked some of these podcasts there are so many more options on Spotify and other streaming platforms.**

What is CBT? (SAS)

Stands for Cognitive Behavioral Therapy

Uses various strategies like journaling, exposure therapy, and other treatments

Targets thought patterns to make changes in behavior

Stands for Cognitive Biological Theories

Can only be used for Anxiety and Depression

Has NO research or data to support its effectiveness

Who was the “Father of CBT”?

Aaron Beck

Jean Piaget

Lawrence Kohlberg and Carol Gilligan

Erik Erikson

In the ABC Therapy Technique of CBT, what does ABC stand for?

Antecedent, Belief, Consequence

Automatic, Biological, Cognition

Aces, Belonging, Cortisol

Ability, Belief, Conformity

What are some of the benefits of CBT? (SATA)

Decrease in Mental Health Symptoms/Effects

Targets negative thought processes

Helps with Substance Abuse

Increase in Mental Health symptoms/effects

Targets negative thought processes

Helps with Substance Abuse

No medication is neede for mental health

It is more effective than othneededer therapies like Light Therapy or other counseling techniques

Increases risks of aggression, depression, and spontaneity.