About all

Cognitive behavioral strategies: Tools for Cognitive Behavioral Therapy

Tools for Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a common form of talk therapy. Unlike some other therapies, CBT is typically intended as a short-term treatment, taking anywhere from a few weeks to a few months to see results.

Although the past is certainly relevant, CBT focuses on providing you with tools to solve your current problems. And there a lot of ways to get there with this type of therapy.

Here’s a look at some of the techniques used in CBT, what types of issues they address, and what to expect with CBT.

The key principle behind CBT is that your thought patterns affect your emotions, which, in turn, can affect your behaviors.

For instance, CBT highlights how negative thoughts can lead to negative feelings and actions. But, if you reframe your thoughts in a more positive way, it can lead to more positive feelings and helpful behaviors.

Your therapist will teach you how to make changes you can implement right now. These are skills you can continue to use for the rest of your life.

Depending on the issue you’re dealing with and your goals, there are several ways to approach CBT. Whatever approach your therapist takes, it will include:

  • identifying specific problems or issues in your daily life
  • becoming aware of unproductive thought patterns and how they can impact your life
  • identifying negative thinking and reshaping it in a way that changes how you feel
  • learning new behaviors and putting them into practice

After speaking with you and learning more about the issue you want help with, your therapist will decide on the best CBT strategies to use.

Some of the techniques that are most often used with CBT include the following 9 strategies:

1. Cognitive restructuring or reframing

This involves taking a hard look at negative thought patterns.

Perhaps you tend to over-generalize, assume the worst will happen, or place far too much importance on minor details. Thinking this way can affect what you do and it can even become a self-fulfilling prophecy.

Your therapist will ask about your thought process in certain situations so you can identify negative patterns. Once you’re aware of them, you can learn how to reframe those thoughts so they’re more positive and productive.

For example: “I blew the report because I’m totally useless” can become “That report wasn’t my best work, but I’m a valuable employee and I contribute in many ways.”

2. Guided discovery

In guided discovery, the therapist will acquaint themselves with your viewpoint. Then they’ll ask questions designed to challenge your beliefs and broaden your thinking.

You might be asked to give evidence that supports your assumptions, as well as evidence that does not.

In the process, you’ll learn to see things from other perspectives, especially ones that you may not have considered before. This can help you choose a more helpful path.

3. Exposure therapy

Exposure therapy can be used to confront fears and phobias. The therapist will slowly expose you to the things that provoke fear or anxiety, while providing guidance on how to cope with them in the moment.

This can be done in small increments. Eventually, exposure can make you feel less vulnerable and more confident in your coping abilities.

4. Journaling and thought records

Writing is a time-honored way of getting in touch with your own thoughts.

Your therapist may ask you to list negative thoughts that occurred to you between sessions, as well as positive thoughts you can choose instead.

Another writing exercise is to keep track of the new thoughts and new behaviors you put into practice since the last session. Putting it in writing can help you see how far you’ve come.

5. Activity scheduling and behavior activation

If there’s an activity you tend to put off or avoid due to fear or anxiety, getting it on your calendar can help. Once the burden of decision is gone, you may be more likely to follow through.

Activity scheduling can help establish good habits and provide ample opportunity to put what you’ve learned into practice.

6. Behavioral experiments

Behavioral experiments are typically used for anxiety disorders that involve catastrophic thinking.

Before embarking on a task that normally makes you anxious, you’ll be asked to predict what will happen. Later, you’ll talk about whether the prediction came true.

Over time, you may start to see that the predicted catastrophe is actually not very likely to happen. You’ll likely start with lower-anxiety tasks and build up from there.

7. Relaxation and stress reduction techniques

In CBT, you may be taught some progressive relaxation techniques, such as:

  • deep breathing exercises
  • muscle relaxation
  • imagery

You’ll learn practical skills to help lower stress and increase your sense of control. This can be helpful in dealing with phobias, social anxieties, and other stressors.

8. Role playing

Role playing can help you work through different behaviors in potentially difficult situations. Playing out possible scenarios can lessen fear and can be used for:

  • improving problem solving skills
  • gaining familiarity and confidence in certain situations
  • practicing social skills
  • assertiveness training
  • improving communication skills

9. Successive approximation

This involves taking tasks that seem overwhelming and breaking them into smaller, more achievable steps. Each successive step builds upon the previous steps so you gain confidence as you go, bit by bit.

In your first session, you’ll help the therapist understand the problem you’re dealing with and what you hope to achieve with CBT. The therapist will then formulate a plan to achieve a specific goal.

Goals should be:

  • Specific
  • Measurable
  • Achievable
  • Realistic
  • Time-limited

Depending on your situation and your SMART goals, the therapist might recommend individual, family, or group therapy.

Sessions generally last about an hour and take place once a week, though this can vary according to individual needs and availability.

Homework is also part of the process, so you’ll be asked to fill out worksheets, a journal, or perform certain tasks between sessions.

Open communication and feeling comfortable with your therapist are key. If you don’t feel completely comfortable with your therapist, try to find a therapist you can connect with and open up to more easily.

Look for a therapist who’s trained in CBT and who has experience treating your specific problem. Check to make sure they’re properly certified and licensed.

You may want to talk to your doctor or other healthcare providers for recommendations. Practitioners may include:

  • psychiatrists
  • psychologists
  • psychiatric nurse practitioners
  • social workers
  • marriage and family therapists
  • other professionals with mental health training

Most of the time, CBT takes a few weeks to a few months to start seeing results.

CBT can help with a variety of everyday problems, such as learning to cope with stressful situations or dealing with anxiety over a certain issue.

You don’t need a medical diagnosis to benefit from CBT.

It can also help with:

  • learning to manage powerful emotions like anger, fear, or sadness
  • dealing with grief
  • managing symptoms or preventing mental illness relapses
  • coping with physical health problems
  • conflict resolution
  • improving communication skills
  • assertiveness training

CBT can be effective for a variety of conditions, either alone or in combination with other therapies or medications. This includes:

  • addictions
  • anxiety disorders
  • bipolar disorders
  • chronic pain
  • depression
  • eating disorders
  • obsessive-compulsive disorder (OCD)
  • phobias
  • post-traumatic stress disorder (PTSD)
  • schizophrenia
  • sexual disorders
  • sleep disorders
  • tinnitus

CBT is not generally considered a risky therapy, though there are some things to keep in mind:

  • It’s a very individual thing, but in the beginning, some people might find it stressful or uncomfortable to confront their problems.
  • Some types of CBT, like exposure therapy, can increase stress and anxiety while you’re working your way through it.
  • It doesn’t work overnight. It takes commitment and willingness to work on new techniques between sessions and after therapy has ended. It’s helpful to think of CBT as a lifestyle change that you intend to follow and improve upon throughout your life.

Cognitive behavioral therapy (CBT) is a well-established, effective type of short-term therapy. It’s based on the connections between your thoughts, emotions, and behaviors, and how they can influence each other.

There are quite a few techniques that are used with CBT. Depending on the type of issue you want help with, your therapist will help figure out which CBT strategy is best suited to your particular needs.

Tools for Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a common form of talk therapy. Unlike some other therapies, CBT is typically intended as a short-term treatment, taking anywhere from a few weeks to a few months to see results.

Although the past is certainly relevant, CBT focuses on providing you with tools to solve your current problems. And there a lot of ways to get there with this type of therapy.

Here’s a look at some of the techniques used in CBT, what types of issues they address, and what to expect with CBT.

The key principle behind CBT is that your thought patterns affect your emotions, which, in turn, can affect your behaviors.

For instance, CBT highlights how negative thoughts can lead to negative feelings and actions. But, if you reframe your thoughts in a more positive way, it can lead to more positive feelings and helpful behaviors.

Your therapist will teach you how to make changes you can implement right now. These are skills you can continue to use for the rest of your life.

Depending on the issue you’re dealing with and your goals, there are several ways to approach CBT. Whatever approach your therapist takes, it will include:

  • identifying specific problems or issues in your daily life
  • becoming aware of unproductive thought patterns and how they can impact your life
  • identifying negative thinking and reshaping it in a way that changes how you feel
  • learning new behaviors and putting them into practice

After speaking with you and learning more about the issue you want help with, your therapist will decide on the best CBT strategies to use.

Some of the techniques that are most often used with CBT include the following 9 strategies:

1. Cognitive restructuring or reframing

This involves taking a hard look at negative thought patterns.

Perhaps you tend to over-generalize, assume the worst will happen, or place far too much importance on minor details. Thinking this way can affect what you do and it can even become a self-fulfilling prophecy.

Your therapist will ask about your thought process in certain situations so you can identify negative patterns. Once you’re aware of them, you can learn how to reframe those thoughts so they’re more positive and productive.

For example: “I blew the report because I’m totally useless” can become “That report wasn’t my best work, but I’m a valuable employee and I contribute in many ways.”

2. Guided discovery

In guided discovery, the therapist will acquaint themselves with your viewpoint. Then they’ll ask questions designed to challenge your beliefs and broaden your thinking.

You might be asked to give evidence that supports your assumptions, as well as evidence that does not.

In the process, you’ll learn to see things from other perspectives, especially ones that you may not have considered before. This can help you choose a more helpful path.

3. Exposure therapy

Exposure therapy can be used to confront fears and phobias. The therapist will slowly expose you to the things that provoke fear or anxiety, while providing guidance on how to cope with them in the moment.

This can be done in small increments. Eventually, exposure can make you feel less vulnerable and more confident in your coping abilities.

4. Journaling and thought records

Writing is a time-honored way of getting in touch with your own thoughts.

Your therapist may ask you to list negative thoughts that occurred to you between sessions, as well as positive thoughts you can choose instead.

Another writing exercise is to keep track of the new thoughts and new behaviors you put into practice since the last session. Putting it in writing can help you see how far you’ve come.

5. Activity scheduling and behavior activation

If there’s an activity you tend to put off or avoid due to fear or anxiety, getting it on your calendar can help. Once the burden of decision is gone, you may be more likely to follow through.

Activity scheduling can help establish good habits and provide ample opportunity to put what you’ve learned into practice.

6. Behavioral experiments

Behavioral experiments are typically used for anxiety disorders that involve catastrophic thinking.

Before embarking on a task that normally makes you anxious, you’ll be asked to predict what will happen. Later, you’ll talk about whether the prediction came true.

Over time, you may start to see that the predicted catastrophe is actually not very likely to happen. You’ll likely start with lower-anxiety tasks and build up from there.

7. Relaxation and stress reduction techniques

In CBT, you may be taught some progressive relaxation techniques, such as:

  • deep breathing exercises
  • muscle relaxation
  • imagery

You’ll learn practical skills to help lower stress and increase your sense of control. This can be helpful in dealing with phobias, social anxieties, and other stressors.

8. Role playing

Role playing can help you work through different behaviors in potentially difficult situations. Playing out possible scenarios can lessen fear and can be used for:

  • improving problem solving skills
  • gaining familiarity and confidence in certain situations
  • practicing social skills
  • assertiveness training
  • improving communication skills

9. Successive approximation

This involves taking tasks that seem overwhelming and breaking them into smaller, more achievable steps. Each successive step builds upon the previous steps so you gain confidence as you go, bit by bit.

In your first session, you’ll help the therapist understand the problem you’re dealing with and what you hope to achieve with CBT. The therapist will then formulate a plan to achieve a specific goal.

Goals should be:

  • Specific
  • Measurable
  • Achievable
  • Realistic
  • Time-limited

Depending on your situation and your SMART goals, the therapist might recommend individual, family, or group therapy.

Sessions generally last about an hour and take place once a week, though this can vary according to individual needs and availability.

Homework is also part of the process, so you’ll be asked to fill out worksheets, a journal, or perform certain tasks between sessions.

Open communication and feeling comfortable with your therapist are key. If you don’t feel completely comfortable with your therapist, try to find a therapist you can connect with and open up to more easily.

Look for a therapist who’s trained in CBT and who has experience treating your specific problem. Check to make sure they’re properly certified and licensed.

You may want to talk to your doctor or other healthcare providers for recommendations. Practitioners may include:

  • psychiatrists
  • psychologists
  • psychiatric nurse practitioners
  • social workers
  • marriage and family therapists
  • other professionals with mental health training

Most of the time, CBT takes a few weeks to a few months to start seeing results.

CBT can help with a variety of everyday problems, such as learning to cope with stressful situations or dealing with anxiety over a certain issue.

You don’t need a medical diagnosis to benefit from CBT.

It can also help with:

  • learning to manage powerful emotions like anger, fear, or sadness
  • dealing with grief
  • managing symptoms or preventing mental illness relapses
  • coping with physical health problems
  • conflict resolution
  • improving communication skills
  • assertiveness training

CBT can be effective for a variety of conditions, either alone or in combination with other therapies or medications. This includes:

  • addictions
  • anxiety disorders
  • bipolar disorders
  • chronic pain
  • depression
  • eating disorders
  • obsessive-compulsive disorder (OCD)
  • phobias
  • post-traumatic stress disorder (PTSD)
  • schizophrenia
  • sexual disorders
  • sleep disorders
  • tinnitus

CBT is not generally considered a risky therapy, though there are some things to keep in mind:

  • It’s a very individual thing, but in the beginning, some people might find it stressful or uncomfortable to confront their problems.
  • Some types of CBT, like exposure therapy, can increase stress and anxiety while you’re working your way through it.
  • It doesn’t work overnight. It takes commitment and willingness to work on new techniques between sessions and after therapy has ended. It’s helpful to think of CBT as a lifestyle change that you intend to follow and improve upon throughout your life.

Cognitive behavioral therapy (CBT) is a well-established, effective type of short-term therapy. It’s based on the connections between your thoughts, emotions, and behaviors, and how they can influence each other.

There are quite a few techniques that are used with CBT. Depending on the type of issue you want help with, your therapist will help figure out which CBT strategy is best suited to your particular needs.

Strategies of cognitive-behavioral psychotherapy in the rehabilitation of polydrug addiction // Counseling psychology and psychotherapy – 2015. Volume 23. No. 2

Counseling psychology and psychotherapy
2015. Volume 23. No. 2. P. 93–115
doi:10.17759/cpp.2015230206

ISSN: 2075-3470 / 2311-9446 (online)

‘;
for (var i = 0; i


8478

Abstract

Over the past few years, cognitive behavioral therapy aimed at preventing and minimizing relapse has proven to be the most effective treatment for substance dependence (opium addiction, cocaine addiction, cannabisism and polydrug addiction). This article describes psychotherapeutic protocols for the treatment of polydrug addiction. The integrative principles of short-term cognitive-behavioral psychotherapy along with motivational therapy, psychoeducation and systemic family therapy are given. The steps of conducting a motivational interview, a functional analysis of problem behavior, teaching social skills and techniques to overcome negative stress based on the principle of awareness are presented. Particular attention is paid to the prevention of relapses in patients with polydrug addiction.

Keywords: cognitive behavioral therapy, polydrug addiction, rehabilitation, drug addiction, motivational interview, coping skills

Publication heading: Workshop and methods

Material type: scientific article

DOI: https://doi.org/10.17759/cpp.2015230206

For quote:
Melekhin A.I., Veselkova Yu.V. Strategies of cognitive-behavioral psychotherapy in the rehabilitation of polydrug addiction // Counseling Psychology and Psychotherapy. 2015. Volume 23. No. 2. P. 93–115. DOI: 10.17759/cpp.2015230206

Excerpt from article

Originally Cognitive Behavioral Therapy
drug addiction was developed as a way to prevent relapse in
alcohol-dependent patients in order to teach patients to avoid or
overcome high levels of stress. Later focus of attention of specialists
switched to patients who use cocaine [Samp, Kadden, 2001].

Literature

  1. Buisman V. Cognitive behavioral interventions in therapy
    addiction to psychoactive substances / Guidelines for conducting trainings. M.:
    UNODC, 2007. 57 p.
  2. Garanyan N.G., Kholmogorova A.B. Integration of family system and
    cognitive-behavioral psychotherapy in the treatment of patients with chronic
    forms of anxiety disorders // Journal of the Association of Psychiatrists
    Ukraine”. 2013. No. 4.
  3. McMullin R. Workshop on Cognitive Therapy / Per. from English. St. Petersburg:
    Rech, 2001. 560 p.
  4. Psychological health of the individual and spiritual and moral problems
    modern Russian society / Ed. A.L. Zhuravleva, M.I. Volovikova,
    T.V. Galkin. M: IP RAN, 2014.
  5. Sweet K. Jump off the hook / St. Petersburg: Peter Press, 1997. 256 p.
  6. Sommers-Flanagan D. Clinical interview / 3rd edition. Per. from English.
    M.: Williams Publishing House, 2006. 672 p.
  7. Kharitonov S.V. Fundamentals of behavioral psychotherapy / M .: GEOTAR-Media,
    2015. 128 p.
  8. Kharitonov S.V. Manual of Cognitive Behavioral Therapy
    / M.: Psychotherapy, 2009. 176 p.
  9. Kharitonov S.V. Rehabilitation system for patients with personality disorders
    disorders by methods of cognitive and rational psychotherapy. Diss. … doc.
    honey. Sciences. M., 2013. 279 p.
  10. A Cognitive-behavioral approach: Treating cocaine addiction / Ed. K.M.
    Carroll. National Institutes of Health. 1998.137p.
  11. Bayles C. Using mindfulness in a harm reduction approach to
    substance abuse treatment: A literature review // International journal of
    behavioral consultation and therapy. 2014. Vol. 9. No. 2.
  12. Brief Interventions and Brief Therapies for Substance Abuse // Treatment
    Improvement Protocol (TIP) / Center for Substance Abuse Treatment. rockville
    (MD): Substance Abuse and Mental Health Services Administration (US). 1999. No.
    34.
  13. Cannabis Youth Treatment Series // Ed. by Susan Samp, Ronald Kadden. Center
    for Substance Abuse Treatment. 2001 Vol. 1.156p.
  14. Gonzalez V.M. The Role of Homework in Cognitive-Behavioral Therapy
    for Cocaine Dependence // Journal of Consulting and Clinical Psychology. 2006.
    Vol. 74. no. 3. P. 633-637.
  15. Himelstein S. Mindfulness-Based Substance Abuse Treatment for
    Incarcerated Youth: A Mixed Method Pilot Study // International Journal of
    transpersonal studies. 2011 Vol. 30.
  16. Kadden R. M. Cognitive-behavior therapy for substance dependence:
    coping skills training / University of Connecticut. 2001. 28 p.
  17. Marcus M ., Zgierska A . Mindfulness Based
    Therapies for Substance Use Disorders: Part 1 (Editorial) // Subst Abus. 2009.
    Vol. 30. No. 4. P. 263.
  18. McHugh R., Hearon B . Cognitive-Behavioral Therapy for
    Substance Use Disorders // Psychiatr Clin North Am. 2010 Vol. 33. No. 3.
  19. Moyers T.B., Houck J. Combining Motivational Interviewing With
    Cognitive-Behavioral Treatments for Substance Abuse: Lessons From the COMBINE
    Research Project // Cognitive and Behavioral Practice. 2011 Vol. 18.P.
    38-45.
  20. Ouimette P . Twelve-Step and Cognitive-Behavioral Treatment for
    Substance Abuse: A Comparison of Treatment Effectiveness // Journal of
    Consulting and Clinical Psychology. 1997 Vol. 65. no. 2. P. 230-240.
  21. Petitjean S.A. A randomized, controlled trial of combined
    cognitive-behavioral therapy plus prize-based contingency management for
    cocaine addiction // Drug and Alcohol Dependence. 2014. Vol. 145.p.
    94-100.
  22. Standard and Innovative Strategies in Cognitive Behavior Therapy // Ed. by
    Irismar Reis de Oliveira, InTech. 2012. 202 p.
  23. Witkiewitz K., Bowen S. Depression, craving, and substance use
    following a randomized trial of mindfulness-based relapse prevention // J
    Consult Clinic Psychol. 2010 Vol. 78. No. 3. P. 362-374.
  24. Zgierska A ., Rabago D. Mindfulness Meditation for
    Substance Use Disorders: A Systematic Review // Subst Abus. 2009 Vol. 30. No.
    4.

Melekhin Alexey Igorevich, Candidate of Psychological Sciences, Associate Professor, Humanitarian Institute named after P.A. Stolypina, clinical psychologist of the highest qualification category, somnologist, cognitive behavioral psychotherapist, Moscow, Russia, ORCID: https://orcid.org/0000-0001-5633-7639, e-mail: [email protected]

Veselkova Yuliya Vladimirovna, clinical psychologist, Center for Psychological Rehabilitation and Social Adaptation “KEYS”, Moscow, Russia, e-mail: juisv@mail. ru

Metrics

Views

Total: 4903
Last month: 21
This month: 13

Downloads

Total: 8478
Last month: 10
This month: 7

PlumX

Publication metrics

The Importance of Assessing Client Coping Strategies – Practical Health Psychology

Nadja Garnefsky, Vivian Kraay, Department of Clinical Psychology, Leiden University, The Netherlands

“Rob just found out he has HIV (negative event). He thinks he is the one to blame for this (self-blame), and he avoids meeting friends (avoidance). This situation made him sad. When Rob is at home, he can’t stop thinking about his feelings (rumination) and considers what happened to be a complete disaster (catastrophizing). Because he is sad, he has little energy. As a result, he avoids communication even more, which makes him even sadder. Thus, Rob is drawn into a vicious circle.”

People experience a range of strong emotions in response to negative life events. To cope with these emotions, people can use a variety of cognitive and behavioral strategies. This process is called coping. Lazarus defined coping as an individual’s efforts to cope with stress caused by harm, threat or challenge. In Rob’s case, the negative event was the news of his positive HIV status. Many other stressful events can happen, from single events such as the death of a loved one, divorce, or loss of a job, to long-term events such as bullying, high workloads, and relationship problems. Thus, coping is applicable to all kinds of life stresses.

Coping strategies can be divided into cognitive (“what do you think”) and behavioral (“what do you do”). An example of a cognitive coping strategy is self-blame. People who use this coping strategy blame themselves for what they went through (Rob blamed himself for contracting HIV). Other examples of cognitive strategies are rumination and catastrophizing. Rumination is the repeated reflection on the emotions, thoughts, and feelings associated with a negative experience. Catastrophizing means focusing too much on the destructive aspects of what happened. Rob resorted to all these strategies. Other cognitive strategies are blaming others, accepting, refocusing on more pleasant things, planning your steps, re-evaluating or giving the event a positive value, and putting the event in perspective (in comparison to other, worse events). In total, 9cognitive coping strategies. An example of a behavioral coping strategy is avoidance – avoiding situations and social contacts, which was also observed in Rob. Other behavioral coping strategies include seeking distraction, taking action to cope with the experience, seeking social support, and ignoring—behaving as if nothing had happened. So, in total, 5 behavioral coping strategies are described.

To assess cognitive and behavioral coping strategies, 2 instruments were created and validated – the Cognitive Emotion Regulation Questionnaire (CERQ) and the Behavioral Emotion Regulation Questionnaire (BERQ). CERQ has already been translated and validated in many languages, and BERQ is being actively translated.

Studies that have examined the role of cognitive and behavioral coping strategies using CERQ and BERQ have identified useful and less useful strategies. Among cognitive strategies, rumination, catastrophizing, and self-blame were found to be less useful than positive reappraisal, putting the situation into perspective, and refocusing on the positive. In terms of behavioral strategies, avoidance and ignorance are less helpful than distraction, action, and seeking social support. These are general conclusions; in a particular stressful situation, another can be observed.

Knowledge of the client’s specific cognitive and behavioral coping strategies can help to understand the vicious circle of psychological problems and can suggest ways to change maladaptive patterns and build more adaptive ones.

“Rob has started therapy. The therapist assessed Rob’s cognitive and behavioral coping strategies and found high scores for self-blame, rumination, catastrophizing, and avoidance.