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Cognitive Behavioral Therapy

CBT Helps Your Happiness & Your Therapy

The most broadly practiced therapy in the world isn't difficult to acquire

Most years, the demand for therapists who accept EAP or insurance is high. Now, The New York Times reports that mental health providers struggle to meet the exceptional demand for appointments1. Additionally, clinicians must prevent compassion fatigue more than ever before so that they can support their caseloads.

What to do, waiting on a therapy list

First, if you feel you would harm yourself or another, this qualifies as a clinical emergency. You must call 9-1-1 or go to your nearest emergency department.

Second, reach out to a mental health provider and perhaps your primary care physician (PCP) to obtain a medication consult.

 L. Oberlin/Covers with publisher permission
CBT resources abound and can only help before, during, and after treatment
Source: L. Oberlin/Covers with publisher permission

Third, and this applies if you’ve begun sessions, learn more here to enhance outcomes before, during, and after appointments.

CBT Made Simple

Overcoming Passive-Aggression: How to Stop Hidden Anger From Spoiling Your Relationships, Career, and Happiness reports that “with CBT, clients analyze automatic thoughts (built out of family of origin schemas), recognize cognitive errors, craft positive reframes, and behaviorally learn and practice new skill sets.”2 The cognitive part applies to thoughts; behaviors are your choices and actions. If you work on thoughts or behaviors, preferably both, they influence one another.

For example, if you begin to exercise, take a short daily walk, or ride a bike for 10-20 minutes, you will likely begin to think more positively about exercise. Similarly, if you begin to reframe negative thoughts into can-do, let-me-try-it beliefs, you will likely engage in more frequent exercise.

Judith S. Beck, Ph.D., grew up listening to her father, Aaron T. Beck, M.D., expound about cognitive therapy in the 1960s. Today, it’s used synonymously with cognitive behavior therapy (CBT). Dr. Aaron Beck saw this as a shorter, present-oriented therapy for the anxiety or sadness clients often present with.

Albert Ellis, Ph.D., was another cognitive therapy pioneer, stating similar concepts but using different words. Whereas Beck says we resort to assumptions called "automatic thoughts," Ellis believed that we fall prey to irrational beliefs.

Dysfunctional thinking is actually common. When stressed, many of us resort to a cognitive (thinking) error, the list presented in many psychology-based books. “When people learn to evaluate their thinking in a more realistic and adaptive way, they experience a decrease in negative emotion and maladaptive behavior,” Dr. Judith Beck writes in Cognitive Behavior Therapy: Basics and Beyond, 3rd Edition.3

Incorporating CBT into Everyday Life

Ask yourself if you reply upon all-or-nothing thinking, catastrophize, magnify or minimize problems, discount the positive, personalize, jump to conclusions, label, blame, or overgeneralize—common “thinking errors.” Selective abstraction is another, along with emotional reasoning, which my co-author and I call “feelthink” in our two books.

Write down your automatic thought or irrational belief. If you follow Beck, check out the evidence for that thought. Is there another explanation for it?

Using the Ellis A-B-C-D Model, identify the Activating Event that triggered your Belief. Look at the Consequence (actions or emotions) that resulted. Finally, learn to Dispute your irrational belief and set more realistic expectations in the future.

Both of the pioneering models help us to ruminate less, replacing negative self-talk with positive affirmations and mantras.

Overcoming Passive-Aggression is full of multicultural examples depicting both genders and all ages. Elena is a young woman who swore she sought jobs despite a recession; however, her parents, Mateo and Marcela, often found their daughter sprawled on the couch, electronic gadgets in hand, her chores long forgotten.

We discuss my whiteboard approach with three columns. “My parents want me to get a job” falls under the first: Stuff That Happens. “I might not know the job” or “I might get fired” both go in the second My Mantra column, and “I’d probably get some training” goes under the Better Reframe column.4

Here we have Elena’s dysfunctional thoughts, what she tells herself that stalls forward or positive behavior, and how she can see a new perspective. While it sounds easy, having the help of a therapy professional to teach CBT, given your situation often leads to more mastery.

Self-Help Resources to Guide You and Your Children

I recommend Cognitive Behavioral Therapy (Foreman & Pollard) to my clients as a short primer when dealing with anxiety or low-grade mood. The Worry Decision Tree is a very good behavioral exercise with questions, the answers of which lead to other inquiries and concrete steps. One step is letting go and distraction.5

Full Picture blogs, such as the "One Pandemic Stress Reducer You Should Put to Use," "Surviving & Thriving the Pandemic Indoors Again," and "A Dozen Mindful Distractions," suggest concrete strategies.

The younger the child, the more behavioral the work. As their capacity to think grows with age, more thought work can be accomplished, and kids are not as disadvantaged by lack of life experience to properly weigh their feelings.

In The Angry Child, Dr. Tim Murphy provides explains “feelthink,” a common error that angry or anxious children employ when they confuse feelings with fact. They operate with only emotion as the sole data needed to draw a conclusion. Hence, angry children assume their emotions are accurate and justify strong responses even if the reality of the situation doesn’t support those reactions.6

Mental health counselors or psychologists use professionally-obtained games or card decks to teach CBT to younger clients. One such illustrated card set is The ABCs of CBT which comes with a handy booklet, seven decks of laminated cards, a dry-erase marker, and a cardboard guide.

Judith Beck writes that CBT has been extensively tested since the first outcome study was published in 1977. Two thousand other studies have demonstrated the efficacy of CBT for a wide range of psychological, medical, and psychiatric disorders.

Her 2021 book discusses recovery-oriented cognitive therapy (CT-R), which is an adaptation of traditional CBT that focuses on clients’ future aspirations, their values, and steps to take each week toward goals.7

CBT, an active, homework-driven modality, is the most broadly practiced therapy in the world today.

Copyright @ 2021 by Loriann Oberlin. All Rights Reserved.

References

1 . ‘Nobody Has Openings’: Mental Health Providers Struggle to Meet Demand, article in The New York Times, February 17, 2021 by Christina Caron. https://tinyurl.com/Therapy-Shortage

2. T. Murphy and L. Oberlin, Overcoming Passive-Aggression: How to Stop Hidden Anger from Spoiling Your Relationships, Career and Happiness (Boston: DaCapo Press, 2016). https://tinyurl.com/Overcoming-Passive-Aggression and https://tinyurl.com/OPA-Barnes-Noble

3. J. S. Beck, Cognitive Behavior Therapy: Basics and Beyond, Third Edition (New York: Guilford Press, 2021)

4. T. Murphy and L. Oberlin, Overcoming Passive-Aggression: How to Stop Hidden Anger from Spoiling Your Relationships, Career and Happiness (Boston: DaCapo Press, 2016).

5. E.I. Foreman & C. Pollard, Cognitive Behavioral Therapy: Your Tool Kit to Modify Mood, Overcome Obstructions and Improve Your Life (London: Icon Books, 2016)

6. T. Murphy and L. Oberlin, The Angry Child: Regaining Control When Your Child Is Out of Control (New York: Three Rivers Press, 2002) https://tinyurl.com/The-Angry-Child

7. J. S. Beck, Cognitive Behavior Therapy: Basics and Beyond, Third Edition (New York: Guilford Press, 2021)

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