Cognitive-Behavioral Therapy (CBT) in Halifax
Cognitive-Behavioral Therapists work with their clients to help them identify and challenge maladaptive cognitions (e.g. thoughts), and implicit core beliefs, which are thought to be the primary cause of distressing emotional cycles or problematic behaviors. Depression and anxiety are thus regarded as ‘thinking disorders’ – reflecting a systematic bias in the way clients interpret their subjective experiences. For example, people with low self-esteem, will often have negative thoughts about themselves. This naturally causes anxiety in social situations, leading to behavioral avoidance, further isolation, and continued self-criticism.
Psychologists working within a Cognitive-Behavioral framework will typically focus on the client’s thoughts and feelings, paying particular attention to cognitions that may be distorted or dysfunctional (e.g. irrational). The therapist will help the client notice the implicit assumptions (e.g. ‘automatic thoughts’) that shape their underlying core beliefs about themselves, other people, and the world.
A primary tool for the CBT clinician involves a gentle form of ‘Socratic questioning.’ If a client has assumptive thoughts relevant to a particular issue, the psychologist will invite the client to explore them in more detail. By pointing out or questioning biased interpretations, the client is in a better position to challenge them, and formulate alternative (and more realistic) interpretations. As a result, clients slowly break the dysfunctional thinking that might be causing a large part of their emotional distress or problematic behaviors.
Another important part of CBT involves giving clients ‘homework.’ Homework assignments may include behavioral activation (scheduling and following-through on goal-oriented activities), monitoring automatic thoughts (keeping a dysfunctional thought record), and so on.
Cognitive-Behavioral Therapy is a short-term present-focused therapy that has been heavily researched. CBT therapists often cite an enormous literature of outcome studies demonstrating the proven efficacy of their approach. CBT is regarded as an Empirically Validated Therapy (EVT), and is considered by some to be the preferred first-line treatment for Depression, Anxiety, Phobias, and a host of other issues.
Those less enthusiastic about the universal application of CBT, will typically point out some of the problems within the efficacy literature, including a bias toward manualized forms of therapy (e.g. CBT), which lend themselves most favorably to the Randomized Controlled Trials (RCT’s) preferred by many researchers. Other psychologists, including those who work within a psychodynamic orientation, take issue with some of the theoretical assumptions of the CBT approach. For them, the pathology underlying depression or anxiety is less about ‘disordered thinking’ than ‘conflicted emotions,’ which may operate outside of the client’s own awareness. From this view, thoughts (distorted or otherwise) are less a cause than a symptom of a client’s difficulties.
At Cornerstone, we tend to take an integrated approach to therapy, are familiar with Cognitive-Behavioral Therapy, and will choose an approach to best suit the client in relation to their presenting concerns and therapeutic goals.