Cognitive behavioural therapy (CBT) is a talking therapy that focuses on changing negative thought and behaviour patterns to improve mental health. It was developed from principles of behaviourism and cognitive psychology. CBT is used to treat many conditions like depression, anxiety, addiction, eating disorders, and trauma. Therapists help clients identify distortions in thinking and set goals to practice new coping skills. Sessions involve challenging unhelpful thoughts and confronting fears through techniques like role playing. While effective in the short-term, CBT may not be suitable for all clients and its out-of-office practices raise some ethical issues regarding boundaries and competence.

1. Cognitive Behaviour Therapy
(CBT)
BY: RAMLA KHALID
M-PHIL-II
BHS-011

2. What is CBT?
 “Cognitive behavioural therapy (CBT) is a talking therapy that can help you
manage your problems by changing the way you think and behave.”
 Cognitive is a technical word used to describe anything related to thoughts. CBT is
concerned with how our thoughts influence our emotions and behaviour.
 It focuses on changing negative thought patterns and behaviours to improve
mental health and well being.

4. History
 Principles of behaviourism
 Learning experiments of Ivan Pavlov
 John Watson (Father of behaviourism)
 Thorndike (law of effect)
 Mary cover Jones (Little Albert experiment)
 Andrew salter (Assertion Training)
 Albert Bandura (Social Cognitive Processes)

5.  Cognitive Revolution in experimental psychology (By mid-1960s)
 clinicians naturally came to seek out means of working actively with cognitions
and emotions This clinical interest help set the stage for the development of cognitive
therapy (CT)
 This clinical interest help set the stage for the development of cognitive therapy (CT)
 Meichenbaum (1977), with his focus on adding cognitive modification to coping skills
training to achieve “stress inoculation.”
 Aaron Beck is generally considered the founder of CT and may be the single most
influential figure in the field of CBT.
 In Beckian CT, patients are trained to notice and respond more rationally to
negative automatic thoughts, first by labelling various cognitive distortions

6. Uses of CBT
 Addiction
 Anger issues
 Anxiety
 Bipolar disorder
 Borderline personality disorder
 Eating disorders – such as anorexia and bulimia
 Obsessive compulsive disorder (OCD)
 Panic disorder
 Phobias
 Post-traumatic stress disorder (PTSD)
 Psychosis

7. Techniques of CBT
1-Identifying negative thoughts:
It is important to learn what thoughts, feelings, and situations are contributing to
maladaptive behaviour.
2-Practicing new skills:
In cognitive behavioural therapy, people are often taught new skills that can be used
in real-world situations.
3-Goal setting:
During cognitive behavioural therapy, a therapist can help you build and strengthen
your goal setting skills.

8. 4-Problem solving:
Learning problem solving skills during cognitive behavioural therapy can help you
learn how to identify and solve problems that may arise from life stressors, both big
and small.
 Facing one’s fears instead of avoiding them.
 Using role playing to prepare for potentially problematic interactions with others.
 Learning to calm one’s mind and relax one’s body.

9. How CBT works?
CBT is a more short-term approach than psychoanalysis and psychodynamic
therapies. Other types of therapies may require several years for discovery and
treatment. CBT often requires only up to 20 sessions, according to the National Health
Services, but you can continue seeing your therapist for as long as you need. Every
situation is unique, so how long you pursue treatment is up to you and your therapist.
CBT sessions provide opportunities to identify current life situations that may be
causing or contributing to your mental health conditions, like anxiety or depression.
CBT allows you and your therapist to identify patterns of thinking or distorted
perceptions that are no longer serving you.

10. Cognitive Distortions
 All or nothing thinking: Viewing the world in black in white
 Disqualifying the positive: rejecting the positive experiences
 Automatic negative reactions: having habitual, scolding thoughts
 Magnification: is exaggerating the problems
 Overgeneralization: you make one rule after one event or series of coincidences
 Personalization: taking things too personally or feeling actions are specifically
directed at you
 Mental filter: picking out a single negative detail and dwelling on it exclusively so
that the vision of reality becomes darkened

11.  Jumping to conclusions: There are two ways of jumping to conclusions
i- Mind reading: When you think someone is going to react in a particular way, or you
you believe someone is thinking things that they aren't
ii- Fortune telling: When you predict events will unfold in a particular way, often to
avoid trying something difficult
 Emotional Reasoning: Emotional reasoning is a way of judging yourself or your
circumstances based on your emotions
 Labelling: Labelling is a cognitive distortion that involves making a judgment about
yourself or someone else as a person
 Should statements: involve always thinking about things that you think you "should" or
"must" do.

12. Coping with cognitive distortions
 Become more aware of your thoughts
 Recognize the effect of cognitive distortions
 Challenge your thoughts
 Talk to a professional
 You can practice these coping methods on your own or with your therapist.
Alternately, you can practice them in controlled settings in which you’re
confronted with challenges. You can use these settings to build on your ability to
respond successfully

13. Pros and Cons od CBT
 Some of the advantages of CBT include:
 it can be completed in a relatively short period of time compared with other talking
therapies
 the highly structured nature of CBT means it can be provided in different formats,
including in groups, self-help books and online
 it teaches you useful and practical strategies that can be used in everyday life, even
after the treatment has finished
 it focuses on the person's capacity to change themselves (their thoughts, feelings and
behaviours)
 it can be as effective as medicine in treating some mental health problems and may be
helpful in cases where medicine alone has not worked

14.  Some of the disadvantages of CBT to consider include:
 you need to commit yourself to the process to get the most from it – a therapist can
help and advise you, but they need your co-operation
 attending regular CBT sessions and carrying out any extra work between sessions can
take up a lot of your time
 it may not be suitable for people with more complex mental health needs or learning
difficulties
 it involves confronting your emotions and anxieties – you may experience initial
periods where you're anxious or emotionally uncomfortable
 it does not address any wider problems in systems or families that may have a
significant impact on someone's health and wellbeing

15. Ethical Issues in CBT
 CBT may include some non-traditional methods of treatment outside of the office.
Some common disorders that may call for out-of-office work include specific
phobias, obsessive-compulsive disorder, social phobia, post-traumatic stress
disorder, and severe depression
 CBT has some unique conditions that may require treatment to be delivered in a
client’s home. This circumstance of CBT has created some controversy within the
therapeutic literature. For example, some CBT procedures that may concern
boundary management include modelling/ self-disclosure, out-of-office practices
(homework), and the collaborative nature of the therapeutic relationship

16.  There is ongoing debate over whether the boundary crossing for exposure therapy
is ethical. One relevant ethical consideration for exposure therapy is that of
competence. Because of the complexity of exposure therapy, it is essential that
professionals are trained and remain competent to utilize exposure therapy in
order to benefit clients