Cognitive Behavioral Psychotherapy (CBT) in Psychology. Work techniques, exercise by yourself

Cognitive Behavioral Psychotherapy refers to the techniques that determine the unconscious motivation of a person, transfers to a conscious level, helps to independently change their opinion, belief or behavior, causing various neurological pathology.

What is cognitive behavioral therapy, its goals and objectives

Psychologists and psychotherapists in their work use different approaches to psychoanalysis, in order to further use them in the treatment of patients. One such approach is cognitive behavioral therapy. It is a method used to treat a wide variety of mental illnesses. It is aimed not only at getting the patient out of the problem, but also at the causes of its occurrence.

The technique is designed to identify negative habits and stereotypes in the subconscious of a person, which indicate a negative impact on the psyche. Psychologists consider cognitive behavioral therapy to be one of the main ways that the patient can easily get rid of traumatic memories. The principle is built on changing the patient's negative thinking, directing his thoughts in a positive direction.

An example of a deviation is a person's fear of an accident. He constantly focuses on this not only his attention, but also the attention of the people around him. A person begins to avoid transport, which negatively affects the quality of his life. Due to the manifestation of constant panic, others begin to treat him negatively.

Cognitive-behavioral psychotherapy independently exists from psychoanalysis. These are different techniques. In the first case, doctors help to identify not only negative stereotypes, but also to overcome them. To achieve their goals, the therapist can use role-playing games, journaling, meditation.

The main goal of CBT is to recognize and correct negative thoughts.

To achieve the goals, the following tasks are solved:

• identifying thoughts that shape inappropriate behavior;
• replacing negative beliefs with positive and useful ones;
• carrying out behavior correction through methods of behavioral psychotherapy, role trainings;
• development and consolidation of new skills;
• tracking results.

Cognitive-behavioral psychotherapy alone is not always able to help achieve the desired effect. In especially difficult cases, it can be used in complex treatment together with drugs.

Who should benefit from cognitive behavioral therapy?

Behavioral cognitive therapy is used in the following cases:

• sleep disturbance;
• dependence formation;
• deep depression;
• fears, phobias, panic attacks, post-traumatic stress;
• personality disorder, social maladjustment;
• psychological complexes, low self-esteem.

This method of therapy in psychiatry is often used as the main part of the complex of treatment of disorders and somatic disabilities. It can be used for patients of any age. The technique is often used for children from 2 years of age in the treatment of autism.

When CBT should not be used

Cognitive-behavioral psychotherapy alone can be used only with a number of contraindications.

These include diseases for which the technique will be ineffective:

• the need to receive medical treatment;
• mental disorders that threaten the health and life of the patient, as well as his loved ones;
• a severe form of mental retardation, in which a person is unable to perform the tasks of a psychiatrist;
• severe forms of mental disorders;
• a state of psychosis in the acute stage.

In some individual cases, clinicians may use CBT as an adjunct to medication.

The advantages of the technique

CBT has several advantages:

• quick achievement of results, work using this approach lasts a maximum of 20 sessions;
• therapeutic work has already been proven to be effective with examples of various disorders. For example, according to the results of the study, more than 68% of patients were able to get rid of migraines after using cognitive therapy;
• the technique is based on a scientific basis, the foundation is psychophysiology, neurobiology and cognitive psychology;
• the therapy is characterized by an understandable structure, the doctor always draws up a detailed plan, agreed with the patient;
• there is always a specific goal on the basis of which the doctor sets tasks together with the patient. The work will always be aimed at the spheres of life that are of most interest to a person;
• the psychologist becomes not just a doctor, but a partner who always takes into account the interests of the client, his opinion;
• there are no irrational components. The method is based on existing problems here and now.

Cognitive-behavioral psychotherapy (you can independently use its methods after consulting a psychotherapist) is recognized by foreign insurance companies. This is one of the few methods that, when used in treatment, is covered by health insurance.

Cognitive behavioral techniques

Psychologists in their work use different types of cognitive-behavioral techniques. Their main characteristics are presented in the table.

Type of equipment	Features and characteristics
Cognitive	The technique is based on identifying and further correcting altered distortions in thinking, behavior and emotional response.
Dialectical behavioral	The technique is based on correcting the thinking and reaction of the individual. The implementation of the technique is carried out using various strategies, including the regulation of the emotional background.
Multimodal	The technique is based on the assertion that the patient's treatment must be shaped through interrelated modalities. There are 4 of them: images, sensations, affects, biological factors.
Rational emotional-behavioral	This technique is carried out in stages. First, the psychologist identifies negative psycho-emotional attitudes that prevent a person from leading a normal life. After that, their dispute begins. The person learns to identify them on their own and to deal with them. Rational therapy is considered the most effective treatment method today.
Exposition	The technique is used for people with post-traumatic syndrome. The work uses carefully thought out points that are associated with a negative event. The individual learns to be aware of the fear reactions, to cope with them, to reduce the manifestation of avoidant behavior.

Effective Cognitive Behavioral Therapy Exercises for Self Practice

Cognitive-behavioral psychotherapy is carried out using a variety of exercises that the psychologist chooses for the patient independently, depending on the purpose and complexity of the treatment.

Relief from anxiety

Cognitive behavioral therapy is considered the most effective method for dealing with anxiety, panic fears. These are psychological disorders that are accompanied by a constant feeling of nervousness, dizziness, tremors, and muscle tension.

This disorder is most often based on apprehension. It manifests itself regularly, it can turn into a chronic stage. For other areas of psychotherapy, anxiety refers to a clinically difficult case, since the specific causes and cases to which the phenomenon can be linked are unknown.

What makes CBT so special is that you don’t need to look for causes when dealing with fear and anxiety. Therapy deals only with extracting disturbing thoughts from a person's head and replacing them with positive ones. For example, he is assured that increased sweating and heart palpitations can be completely in any situation. These symptoms do not mean that a heart attack is coming.

Dialogue with yourself

The exercise "Dialogue with oneself" was developed by M.Ye. Sandomierz. It should be performed only alone, so that no one interferes and does not distract. The main goal of the dialogue is to urgently help in the event of bodily emotional discomfort.

The exercise consists of 4 steps:

1. A person needs to close his eyes and imagine that he is standing in front of a mirror. At the moment of discomfort, you need to imagine what the face looks like, posture.
2. Concentrate on physical sensations. At this point, you need to understand exactly where the greatest discomfort is experienced.
3. The third step is that a person must say to himself in reflection those words that, according to in his opinion, they will be able to calm down, relieve anxiety, restore self-esteem and self-esteem dignity. In the spoken words, you need to put a maximum of emotions and feelings that are necessary to achieve your goal. The imaginary interlocutor will react to the words, and this will be a signal that everything is being done correctly, that phrases are not pronounced in vain.
4. In conclusion, you need to switch to physical sensations. If everything was correct, and the words reached the goal, then physical suffering will gradually subside, and over time the discomfort will also pass.

If the goal is not achieved, the exercise can be repeated 3 more times. Having learned how to perform it, a person will be able to independently urgently help himself, reduce inadequate manifestations of behavior.

Getting rid of false fears

The Overcoming Fear exercise is used when fear is the result of a misconception.

You need to do the following:

1. try to look at anxiety and fear from the other side, laugh at them;
2. tell a loved one in a confidential conversation about your fears, show your emotions;
3. find the root cause of fear, a misconception, and then replace it with a rational one;
4. observe your fear, understand that it is insignificant.

Doing this will help you realize that the cause of your concern is unfounded. Overcoming fear in such a situation will become easier and easier.

Defining your own essence

The exercise for determining your own essence is based on an outside observation of yourself. Its purpose is to help bring out the real self. The exercise focuses on the fact that each person is like an onion. In it, the real “I” is hidden under a large number of layers. Layers are masks that people choose for each new occasion. Performing the exercise, a person must find his real essence under these mask layers.

The exercise is performed as follows:

1. In a notebook on the first page a question is written, which is the heading - "Who am I?" The time is set and the exact and most honest answer is written. At the same time, the opinion of others and acquaintances is not used.
2. It is comfortable to sit down and close your eyes. Ask yourself this question and imagine yourself as an image. You cannot reason, the image must be exactly the one that arose immediately after the question was raised. Opening your eyes, immediately describe in detail the image that has arisen, the feelings that the person experienced at the same time.

At the end of the exercise, stand in the middle of the room and close your eyes. Ask this question, feel the movements that the body will begin to perform. You cannot try to control them, interfere. Everything should be natural. These movements are important to remember.

Self-examination to correct negative behavior

This method is used by psychotherapists when a person refuses to acknowledge the destructive effect of his thoughts and behavior on his own personality and others. In this case, he is asked to keep a diary in which only facts are recorded. When a person rereads them after a while and analyzes them, he independently comes to the conclusion that he should change something in his life.

Increasing creativity

This exercise is also called "Brainstorming".

It is performed in several steps:

1. Write down possible ideas for solving the problem. They need to be written without hesitation, immediately what comes to mind. This is required in order to exclude the formation of fears for failure in solving the problem. All fears arise on long reflection.
2. Evaluate the selected solutions. This is the analytical part of the exercise, which allows you to choose the most suitable solutions. The assessment is given on a five-point scale.

Finally, the best solution is selected. It can be as one option or several.

Problem solving and skill development

The essence of the technique is that the psychotherapist, together with the patient, works to find ways to solve life's problems. Often people with false attitudes do not cope well with difficult situations in life.

In this situation, the specialist conducts a conversation in which it turns out what problems have worried the patient over the past 7 days. Additionally, it becomes clear what difficulties the patient may face in the near future. After that, the doctor finds out how the person previously solved similar problems, what advice he would give to a person who found himself in the same situation.

Making decisions

Patients with anxiety disorders often lack the ability to make personal decisions. They always wait for someone else to decide for them. For example, they cannot independently understand whether they should change jobs or not, whether they need to start a family. However, they tend to shift responsibility to other people.

To help these patients, doctors suggest making a list with pros and cons. This will help them appreciate the importance of each position, making it easier to make a decision.

Refocusing

This is a technique that involves switching the patient's attention from one activity to another. This method should be used every time automatic thoughts appear. The technique is intended for those patients who often have obsessive thoughts and difficulties with their assessment. The task of the psychologist is to teach the person to accept negative thoughts and judgments as a fact that affects the mood badly. This will make it easier to switch to something new.

Relaxation and Mindfulness

Often, psychologists use various relaxation techniques in working with patients with behavioral reactions. These can include relaxing exercises that help control breathing and muscle tone. The physician's job is to teach the patient the correct use of techniques, teach him the exercises, and observe the reaction.

Often, relaxation exercises have the opposite effect in patients, which is overexcited. Therefore, it is important that their implementation at the initial stage is carried out under the supervision of specialists.

Cognitive-behavioral psychotherapy is an important technique in the treatment of mental disorders, which allows a person to learn how to independently change negative thoughts into positive ones. It is important that the person is able to deal with negative thinking. This is the only way to get back to your normal life.

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