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What is Cognitive Behavioural Therapy (CBT) and why is it so popular?

Most people reading this sentence are far more likely to have heard the name of drugs used to treat depression and anxiety (ex: Prozac and Xanax) than the name of a psychological therapy. However, more and more people are coming to learn about a particular type of therapy that has steadily been gaining attention for the past few decades.

Cognitive Behavioural Therapy (CBT) essentially began in the 1950s and 60s with two eminent psychologists – Aaron Beck and Albert Ellis. At that time, psychology was dominated by Sigmund Freud’s psychoanalysis, psychodynamic therapy, and behaviourism. These therapies tended to focus on factors that were beyond the control of the client. Either the client’s unconscious was causing all kinds of emotional problems (psychoanalysis), or the environment was determining every action (behaviourism). In each case, there was very little focus on the client’s thoughts or beliefs. Beck and Ellis changed the way psychologists conceived of emotional problems – from things that were beyond their control and awareness to their thoughts and behaviours in the present moment.

This is essentially the basic definition of CBT – any therapy that primarily seeks to explain and correct psychological problems by focusing on thoughts and behaviours. Of course, this may sound simplistic and straightforward, but things are actually a more complicated because there are many types of thoughts – beliefs, attitudes, memories, interpretations, and evaluations. Furthermore, these thoughts interact with various types of thought processes – like ruminations, obsessions and worry. Going even one step further, these thoughts and thought processes interact with a wide range of behaviours, including coping strategies, to create all sorts of problems and unique personality profiles. For example, despite having the same disorder (depression), the following two people might look very different:

Kathy
Belief: “I am unlovable”
Behaviour: “Avoid people”
Coping Response: “Drink alcohol to block the thoughts and numb the pain.”

Karen
Belief: “I am a failure”
Behaviour: “Work excessive hours to find success”
Coping Response: “Exercise excessively to avoid feeling like a failure in body image.”

Every client that psychologists work with is unique, and so psychologists must have the training, skill and experience to assess and treat the problem. However, there are many different ways that psychologists can understand and treat psychological problems; when the psychologist tries to understand the client and their problems by examining how their thoughts, emotions and behaviours interact, then he/she is using CBT.

Since the 1960s, CBT has grown in a number of ways. First, the research on CBT and its effectiveness has grown at an incredible rate. There are over 20,000 scientific publications about CBT, and specifically, it has been shown through clinical trials to be a highly effective treatment for most of the more common psychological disorders, including depression, social phobia, panic disorder, generalized anxiety disorder, obsessive compulsive disorder, eating disorders, and chronic pain management. There exist no psychological therapies that have been more vigorously evaluated and examined than CBT.

Second, CBT has grown in popularity among psychologists – both those who practice therapy and those who mainly conduct research. For instance, due to the fact that thoughts play such an important role in psychological disorders, many different types of psychological researchers have contributed to our understanding of these disorders and how they might be helped through CBT. These would include cognitive, developmental and social psychologists. Every day, researchers around the world conduct research that ultimately helps clinical psychologists improve their ability to use CBT to treat client’s problems.

Finally, as mentioned at the start of this article, CBT has also grown immensely in popularity in the general public. With the help of popular books such as David Burns’ The Feeling Good Handbook, media coverage, the rise of internet websites, and of course word of mouth from former clients, CBT is now becoming more commonplace in people’s understanding of how to treat mental health problems. In fact, psychologists at PsyMontreal often hear new clients mention CBT at the first session – they’ve done their research and chose to work with psychologists who specialize in using CBT.

CBT is a therapy that continues to evolve as research evolves. Every year, psychologists specializing in CBT attend conferences around the world to learn about the latest research and clinical practice techniques for therapy, to help psychologists to continue to offer excellent psychotherapy for psychological issues.

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