Treatment is behavioral therapy. Cognitive Behavioral Therapy - Effective Techniques

Date: 03.03.2020

In order to identify, work through and eliminate any problem, a person is advised to first find out the causes of its occurrence. It is very difficult to do this without special techniques and methods. Support from the therapist is also important. The training is carried out not only by the specialist who works with clients, but also by the patients, who, as they work with the therapist, must go through all the stages of behavioral psychotherapy.

This direction in treatment has arisen relatively recently. It is based on the main postulates of behaviorism, which consider behavior as the main source of all emerging problems and a way to overcome difficulties. What is called, how a person created his problem, in the same way he must solve it, that is, take a specific action that will transform him and lead to personal changes.

The online magazine site wishes to acquaint readers with the basic postulates of behavioral psychotherapy in order to demonstrate its usefulness in working through any problems.

What is behavioral psychotherapy?

A fairly young direction in the treatment of many phobias, behavioral negative reactions and manifestations is behavioral psychotherapy. Here psychotherapeutic activity is understood, which is based on changing or correcting the behavior of an individual in order to heal him from the main problem with which he came.

The first step towards solving any problem is to clearly formulate it. Therefore, a visit to a psychologist begins with a study or an incoming request (a complaint or a problem that made a person seek help) in order to collect information as fully as possible. Without a thorough investigation (diagnosis) of the situation by a specialist, the matter will be limited only to assumptions. The two most common methods of psychodiagnostics are structured conversation (interview) and psychological testing.

In behavioral psychotherapy, the main principles are:

The concept of operant and classical conditioning.
Behavioral theories.
Learning principles.

If a person has addictions, phobias, or destructive patterns of behavior, then behavioral psychotherapy is applicable. It is based not only on the verbal discussion of the problem, but also on the modeling of new behavior, its practice and development.

The emphasis is on the "target" - the so-called trigger that triggers the wrong behavior of a person. By identifying, eliminating, or changing attitudes towards it, then the very problem of misbehavior can be eliminated.

It should be noted that it is customary for a person to divide actions into good and bad. The psychotherapist does not evaluate. His main task is to help the client if he sees and notices that his behavior creates problems, does not help him to live happily.

Actions cannot be good or bad in and of themselves. It all depends on the situation in which they are applied. Actions may be appropriate or impractical. In other words, a person performs exactly such actions that help him achieve his goal in a particular situation. If the desired is not achieved, then the actions are considered inappropriate.

Most people use exactly those behaviors that have been developed over the years. Conservatism and traditions are precisely those behavioral reactions when a person does not think, but simply performs his usual actions. Here, various problem situations often arise when a person cannot understand that he himself created a conflict by his routine actions. It is necessary to change actions and be flexible in each individual situation, which is what behavioral psychotherapy teaches.

The worst thing that can be done is to get hung up on something: did not defend a thesis, did not say "I love", acted selfishly. It is important to let go of the past, to change your thinking, behavior, which no longer gives the desired result. It is important to create something new that will bring the desired result here and now.

Old patterns of behavior, desires, fears and people were useful to a person sometime in the past. But now this may not bring the desired result, so you need to get rid of ballast and develop new ones, which will help to achieve the goal that is important today.

Old patterns of behavior do not bring the desired results in the present. So, you need to change them. If you continue to do what you usually do, then, accordingly, you will get the usual result for yourself. It is impossible to perform the same actions and get a different result every time. If you do not change anything in the factors that are involved in the formation of a particular situation, then you constantly get the same result. But if you change something in yourself or in external factors, you immediately get a completely new result.

Old patterns of behavior do not bring the desired results in the present. And the worst thing you can do in such a situation is not to change anything. People often blame circumstances for their troubles, but they themselves allowed the old circumstances to participate in the formation of the situation. If you change at least the external circumstances, then the situation itself will change. And if you also change your behavior, way of thinking, beliefs, then you can significantly change the course of events. So, if you want to change your life, start by changing your behavior or thinking. And you will notice how your life becomes different.

Cognitive Behavioral Therapy

Thought precedes actions. Thus, A. T. Beck created a new direction in psychotherapy, which is called cognitive-behavioral. First, a person thinks about something, after which his thoughts provoke actions. Therefore, in order to identify the causes of the problem with which the client came to the psychotherapist, it is necessary to find out what thoughts are spinning in his head at the same time.

Cognitive-behavioral psychotherapy is actively used to eliminate negative conditions:

Phobias.
Irritation.
Anxiety.
Suicidal tendencies, etc.

First, a person must understand what thoughts he is thinking about before committing an unpleasant act. Thus, cognitive-behavioral psychotherapy helps negatively colored thoughts, create new thinking patterns, and reinforce new beliefs.

In this case, the following techniques are used:

Finding unnecessary and desired thoughts. Finding the causes of unwanted thoughts.
Formation of new templates.
Visualization that helps you combine new patterns with concrete action and emotional well-being.
Using new beliefs and behaviors in real life to make them familiar.

Life can be changed for the better, and everything starts with a person. It is not the circumstances that shape the scenario of life, but the attitude that a person shows to these circumstances, which develops fears, anxiety, panic, and anger. An inadequate assessment of objects, people, phenomena, situations leads to the fact that a person develops a certain attitude towards them. He begins to act depending on his attitude. Wherein:

A person endows people, objects, etc. with unusual qualities, which indicates an inadequate perception of what is happening.
A person forms in himself exactly that attitude to what is happening, which corresponds to the direction of his thinking. Cognitive behavioral therapy aims to change the way a person thinks about everything that happens to him.

The absurdity of some thoughts can be noted when a person is afraid of something that has not yet happened. When a situation arises that does not proceed according to the terrible scenario that the person drew in his head, he begins to understand how wrong he was and how senselessly he suffered. Thus, many experiences are absurd only because a person imagines them before the terrible happens, or keeps them in his head for a long time, when the event has long been in the past.

Behavioral psychotherapy techniques

The main goal of behavioral psychotherapy is to transform the client's behavior. He must change, change or modify his actions to make them more effective. Various methods are used here:

Aversive therapy, in which a person is directly affected by a negative stimulus. Infrequently used.
Token system, when the client is awarded with “tokens” for any effective action. Then he can exchange these tokens for useful and pleasant things for himself.
Mental "stop" when the client consciously stops the course of negative thoughts that cause him unpleasant sensations.
Phased reinforcement and self-reinforcement.
Self-instruction and self-control.
Model learning.
Reinforcement training.
Self-affirmation training.
Systematic desensitization.
Conditioned reflex therapy.
Targeted and covert reinforcement.
The system of penalties.

Behavioral psychotherapy techniques

Behavioral psychotherapy uses a variety of techniques to help address specific psychological problems:

The "flood" technique, when a traumatic situation is created for a person, is immersed in it. He must stay in it until the functions of inhibition begin to turn on, that is, the fear itself does not begin to disappear due to the constant impact of a frightening stimulus on a person. This technique is used up to 10 times.
Token system, when a person is rewarded for correct behavior.
Systematic desensitization, when, in a moment of stress, a person engages in relaxation.
Exposure is the patient's entry into a frightening situation.

What are the results of behavioral psychotherapy?

The main goals of behavioral psychotherapy are to influence the client's train of thought and attitudes in order to regulate behavior to improve self-awareness. Results can be achieved in a matter of sessions if the client fully submits to the guidance of the therapist.

It should be understood that it is through his actions that a person forms his problems. These actions are based on beliefs, thoughts, fears, complexes and other psychological factors. Often, a person uses old models of behavior, which already today do not give the desired effect. That is why, by working out your own stereotypes, you can also change behavior, which will finally give the desired result.

First, you need to understand what controls a person, and then begin to control this factor yourself in order to perform beneficial actions for yourself.

Psychotherapy. Tutorial Team of Authors

Chapter 4. Behavioral psychotherapy

History of the behavioral approach

Behavioral therapy as a systematic approach to the diagnosis and treatment of psychological disorders emerged relatively recently - in the late 1950s. In the early stages of development, behavioral therapy was defined as the application of "modern learning theory" to the treatment of clinical problems. The concept of "modern learning theories" then referred to the principles and procedures of classical and operant conditioning. The theoretical source of behavioral therapy was the concept of behaviorism by the American zoopsychologist D. Watson (1913) and his followers, who understood the enormous scientific significance of Pavlov's doctrine of conditioned reflexes, but interpreted and used them mechanically. According to the views of behaviorists, human mental activity should be investigated, as in animals, only by registering external behavior and be exhausted by establishing the relationship between stimuli and reactions of the body, regardless of the influence of the personality. In an attempt to soften the clearly mechanistic positions of their teachers, non-behaviorists (EC Tolman, 1932; KL Hull, 1943; past experience, etc., but still ignored the personality. In fact, behaviorism followed the long-standing teaching of Descartes about "animal machines" and the concept of the French materialist of the 18th century. J. O. La Mettrie on the "man-machine".

Based on theories of learning, behavioral therapists viewed human neuroses and personality anomalies as an expression of maladaptive behavior developed in ontogeny. J. Wolpe (1969) defined behavioral therapy as “the application of experimentally established learning principles for the purpose of changing maladaptive behavior. Non-adaptive habits are weakened and eliminated, adaptive habits arise and intensify "(Zachepitsky R. A., 1975). At the same time, the elucidation of the complex mental causes of the development of psychogenic disorders was considered superfluous. LK Frank (1971) even stated that the opening of such causes does little to help the treatment. Focusing on their consequences, that is, on the symptoms of the disease, according to the author, has the advantage that the latter can be directly observed, while their psychogenic origin is caught only through the patient's selective and distorting memory and the preconceived notions of the doctor. Moreover, G. Eysenck (1960) argued that it is enough to relieve the patient of symptoms and thereby the neurosis will be eliminated.

Over the years, optimism about the special effectiveness of behavioral therapy began to wane everywhere, even among its prominent founders. Thus, M. Lazarus (1971), a student and former closest collaborator of J. Volpe, objected to his teacher's assertion that behavioral therapy supposedly has the right to challenge other types of treatment as the most effective. On the basis of his own follow-up data, M. Lazarus showed a "discouragingly high" recurrence rate after behavior therapy in 112 patients. The ensuing disappointment was vividly expressed, for example, by W. Ramsay (1972), who wrote: "The initial statements of behavioral therapists about the results of treatment were amazing, but have now changed ... The range of disorders with a favorable response to this form of treatment is currently small." Its reduction was also reported by other authors, who recognized the success of behavioral methods mainly with simple phobias or with insufficient intelligence, when the patient is not able to formulate his problems in verbal form.

Critics of the isolated application of behavioral therapy methods see its main defect in a one-sided orientation towards the action of the elementary technique of conditioned reinforcement. The prominent American psychiatrist L. Volberg (1971) pointed out, for example, that when a psychopath or alcoholic is constantly punished or rejected for antisocial behavior, they themselves repent of their actions. Nevertheless, they are pushed to relapse by an intense internal need, much stronger than conditioned reflex influence from the outside.

The fundamental drawback of the theory of behavioral therapy lies not in the recognition of the important role of the conditioned reflex in the neuropsychic activity of a person, but in the absolutization of this role.

In recent decades, behavioral therapy has undergone significant changes, both in nature and in scope. This is due to advances in experimental psychology and clinical practice. Now behavioral therapy cannot be defined as an application of classical and operant conditioning. The various approaches in behavioral therapy today differ in the degree to which cognitive concepts and procedures are used.

At one end of the continuum of behavioral therapy procedures is functional behavior analysis, which focuses exclusively on observed behavior and rejects all intermediate cognitive processes; at the other end is social learning theory and cognitive behavior modification, which are based on cognitive theories. Behavioral therapy (also called "behavior modification") is a treatment that uses learning principles to change behavior and thinking. Consider the different types of learning in their meaning for therapy.

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Cognitive behavioral therapy was born out of two popular psychotherapy methods of the second half of the 20th century. These are cognitive (thinking change) and behavioral (behavior correction) therapy. Today CBT is one of the most studied therapies in this area of medicine, has undergone many formal trials and is actively used by doctors around the world.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is a popular psychotherapy treatment based on correcting thoughts, feelings, emotions and behavior to improve the patient's quality of life and relieve addictions or psychological disorders.

In modern psychotherapy, CBT is used to treat neuroses, phobias, depression, and other mental problems. And also - to get rid of any type of addiction, including drug addiction.

CBT is based on a simple principle. Any situation first forms a thought, then an emotional experience comes, which translates into concrete behavior. If the behavior is negative (for example, taking psychotropic drugs), then it can be changed by changing the way of thinking and the emotional attitude of a person to the situation that caused such a harmful reaction.

Cognitive behavioral therapy (CBT) is a relatively short technique, usually lasting 12-14 weeks. Such treatment is used at the stage of rehabilitation therapy, when the intoxication of the body has already been carried out, the patient has received the necessary medication, and the period of work with a psychotherapist begins.

Method essence

From a CBT perspective, drug dependence consists of a number of specific behaviors:

imitation ("friends have smoked / smelled / injected, and I want to") - the actual modeling;
based on personal positive experience from drug use (euphoria, withdrawal from pain, increased self-esteem, etc.) - operant conditioning;
coming from the desire to experience pleasant sensations and emotions once again - a classic conditioning.

The scheme of exposure to the patient during treatment

In addition, a person's thoughts and emotions can be influenced by a number of prerequisites that “perpetuate” addiction:

social (conflicts with parents, friends, etc.);
the influence of the environment (TV, books, etc.);
emotional (depression, neurosis, desire to relieve stress);
cognitive (the desire to get rid of negative thoughts, etc.);
physiological (intolerable pain, "withdrawal", etc.).

When working with a patient, it is very important to determine the group of prerequisites that influenced him specifically. If you form other psychological attitudes, teach a person to react to the same situations in a different way, you can get rid of drug addiction.

CBT always starts with physician-patient contact and functional analysis of addiction. The doctor must determine what exactly makes a person turn to drugs in order to work with these reasons in the future.

Then it is required to establish triggers - these are conditioned signals that a person associates with drugs. They can be external (friends, dealers, specific location where consumption occurs, Friday night for stress relief, etc.). And also internal (anger, boredom, excitement, fatigue).

To identify them, a special exercise is used - the patient must, for several days, indicating the date and date, write down his thoughts and emotions in the following table:

Situation	Automatic thoughts	The senses	Rational answer	Result
Real event	A thought that arose before an emotion	Specific emotion (anger, anger, sadness)	Answer to a thought
Thoughts that made you feel uncomfortable	The degree of automatism of thought (0-100%)	Emotion Strength (0-100%)	The degree of rationality of the answer (0-100%)	Feelings that appeared after rational thought
Unpleasant emotions and physical sensations				Feelings that appeared after rational thought

In the future, various methods of developing personal skills and interpersonal relationships are applied. The former include techniques for managing stress and anger, various ways to take leisure time, etc. Teaching interpersonal relationships helps to resist the pressure of acquaintances (suggestions to use a drug), teaches us to fight criticism, re-interact with people, etc.

The technique of understanding and overcoming drug hunger is also used, the skills of quitting drugs and prevention of relapse are practiced.

Indications and steps for CBT

Cognitive-behavioral therapy has long been successfully used all over the world, it is an almost universal technique that can help in overcoming various life difficulties. Therefore, most psychotherapists are convinced that this treatment is suitable for absolutely everyone.

However, the most important condition for treatment with CBT is that the patient himself must realize that he is suffering from addiction and make a decision to fight drug addiction on his own. For people prone to introspection, accustomed to monitoring their thoughts and feelings, this therapy will have the greatest effect.

In some cases, before starting CBT, it is required to practice skills and techniques for overcoming difficult life situations (if the person is not used to coping with difficulties on their own). This will improve the quality of future treatment.

There are many different CBT modalities - different clinics may use specific techniques.

Any CBT always consists of three consecutive stages:

Logical analysis. Here, the patient analyzes his own thoughts and feelings, identifies errors that lead to an incorrect assessment of the situation and incorrect behavior. That is, the use of illegal drugs.
Empirical analysis. The patient learns to distinguish between objective reality and perceived reality, analyzes his own thoughts and behavior patterns in accordance with objective reality.
Pragmatic analysis. The patient identifies alternative ways of responding to the situation, learns to form new attitudes and use them in life.

Efficiency

The uniqueness of the methods of cognitive-behavioral therapy is that they involve the most active participation of the patient himself, continuous introspection, his own (and not imposed from the outside) work on mistakes. CBT can take many forms - individual, alone with a doctor, and group - and it works well with medications.

CBT has the following effects when working on drug addiction recovery:

provides a stable psychological state;
eliminates (or significantly reduces) the signs of a psychological disorder;
significantly increases the benefits of drug treatment;
improves social adaptation of a former drug addict;
reduces the risk of further disruptions.

Studies have shown that CBT has the best results in treatment. Methods of cognitive-behavioral therapy and in getting rid of cocaine addiction are widely used.

In the experiences of people, themes of hopelessness, a gloomy perception of the world and dissatisfaction with oneself are often heard. Cognitive psychotherapy helps identify established stereotypes by working with thinking and replacing “automatic” negative thoughts with positive ones. The patient is an active participant in the therapy process.

Cognitive therapy - what is it?

Aaron Beck, an American psychotherapist, one of the founders of the direction in 1954 researching depression in the framework of psychoanalysis did not receive any encouraging reliable results. This is how a new direction of psychotherapeutic assistance for panic attacks, depression, and various addictions appeared. Cognitive therapy is a short-term technique aimed at recognizing negative thought patterns that lead a person to suffering and replacing them with constructive thoughts. The client learns a new perception, begins to believe in himself and think positively.

Cognitive psychotherapy techniques

The psychotherapist initially negotiates and establishes a cooperative relationship with the patient. A list of target problems is formed in order of the significance of the study for the patient, automatic negative thoughts are revealed. Cognitive behavioral therapy (CBT) methods cause positive changes at a fairly deep level, and include:

struggle with negative thoughts (“this is pointless”, “this is useless”, “nothing good will come of this,” “unworthy to be happy”);
alternative ways of perceiving the problem;
rethinking or living a traumatic experience from the past that affects the present and does not adequately assess reality for the patient.

Cognitive psychotherapy techniques

The psychotherapist encourages the patient to actively participate fully in therapy. The goal of the therapist is to inform the client that he is unhappy with his old beliefs, there is an alternative to start thinking in a new way, to take responsibility for his thoughts, state, behavior. Homework is required. Cognitive therapy for personality disorders contains a number of techniques:

Tracking and recording negative thoughts, attitudes when it is necessary to perform any important action. The patient writes down on paper in order of priority the thoughts that come up during the decision.
Keeping a diary... During the day, thoughts are recorded that most often arise in the patient. The diary helps you keep track of thoughts that affect your well-being.
Checking the negative attitude in action... If the patient claims that "he is not capable of anything," the therapist encourages to begin with small successful actions, then complicates the tasks.
Catharsis... Technique of living emotions out of the state. If the patient is sad, is in rejection of himself, the therapist suggests expressing the sadness, for example, by crying.
Imagination... The patient is afraid or not confident in his abilities in order to take action. The therapist encourages you to imagine and try.
Three Column Method... The patient writes in the columns: situation-negative thought-corrective (positive) thought. The technique is useful for teaching the skill of replacing negative thoughts with positive ones.
Recording the events of the day... The patient may believe that people are aggressive towards him. The therapist suggests keeping an observation list, where to put "+" "-", during the day at each interaction with people.

Cognitive therapy - exercise

The lasting result and success in therapy is ensured by the consolidation of new constructive attitudes and thoughts. The client does the homework and exercises assigned by the therapist: relaxation, tracking pleasant events, learning new behaviors and self-change skills. Cognitive psychotherapy self-confidence exercises are essential for patients with high anxiety and depression from self-dissatisfaction. In the course of working out the desired "self-image", a person tries on and tries different options for behavior.

Cognitive therapy for social phobia

Fear and high unjustified anxiety prevent a person from performing his social functions normally. Social phobia is a fairly common disorder. Cognitive psychotherapy for social phobia helps to identify the "benefits" of such thinking. Exercises are tailored to the specific problems of the patient: fear of leaving the house, and so on.

Cognitive Addiction Therapy

Alcoholism, drug addiction - diseases caused by a genetic factor, sometimes it is a model of behavior of people who do not know how to solve problems and see stress relief in the use of psychoactive substances without solving the problems themselves. Cognitive behavioral addiction therapy is aimed at identifying triggers (situations, people, thoughts) that trigger the mechanism of addiction. Cognitive therapy successfully helps a person cope with addictions through awareness of thoughts, working through situations and changing behavior.

Cognitive Behavioral Therapy - Best Books

People cannot always seek help from a specialist. The techniques and methods of well-known psychotherapists can help to independently advance towards solving some problems, but they will not replace the psychotherapist himself. Cognitive Behavioral Therapy books:

"Cognitive therapy for depression" A. Beck, Arthur Freeman.
"Cognitive psychotherapy of personality disorders" A. Beck.
"Psycho-training according to the Albert Ellis method" A. Ellis.
"The Practice of Rational-Emotional Behavioral Psychotherapy" A. Ellis.
"Methods of behavioral therapy" V. Meyer, E. Chesser.
"Guide to Cognitive Behavioral Therapy" S. Kharitonov.

This suggests that their perception of the situation is the same. Behavior will depend on the perception of the situation, and outlooks on life are formed during a person's life.

Definition of cognitive behavioral psychotherapy

Cognitive-behavioral psychotherapy or cognitive-behavioral psychotherapy is one of the branches of science, based on the assumption that the causes of mental disorders are dysfunctional attitudes and beliefs.

This can be said about the useful habit of preparing for tomorrow, so that you get ready on time and not be late for school or work. It is worth not doing this once and there will be an unpleasant experience of untimely arrival, for example, to a meeting. As a result of the acquisition of negative experience in the subconscious of a person, it is memorized. When this situation repeats, the brain gives a signal or a guide to action to get away from trouble. Or vice versa, do nothing. That is why some people, having received a rejection of an offer for the first time, try not to do it again the next time. We are always guided by our thoughts, we are under the influence of our own images. What about a person who during his life had many negative contacts, and under their influence a certain worldview was formed? It interferes with moving on, conquering new peaks. There is an exit. Cognitive-behavioral psychotherapy is called.

This method is one of the modern trends in the treatment of mental illness. The treatment is based on the study of the origin of human complexes and his psychological problems. The American psychiatrist Aaron Beck is considered the creator of this method of therapy. Currently, Beck's cognitive psychotherapy is one of the most effective ways to treat depression and suicidal tendencies. Psychotherapy uses the principle of changing the patient's behavior and detecting the thoughts that cause the illness.

Purpose of therapy

The main goals of cognitive therapy are:

Elimination of symptoms of the disease.
Reducing the frequency of relapses after treatment.
The effectiveness of the use of drugs is increasing.
The solution to many of the patient's social problems.
Eliminating the causes that can cause this condition, changing human behavior, adapting it to various life situations.

Basic Principles of Cognitive Behavioral Psychotherapy

This technique allows you to eliminate negative thoughts, create new ways of thinking and analyze the real problem. Psychoanalysis includes:

The emergence of new thinking stereotypes.
Investigating unwanted or desirable thoughts and what triggers them.
Visualizing that a new behavior pattern can lead to emotional well-being.
How to apply new conclusions in your life, new situations.

The main idea of cognitive psychotherapy is that all of the patient's problems stem from his thinking. A person himself forms his attitude to everything that happens. Thus, he has corresponding feelings - fear, joy, anger, excitement. The person who inadequately evaluates the things around him, people and events, can endow them with such qualities that are not inherent in them.

Doctor's help

First of all, a psychiatrist, when treating such patients, tries to identify how they think, which leads to neurosis and suffering. And how to try to replace these categories of feelings with positive ones. People are again learning new methods of thinking that will lead to a more adequate assessment of any life situation. But the main condition for treatment is the patient's desire to be cured. If a person is not aware of his illness, experiences some resistance, then the treatment may be ineffective. An attempt to change negative thoughts and stimulation to change is quite difficult, because a person does not want to change his behavior, thinking. Many do not understand why they should change something in their life, if they already feel good. Conducting cognitive behavioral therapy alone will be ineffective. The treatment, diagnosis and assessment of the degree of impairment should be dealt with by a specialist.

Varieties of therapy

Like other treatments, cognitive psychotherapy comes in a variety of ways. Here are some of the most popular ones:

Simulation treatment. A person imagines the possible development of a situation as a consequence of his behavior. An analysis of his actions is carried out and how you can cope with this. Various relaxation techniques are used to get rid of anxiety and remove possible triggers that lead to stress. The method has proven itself well in the treatment of self-doubt and various fears.
Cognitive therapy. It is based on the acceptance that when the patient is emotionally disturbed, he deliberately has thoughts of failure. A person immediately thinks that he will not succeed, while self-esteem is lowered, the slightest hint of failure is perceived as the end of the world. During treatment, the cause of such thoughts is studied. Various situations are asked in order to have a positive life experience. The more successful events in life, the more self-confident the patient is, the faster he develops a positive opinion of himself. Over time, a person turns from a loser into a successful and self-confident person.
Anxiety control exercise. The doctor teaches the patient to use the feeling of anxiety as a relaxant. During the session, the psychiatrist works out possible situations to prepare the patient for frequently occurring events. This technique is used for those people who, in stressful situations, cannot control themselves and cannot make a decision quickly.
Dealing with stress. As a result of applying this technique against stress, the patient is taught relaxation with the help of a psychotherapist. The person gets stressed on purpose. This helps to gain experience with the relaxation technique, which may be useful in the future.
Rational emotive therapy. There are people who consider themselves to be the best. These thoughts often lead to a discrepancy between real life and dreams. Which can lead to constant stress, the divergence of dreams and reality is perceived as a terrible event. Treatment is about motivating the person to live a real life, not a fictional one. Over time, the ability to make the right decisions will protect you from unnecessary stress, the patient will no longer be dependent on his dreams.

What the patient will receive as a result of treatment:

The ability to identify negative thoughts.
Realistically evaluate thoughts, change them to more constructive ones that do not cause anxiety and depression.
Normalize and maintain a lifestyle, eliminate provoking factors for stress.
Use the skills you learn to deal with anxiety.
Overcome anxiety, not hide problems from loved ones, consult with them and enjoy their support.

What is the peculiarity of the method of cognitive-behavioral psychotherapy?

Cognitive-behavioral psychotherapy is based on the principles of learning theory, which assumes that different types of behavior and those signs that accompany them develop due to a person's habitual reaction, a reaction to a situation that has arisen.

A person reacts to external stress in a certain way and at the same time a certain behavior model is developed that is inherent exclusively to this person and a reaction that is familiar only to him, which is far from always correct. " Wrong"Behavior pattern or" wrong "response and causes the symptoms of the disorder. However, you need to clearly understand that this model can be changed, and you can unlearn the developed habitual reaction, and most importantly, you can learn. " correct”, Useful and constructive, which will help to cope with difficulties without bringing on new stresses and fears.

Cognitiveness in psychology is a person's ability to mentally perceive and process external information based on their deepest beliefs, attitudes and automatic (unconscious) thoughts. Such thought processes are commonly referred to as the "mental state of a person."

Cognitions are stereotypical, "automatic", sometimes instantaneous thoughts that arise in a person and are a reaction to a certain situation. Cognitions psychologically traumatize a person and lead him to panic attacks, fears, depression and other nervous disorders. Such disastrous assessments and negative attitudes make a person react to what is happening with resentment, fear, guilt, anger, or even hopelessness. This is what the psychologist works with.

Cognitive-behavioral psychotherapy can be expressed as a cognitive formula:

Negative feelings of a person are not the result of a given situation, but the ability of a person, once in a certain situation, to develop his own opinion about it and it is after that to decide how he relates to this situation, who he sees himself in it and what emotions it causes in him ...

In other words, for a person it is not so important what happens to him, as much as what he thinks about it, what thoughts underlie his experiences and how he will continue to act... It is precisely these thoughts that lead to negative experiences (panic fears, phobias and other nervous disorders) and are unconscious "taken for granted" and therefore are poorly understood by a person.

The main task of the CBT psychologist is to work with thoughts, with an attitude to a given situation, with correcting distortions and thinking errors, which will ultimately lead to the formation of more adaptive, positive, constructive and life-affirming stereotypes of future behavior.

Cognitive behavioral therapy consists of several stages... During consultations with a psychologist, the client gradually "step by step" learns to change his thinking, which leads him to panic attacks, he gradually opens the vicious circle consisting of fear that causes this panic, and also learns techniques aimed at reducing the level of anxiety. As a result, the client overcomes frightening situations and qualitatively changes his life.

The main advantage of cognitive-behavioral psychotherapy is that the result obtained from consultations with a psychologist is stable and lasts a long time. This is due to the fact that after CBT, the client becomes his own psychologist, since during the consultations he masters the methods and techniques of self-control, self-diagnosis and self-treatment.

The main points of cognitive-behavioral psychotherapy:

Your negative experiences are not the result of the past situation, but your personal assessment of this situation, your thoughts about it, as well as who you see yourself and the people who surround you in this situation.
It is possible to radically change your assessment of a particular situation and change the flow of thoughts about it from negative to positive.
Although your negative beliefs look plausible in your opinion, this does not mean that they are true. It is from such false "plausible" thoughts that you get worse and worse.
Your negative experiences are directly related to the patterns of typical thinking to which you are accustomed, as well as to the erroneous processing of information that you received. You can change your thinking pattern and check for mistakes.

identify negative thoughts that cause PA, fears, depression and other nervous disorders;
revise the lifestyle and normalize it (for example, avoid chronic overload, revise the poor organization of work and rest, eliminate all provoking factors, etc.);
keep the results obtained for a long time and not lose in the future the acquired skills (not to avoid, but to resist future negative situations, to be able to cope with depression and anxiety, etc.);
overcome the shame of anxiety, stop hiding your existing problems from loved ones, enjoy support and accept help with gratitude.

Cognitive techniques (techniques) of cognitive-behavioral psychotherapy:

At consultations, the CBT psychologist, depending on the problem, uses various cognitive techniques (techniques) that help to analyze and recognize the negative perception of the situation in order to eventually change it to a positive one.

Very often a person is afraid of what he has prophesied to himself and in anticipation of this moment he starts to panic. On a subconscious level, he is already ready for danger, long before it happens. As a result, the person is mortally frightened in advance and tries in every possible way to avoid this situation.

Cognitive techniques can help control negative emotions and change negative thinking, thereby reducing premature fear that escalates into panic attacks. With the help of these techniques, a person changes his fatal perception of panic (which is characteristic of his negative thinking) and thereby shortens the duration of the attack itself, and also significantly reduces its impact on the general emotional state.

During consultations, a psychologist creates an individual system of tasks for his client. (How positive the result of the course of therapy depends on the active participation of the client and the completion of homework). This technique is better called "learning". The psychologist teaches the client to control his negative thoughts and resist them in the future.

These homework assignments include introducing a special diary, following step-by-step instructions, practicing optimistic internal dialogue, using relaxation (relaxation) exercises, performing certain breathing exercises, and much more. In each case, different cognitive techniques are selected.

Cognitive psychotherapy - methods and techniques for the treatment of personality disorders

Cognitive therapy - what is it?

Cognitive psychotherapy techniques

struggle with negative thoughts (“this is pointless”, “this is useless”, “nothing good will come of this,” “unworthy to be happy”);
alternative ways of perceiving the problem;
rethinking or living a traumatic experience from the past that affects the present and does not adequately assess reality for the patient.

Cognitive psychotherapy techniques

Tracking and writing down negative thoughts, attitudes, when it is necessary to perform any important action. The patient writes down on paper in order of priority the thoughts that come up during the decision.
Keeping a diary. During the day, thoughts are recorded that most often arise in the patient. The diary helps you keep track of thoughts that affect your well-being.
Checking the negative attitude in action. If the patient claims that "he is not capable of anything," the therapist encourages to begin with small successful actions, then complicates the tasks.
Catharsis. Technique of living emotions out of the state. If the patient is sad, is in rejection of himself, the therapist suggests expressing the sadness, for example, by crying.
Imagination. The patient is afraid or not confident in his abilities in order to take action. The therapist encourages you to imagine and try.
Three Column Method. The patient writes in the columns: situation-negative thought-corrective (positive) thought. The technique is useful for teaching the skill of replacing negative thoughts with positive ones.
Recording the events of the day. The patient may believe that people are aggressive towards him. The therapist suggests keeping an observation list, where to put "+" "-", during the day at each interaction with people.

Cognitive therapy - exercise

Cognitive therapy for social phobia

Fear and high unjustified anxiety prevent a person from performing his social functions normally. Social phobia is a fairly common disorder. Cognitive psychotherapy for personality disorders in social phobia helps to identify the “benefits” of such thinking. The exercises are tailored to the specific problems of the patient: fear of leaving the house, fear of public speaking, and so on.

Cognitive Addiction Therapy

Cognitive Behavioral Therapy - Best Books

"Cognitive therapy for depression" A. Beck, Arthur Freeman.
"Cognitive psychotherapy of personality disorders" A. Beck.
"Psycho-training according to the Albert Ellis method" A. Ellis.
"The Practice of Rational-Emotional Behavioral Psychotherapy" A. Ellis.
"Methods of behavioral therapy" V. Meyer, E. Chesser.
"Guide to Cognitive Behavioral Therapy" S. Kharitonov.

Cognitive-behavioral psychotherapy. Cognitive Behavioral Therapy Techniques

Studying the world, we look at it through the prism of already acquired knowledge. But sometimes it may turn out that our own thoughts and feelings can distort what is happening and injure us. Such stereotyped thoughts, cognitions, arise unconsciously, showing a reaction to what is happening. However, despite their unintentional appearance and seeming harmlessness, they interfere with living in harmony with oneself. These thoughts need to be dealt with through cognitive behavioral therapy.

History of therapy

Cognitive Behavioral Therapy (CBT), also called cognitive behavioral therapy, originated in the 1950s and 1960s. The founders of cognitive-behavioral therapy are A. Beck, A. Ellis and D. Kelly. Scientists have studied a person's perception of various situations, his mental activity and further behavior. This was the innovation - the fusion of the principles and methods of cognitive psychology with behavioral ones. Behaviorism is a direction in psychology that specializes in the study of human and animal behavior. However, the discovery of CBT did not mean that such methods had never been used in psychology. Some psychotherapists have used the cognitive capabilities of their patients to dilute and complement behavioral therapy.

It is not by chance that the cognitive-behavioral direction in psychotherapy began to develop in the United States. At that time, behavioral psychotherapy was popular in the United States - a positive-minded concept that believes that a person can create himself, while in Europe, on the contrary, pessimistic psychoanalysis prevailed. The direction of cognitive-behavioral psychotherapy was based on the fact that a person chooses behavior based on their own ideas about reality. A person perceives himself and other people based on his own type of thinking, which, in turn, is obtained through learning. Thus, the wrong, pessimistic, negative thinking, which a person has learned, carries with it wrong and negative ideas about reality, which leads to inappropriate and destructive behavior.

Therapy model

What is cognitive behavioral therapy and what is it? The basis of cognitive behavioral therapy is the elements of cognitive and behavioral therapy aimed at correcting a person's actions, thoughts and emotions in problem situations. It can be expressed in the form of a kind of formula: situation - thoughts - emotions - actions. In order to understand the current situation and understand your own actions, you need to find answers to the questions - what did you think and feel when this happened. Indeed, in the end, it turns out that the reaction is predetermined not so much by the current situation as by your own thoughts on this matter, from which your opinion is formed. It is these thoughts, sometimes even unconscious ones, that lead to the emergence of problems - fears, anxieties and other painful sensations. It is in them that the key to solving many problems of people is located.

The main task of the psychotherapist is to identify erroneous, inadequate and inapplicable thinking, which must be corrected or completely changed, instilling in the patient acceptable thoughts and behavior patterns. For this, therapy is carried out in three stages:

logical analysis;
empirical analysis;
pragmatic analysis.

At the first stage, the psychotherapist helps the patient analyze emerging thoughts and feelings, finds mistakes that need to be corrected or removed. The second stage is characterized by teaching the patient to accept the most objective model of reality and to compare the perceived information with reality. At the third stage, the patient is offered new, adequate life attitudes, based on which it is necessary to learn how to react to events.

Cognitive errors

Inappropriate, painful, and negatively directed thoughts are viewed by the behavioral approach as cognitive errors. Such errors are quite common and can occur in different people in different situations. These include, for example, arbitrary inferences. In this case, a person draws conclusions without any confirmation or even in the presence of facts that contradict these conclusions. There is also overgeneralization - a generalization based on several incidents, which implies the allocation of general principles of action. However, it is abnormal here that such overgeneralization is applied in situations in which it should not be done. The next mistake is selective abstraction, in which certain information is selectively ignored, and information is pulled out of context. Most often this happens with negative information to the detriment of positive.

Cognitive errors also include inadequate perception of the significance of an event. Within the framework of this error, both exaggeration and underestimation of significance can occur, which, in any case, does not correspond to reality. A deviation such as personalization also does not bring anything positive. Personalization-minded people perceive the actions, words, or emotions of others as related to them, when in fact they had nothing to do with them. Maximalism, also called black and white thinking, is also considered abnormal. With him, a person distinguishes between things that have happened into completely black or completely white, which makes it difficult to see the essence of the actions.

Basic principles of therapy

If you want to get rid of negative attitudes, you need to remember and understand some of the rules on which CBT is based. The most important thing is that your negative feelings are primarily caused by your assessment of what is happening around, as well as yourself and everyone around you. The significance of the situation that happened should not be exaggerated, you need to look inside yourself, in an effort to understand the processes driving you. Assessment of reality is usually subjective, therefore, in most situations, you can radically change the attitude from negative to positive.

It is important to realize this subjectivity even when you are confident in the veracity and correctness of your conclusions. This frequent occurrence of a discrepancy between internal attitudes and reality disturbs your peace of mind, so it is better to try to get rid of them.

It is also very important for you to understand that all this - wrong thinking, inadequate attitudes - can be changed. The typical mindset you have developed can be corrected for minor problems, and for major problems it can be completely corrected.

Teaching new thinking is carried out with a psychotherapist in sessions and independent studies, which subsequently ensures the patient's ability to adequately respond to emerging events.

Therapies

The most important element of CBT in counseling is teaching the patient to think correctly, that is, to critically assess what is happening, to use the available facts (and search for them), understand the likelihood and analyze the collected data. This analysis is also called empirical testing. The patient carries out such a check independently. For example, if it seems to a person that everyone is constantly turning at him on the street, you just need to take and count, and how many people will actually do this? This uncomplicated test can achieve significant results, but only if done and done responsibly.

Therapy for mental disorders involves the use of psychotherapists and other techniques, for example, the reevaluation technique. When using it, the patient checks for the likelihood of this event occurring due to other reasons. The most complete analysis of the many possible causes and their influence is carried out, which helps to soberly assess what happened as a whole. Depersonalization is used in cognitive behavioral therapy for those patients who feel constantly in the spotlight and suffer from it.

With the help of assignments, they understand that others are most often carried away by their affairs and thoughts, and not by the patient. An important direction is also the elimination of fears, for which they use conscious self-observation and decatastrophication. With these methods, the specialist tries to get the patient to understand that all bad events end, that we tend to exaggerate their consequences. Another behavioral approach implies the repetition of the desired result in practice, its constant consolidation.

Treatment of neuroses with therapy

Cognitive behavioral therapy is used to treat a wide variety of conditions, the list of which is vast and overwhelming. In general, using her methods, they treat fears and phobias, neuroses, depression, psychological trauma, panic attacks and other psychosomatics.

There are a lot of methods of cognitive-behavioral therapy, and their choice depends on a particular person and his thoughts. For example, there is a technique called reframing, in which the therapist helps the patient to get rid of the rigid framework into which he has driven himself. In order to better understand oneself, the patient may be offered to keep a kind of diary in which feelings and thoughts are recorded. Such a diary will also be useful for the doctor, as he can thus choose a more suitable program. A psychologist can teach his patient positive thinking, which replaces the formed negative picture of the world. The behavioral approach has an interesting way - role reversal, in which the patient looks at the problem from the outside, as if it is happening in another person, and tries to give advice.

Behavioral therapy uses implosion therapy to treat phobias or panic attacks. This is the so-called immersion, when the patient is deliberately forced to remember what happened, as if to relive.

Systematic desensitization is also used, which differs in that the patient is pre-trained in relaxation techniques. Such procedures are aimed at eliminating unpleasant and traumatic emotions.

Depression treatment

Depression is a common mental disorder, one of the key symptoms of which is impaired thinking. Therefore, the need for CBT in the treatment of depression is undeniable.

Three typical patterns have been found in the thinking of people with depression:

thoughts about the loss of loved ones, the destruction of love relationships, loss of self-esteem;
negatively directed thoughts about oneself, the expected future, others;
uncompromising attitude towards oneself, presentation of unreasonably strict requirements and frameworks.

Behavioral therapy should be helpful in solving problems caused by such thoughts. For example, stress inoculation techniques are used to treat depression. For this, the patient is taught to be aware of what is happening and to intelligently deal with stress. The doctor teaches the patient, and then fixes the result with independent studies, the so-called homework.

But with the help of the reattribution technique, you can show the patient the inconsistency of his negative thoughts and judgments and give new logical attitudes. CBT methods such as the stop technique, in which the patient learns to stop negative thoughts, are also used to treat depression. At the moment when a person begins to return to such thoughts, it is necessary to erect a conditional barrier for the negative, which will not allow them. By bringing the technique to automatism, you can be sure that such thoughts will no longer bother you.

Cognitive behavioral therapy - the essence and effectiveness of the method

Cognitive behavioral therapy was born out of two popular psychotherapy methods of the second half of the 20th century. These are cognitive (thinking change) and behavioral (behavior correction) therapy. Today CBT is one of the most studied therapies in this area of medicine, has undergone many formal trials and is actively used by doctors around the world.

Cognitive Behavioral Therapy

In modern psychotherapy, CBT is used to treat neuroses, phobias, depression, and other mental problems. And also - to get rid of any type of addiction, including drug addiction.

Method essence

From a CBT perspective, drug dependence consists of a number of specific behaviors:

imitation ("friends have smoked / smelled / injected, and I want to") - the actual modeling;
based on personal positive experience from drug use (euphoria, withdrawal from pain, increased self-esteem, etc.) - operant conditioning;
coming from the desire to experience pleasant sensations and emotions once again - a classic conditioning.

The scheme of exposure to the patient during treatment

social (conflicts with parents, friends, etc.);
the influence of the environment (TV, books, etc.);
emotional (depression, neurosis, desire to relieve stress);
cognitive (the desire to get rid of negative thoughts, etc.);
physiological (intolerable pain, "withdrawal", etc.).

To identify them, a special exercise is used - the patient must, for several days, indicating the date and date, write down his thoughts and emotions in the following table:

Feelings that appeared after rational thought

The technique of understanding and overcoming drug hunger is also used, the skills of quitting drugs and prevention of relapse are practiced.

Indications and steps for CBT

There are many different CBT modalities - different clinics may use specific techniques.

Any CBT always consists of three consecutive stages:

Logical analysis. Here, the patient analyzes his own thoughts and feelings, identifies errors that lead to an incorrect assessment of the situation and incorrect behavior. That is, the use of illegal drugs.
Empirical analysis. The patient learns to distinguish between objective reality and perceived reality, analyzes his own thoughts and behavior patterns in accordance with objective reality.
Pragmatic analysis. The patient identifies alternative ways of responding to the situation, learns to form new attitudes and use them in life.

Efficiency

CBT has the following effects when working on drug addiction recovery:

provides a stable psychological state;
eliminates (or significantly reduces) the signs of a psychological disorder;
significantly increases the benefits of drug treatment;
improves social adaptation of a former drug addict;
reduces the risk of further disruptions.