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What to Expect with a CBT Therapist

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) sounds a bit intimidating at first glance because when we draw attention to our behaviors, there's usually some problem that exists. We then find ourselves thinking of the word "behavior" as having a negative connotation, rather than having some curiosity about what's happening at a deeper level of our thinking. If that's true for you, let's shift our perspective. Afterall, that's what CBT is really about; challenging a perspective of ourselves and the world around us so that we can live a more effective, joyful life. How is such an ambitious pursuit achieved, though? If you are seeking therapy, it's helpful to know ahead of time what to expect.

Mental health providers agree that CBT is one of the most effective treatment methods for addressing depression, anxiety, and healthy life transitions. Some research even indicates that it is as effective as medications for depression (note that you should discuss all medical and prescription drug use with your provider before making changes).

CBT is often used as a "brief" therapy, which means that CBT produces benefits within the first couple of sessions and significantly resolved symptoms in a matter of 1-3 months of routine attendance and fully engaging in every session. Like most investments, you get out of it what you put into it. A well-trained, intuitive therapist will patiently and gently challenge their client to collaborate on how to face fears, rather than numbing our or avoiding entirely. The goal is to build an alliance where the therapist normalizes the behavior but also identifies more adaptive ways to respond to stress. This isn't confessional or a listing of all your flaws. It's a non-judgmental observation of how you think about (cognitive) and interact with (behavioral) the world.

Even if it's slow going at first, opening up to your therapist about thoughts and feelings will help lay the groundwork for areas of growth, such as:

Finding the source of your anxiety, such as holding conflicting beliefs at the same time.

Identify ways to manage emotions better, such as tolerating distress when you can't control your situation.

Improve relationship communication where boundaries are clear for yourself and others.

Learn to cope with stress and life transitions while honoring what you can and cannot control.

Your therapist will use CBT to teach you how to identify patterns of thinking that are unhelpful and replace them with helpful ones. I should highlight this word...TEACHING is a huge part of why CBT is so effective and brief. In CBT, a client is taught how to identify and correct patterns of thinking and behavior so that they will be able to graduate from therapy and maintain their progress because it's independently driven. The client can problem solve in a way that builds confidence in their own strength.

The basic assumption of CBT is this: The clients have all they need within themselves to heal. The client and their therapist simply connect in a way that helps the client feel safe to explore.

Now that we've discussed the concept behind CBT, you might wonder still-what does it actually look like? Because of the structured approach, you will find acronyms used to recall and practice during and between sessions. My favorite tool to use is "ABCDE," which stands for the following:

"Activating Event"- What is the event that just caused emotional disturbance in you?

"Belief"- What is your core belief about what just happened (or, what does this say or mean about you?) This is almost always something shameful or hurtful, such as "I'm not good enough" or "I'm unlovable."

"Consequence"- What emotions or behaviors arise in you as a result? Can you scale your emotions on a 0-10 scale right now?

"Dispute"- Let's dispute the core belief above. Is this belief really true about you globally? Are you truly not good enough? Have there been times when you did not feel that way? If there are exceptions, then we know the belief is not entirely true and it loses power to disrupt our sense of self and our peace.

"Effective New Belief"- Now that you have disputed the original belief, what would you rather believe about yourself, knowing the activating event has occurred? Perhaps here you assign appropriate responsibility. You are good enough, but you are also a human with flaws and that's okay. You will learn and grow every day. If this is your effective new belief, you now want to see what behaviors are associated with this type of thinking? Check and see how intense your uncomfortable emotions are right now. Did they lessen in intensity in this exercise? They almost always do.

If you find that self-help isn't quite enough, I encourage you to seek support from a qualified therapist to collaborate with you on your journey. We are wired for connection. Now is no exception. I hope you've found this helpful.

Thank you for letting me share with you one of the most effective tools in my practice. Feel free to exercise it on your own. If you find you need support, here are some recommended readings and a worksheet! You might also want to check out my online e-learning course for cultivating peace here.

Please know that the light within me sees and honors the light within you.

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