If you have ever visited a therapist, a campus counselor, or any other mental health professional, chances are that you have participated in some form of cognitive behavioral therapy, commonly known as CBT. Cognitive behavior therapy works around the central idea that your thinking pattern influences your feelings and behaviors. CBT practitioners believe that you can change the way you feel if you can change the way you think.
This article explains the basics of cognitive behavior therapy and its benefits and enlists some very effective CBT exercises that you can practice at home to improve your life.
What is Cognitive Behavioral Therapy?
Cognitive behavior therapy was developed by Aaron Beck in the 1960s, primarily for the treatment of depression. He noticed that individuals with depression have a negative way of interpreting things about themselves and about the world.
Today CBT is a scientifically proven method, widely used for the treatment of a wide variety of mental health problems and disorders, such as anxiety, post-traumatic stress disorder, phobias and panic disorder, bipolar disorder, insomnia, etc.
In formal words, Cognitive behavior therapy is a psycho-social form of treatment that works by challenging and changing cognitive distortions (maladaptive ways of perceiving events), improving emotional regulation and instilling emotional control, and facilitating healthy coping strategies in an individual.
Cognitive behavior therapy focuses on the relationship between one’s negative thoughts and maladaptive behaviors. It aims to break the negative feedback cycle, by creating a healthy sequence of thoughts, feelings, and behaviors.
How Does Cognitive Behavior Therapy Work?
As mentioned above, CBT focuses on three components of psychological problems: thoughts, feelings, and behaviors. Thoughts impact the feelings and emotions of individuals, which in turn affects their actions and behaviors. CBT requires the patient to break down their problem into these three components. This simplifies the issue and makes it clear to the therapist which step is help or intervention needed.
If a person has a negative way of perceiving events, the therapist helps them acquire a new and healthy thinking pattern. Similarly, if an individual behaves negatively in response to certain situations or emotions, the therapist helps them learn new behavioral responses.
However, the psychological problems people face are mostly quite complex, and it is not easy to categorize them into these three components. In such cases, CBT targets all three components simultaneously.
CBT is most helpful when professional help is sought from licensed therapists and mental health practitioners. BetterHelp has a team of licensed psychologists who specialize in providing cognitive behavior therapy online.
You can head over to their website and book yourself a session with the therapist of your choice right now to improve your mental health. Alternatively, the following are some very effective CBT exercises that you can practice at home by yourself.
Cognitive Behavioural Therapy Exercises
1. Simple Journaling
Homework assignments given by the therapist are an integral part of cognitive behavior therapy. The most common and cathartic assignment given by therapists to their clients is journaling. This simple exercise helps people put their thoughts in order and keep their emotions and behaviors in check.
Journaling can help people identify their thinking and behavioral patterns, as well as their consequences, which can help those people change them.
This CBT exercise involves noting down distressing and anxiety-provoking situations and rating the level of stress experienced in each situation on a scale from 1 to 10. Ranking the situations by the level of distress they cause provides you with an idea about the issues in your life that require your attention the most.
This way, you can resolve the most distressing conflicts first, which will automatically leave you more clear-headed to resolve the rest of the issues. This is an excellent exercise for people who are unclear about why they feel so anxious.
3. Identifying Cognitive Distortions Through Thought Monitoring Worksheet
The primary goal of cognitive behavior therapy is to identify the flawed ways in which we perceive events and situations around us, otherwise known as cognitive distortions. Some people magnify a minor inconvenience and blow it out of proportion, some see the world as either good or bad, while others discount all the positive things that happen to them and only focus on the negatives.
To target these cognitive distortions, you first need to identify the ones from which you suffer. In order to do that, you can simply start monitoring your thoughts and feelings by noting them down. Write down your disturbing moods and thoughts, at what time they occurred, what caused them, how intensely you felt them and how you responded to them.
By monitoring your thoughts, you will be able to identify your negative automatic thoughts and core beliefs that are at the root of your emotional problems and change them through cognitive restructuring.
Cognitive restructuring involves reframing negative thoughts by perceiving situations from a different perspective. The therapist suggests an alternative view that you can consider when a triggering situation occurs instead of your usual negative automatic thought.
For example, instead of thinking “I am a failure because I got a bad grade on my exam”, you can say “I got a bad grade but that doesn’t define me as a student. I am sure if I work harder next time, my result will improve”.
This can be done with the help of a professional, or in some cases, you can even get over them on your own if you have enough insight and knowledge.
4. Evidence-Based Guided Discovery
This exercise is best done with the guidance of a therapist, but you can also practice it at home. In this technique, you have to write down your negative automatic thoughts or core beliefs on a paper. The therapist then asks you different questions about those thoughts, challenging your underlying beliefs. You will be asked to provide evidence for your beliefs.
For example, if you have this negative automatic thought: “my husband left for work while I was sleeping. I know I am not important to him because he left without seeing me”, your therapist might challenge your belief by asking questions like: “Has your husband ever said anything that might imply you are not important to him? Does your husband never show you any affection? Is it possible he did not want to wake you up because you were tired from last night and he did not want to disturb you?”.
This exercise helps you differentiate between facts and opinions. You start to see things from new and different perspectives and unlearn unhealthy and maladaptive ways of thinking.
5. Visualization Therapy
Visualization therapy is also known as imagery-based exposure. This CBT technique is very beneficial for people suffering from phobias, panic disorders, or anxiety. It involves imagining or visualizing a distressing or anxiety-provoking situation and playing it out in your mind from start to end.
The therapist can also guide you through the events of that situation, helping you realize that you can get through that situation and everything will turn out just fine. Imagining an anxiety-provoking situation a few times will desensitize you to the distressing emotions that surround it, helping you cope with your emotions when you are actually in that situation.
This technique is also helpful to get over past events that still cause strong negative emotional reactions in you. The therapist asks you to analyze different aspects of the situation that occurred, how you felt, how the people around you reacted, and whether or not that situation still impacts your life in any way.
The therapist identifies your cognitive distortions and negative automatic thoughts along the way and helps you reframe that situation positively using cognitive restructuring. This is done repeatedly until that situation has no power to elicit emotions of anxiety, guilt, embarrassment, or fear in you.
6. Functional Analysis
Functional analysis works on the basis of the ABC model. The ABC model helps in changing problematic behaviors by targeting its maintaining conditions. In simple words, the maintaining conditions of a behavior refer to the events that take place before the person engages in the behavior (antecedents) and the things that happen after the behavior has occurred (consequences).
The therapist asks the client to note down whenever they engage in behavior that needs to be changed, for example, drinking alcohol. In the next session, the therapist asks the client about the situations or factors that led up to that behavior and the consequences of the behavior.
The client may notice that he only drinks excessively when he hangs out with a certain friend. The consequences of drinking can be feeling relaxed or de-stressed which reinforces the drinking behavior.
The therapist will then target the maintaining conditions of the behavior, rather than trying to eliminate the behavior directly. The client can be asked not to hang out with that friend alone or talk to him/her directly about this issue. The action of drinking can be associated with a noxious feeling, mostly done through imagery, which may lead the client to repulse drinking.
7. Longitudinal Formation
This technique is similar to functional analysis but it provides a deeper insight into an individual regarding their problems. This worksheet helps in identifying our negative ways of living and constructing new rules of living.
Firstly, the client has to list down all the factors that lead up to and perpetuate the undesired behavior (including childhood events), the internal rules the client follows when engaging in that behavior, and the consequences of following those internal rules.
The client is then asked to list down protective factors, which refer to personal or social resources that they can draw on to deal with their problem better. After acknowledging these resources, the client is asked to formulate new rules for living.
For example, if the client has an internal rule that “I must do everything myself”, they can be asked to think about the family members or friends (protective factors) who would always be willing to help them out without passing judgment. The client can then formulate a new rule: “it is alright to ask others for help when I need it”, which will break the loop of negativity for them.
8. Relaxation and stress reduction techniques
Relaxation techniques, such as deep breathing, mindful meditation, muscle relaxation, guided imagery, etc. can be used to help clients deal with a multitude of problems.
By calming the physiological reactions of the body and putting it into a low arousal state, the body’s resources can be used to resolve the problem at hand by thinking more clearly. Relaxation techniques help by allowing you to stay grounded and silently reflect on your thoughts and feelings in the present moment.
What is Cognitive Behavior Therapy used for?
CBT was originally developed for the treatment of anxiety but today is used to treat a wide range of mental problems, including but not limited to anxiety, post-traumatic stress disorder, personality disorders, eating disorders, somatoform disorder, body dysmorphic disorder, obsessive-compulsive disorder, and psychosis.
Do you need a diagnosis?
A diagnosis is not required to benefit from cognitive behavior therapy. CBT can help with many normal life processes and issues, for example dealing with grief or a loss, assertiveness training, self-esteem and confidence issues, anger management, and coping with physical illnesses.
How long does it take to get better?
It takes around 8-12 weekly sessions of 60 minutes on average for people to get better through cognitive behavior therapy.
Can I do cognitive behavioral therapy on my own?
Cognitive behavior therapy is most effective when directed by a therapist, but you can definitely practice CBT techniques by yourself at home. Most of the techniques mentioned in this article can be very effective even if they are self-directed.
Are there any risks?
There are not any major risks associated with cognitive behavior therapy, but some people may find revisiting their embarrassing or traumatic memories quite stressful, especially at the beginning of the treatment.
However, in most cases, this tends to get better with time after individuals realize that CBT requires willingness and commitment to work through the difficult phases of the treatment.