Cognitive Behavioral Therapy

Cognitive Behavioral Therapy. By Our Student Pharmacist, Stephanie Brokaw.

June 8th, 2020

With the increase in reports of depression and anxiety due to the COVID-19 pandemic, I would like to highlight one modality of treating depression and anxiety that can be used alone or in combination with pharmacological therapy: Cognitive Behavioral Therapy

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy in which a therapist helps a patient identify and correct distortive, maladaptive beliefs through education, relaxation exercises, coping training skills, stress management, or assertive training¹.

Unlike other types of therapy, CBT is designed to focus on current aspects of your life which are causing your issues, instead of evaluating issues from the past². CBT sessions generally occur once every one to two weeks and each session lasts 30-60 minutes².

There are four major steps to CBT that your therapist will go through with you.

These are:

1. Identify troubling situations in your life.
2. Become aware of your thoughts, emotions, and beliefs about these problems.
3. Identify negative or inaccurate thinking.
4. Reshape negative or inaccurate thinking⁴.

To best help track these throughout your course of treatment, your therapist may ask you to keep a journal of these situations, thoughts, and feelings. Some people’s problem source relates to negative thoughts or associations they developed in early childhood and have solidified over time⁵. Therapists may encourage reversal of this negative thought process by encouraging patients to focus more on facts related to a situation instead of opinions⁵.

Who would benefit from Cognitive Behavioral Therapy?

CBT is an evidence-based treatment for patients who suffer from psychiatric disorders including:

depression
generalized anxiety disorder
post-traumatic stress disorder
panic disorder
eating disorders
obsessive compulsive disorders¹

CBT can also be used in other medical disorders relating to the mind including:

insomnia
smoking cessation
lower back pain¹

CBT is most effective in highly motivated patients who value a problem solving approach and a willingness to learn and implement skills related to self-observation¹.

How effective is Cognitive Behavioral Therapy?

CBT effectiveness highly depends on an individual’s willingness to engage in therapy and complete recommendations and skills taught from therapy in everyday life¹. Studies have shown CBT to be more effective in smoking cessation alone or in combination with nicotine replacement therapies in comparison to nicotine therapies alone³. CBT has been shown to have similar efficacy to pharmacotherapy in depression, and combination therapy may bring the greatest efficacy to patients³. CBT is a reliable first-line treatment for anxiety disorder and brings a positive effect to symptoms related to anxiety such as sleep dysfunction and a patient’s sensitivity to anxiety³. CBT is also effective in general stress and stress related to other medical diagnoses such as HIV or cancer³.

Local and Virtual Resources:

Free Online Worksheets to use CBT to Identify and Change Negative Thoughts and Feelings

https://positivepsychology.com/wp-content/uploads/2017/03/Coping-Styles-Formulation-Worksheet.pdf

https://positivepsychology.com/wp-content/uploads/2017/03/ABC-Functional-Analysis-Worksheet.pdf

https://positivepsychology.com/wp-content/uploads/2017/03/Case-Formulation-Worksheet.pdf

https://positivepsychology.com/wp-content/uploads/2017/03/Extended-Case-Formulation-Worksheet.pdf

https://positivepsychology.com/wp-content/uploads/2017/03/Dysfunctional-Thought-Record.pdf

https://positivepsychology.com/wp-content/uploads/2017/03/Cognitive-Restructuring-Worksheet.pdf

https://positivepsychology.com/wp-content/uploads/2017/03/Pleasant-Activity-Scheduling-Worksheet.pdf

Therapists in Columbus:

https://ccbtcolumbus.com/

https://wexnermedical.osu.edu/mental-behavioral/psychotherapy

References:

Lebow J. Overview of Psychotherapies. In: Solomon D, ed. Waltham, MA: UpToDate; 2019. www.uptodate.com. Assessed June 2, 2020.
National Health Service. Overview: Cognitive Behavioral Therapy. NHS. https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/. Published July 16, 2019. Accessed June 4, 2020.
Hoffman SG, Asnaani A, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012; 36 (5): 427-440. DOI: 1007/s10608-012-9476-1.
Mayo Clinic. Cognitive Behavioral Therapy. Patient Care and Health Information Tests and Procedures. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610. Published March 15, 2019. Accessed June 4, 2020.
Cully CA, Teten AL. A Therapist’s Guide to Brief Cognitive Behavioral Therapy. Department of Veterans Affairs South Central MIRECC. 2008. https://depts.washington.edu/dbpeds/therapists_guide_to_brief_cbtmanual.pdf Accessed June 4, 2020.