29 September 2011

What is CBT?

The idea that our thoughts, attitudes, and beliefs have a profound influence on the way we feel and react to what life throws at us has been around for centuries.


This article is part of our introductory series on cognitive-behaviour therapy.

The idea that our thoughts, attitudes, and beliefs have a profound influence on the way we feel and react to what life throws at us has been around for centuries; since the early Greek philosophers. The scientific discipline of psychology has, however, only recently given attention to this phenomenon as a means of understanding and treating psychological problems.

While the initial psychological theory of human emotion and behaviour (originally based on the work of Sigmund Freud) certainly made significant contributions toward the development of the profession, few theoretical frameworks have had as significant an impact on the treatment of psychological distress as cognitive behaviour therapy (CBT).

The primary difference between CBT and other psychotherapeutic models is based on the notion that emotional and behavioural disturbance is essentially driven by the way in which we think about that with which we are confronted. 

The fictitious scenario below provides an example of the type of thinking that would typically be associated with depressed mood.

Case study

Joe fails his economics exam and thinks “I am such a failure; I’ll never manage to get through this degree; the rest of my life is ruined”. As a result, Joe (1) feels depressed, (2) withdraws himself, (3) renders himself helpless and his situation hopeless and (4) drops out prematurely from his studies.

Alternatively, if Joe was able to think in a more helpful and realistic manner and consider the following thoughts such as, “oh well, I failed, but then who hasn’t? This is a real inconvenience, but is it really a catastrophe? I could certainly learn from my mistakes and try again; this isn’t the only thing I can study or do with my life”, then he’d be more likely to (1) feel sad or disappointed but not feel depressed, (2) not withdraw himself or (3) not give up prematurely.

His disappointment would be considered healthy and may actually help motivate him to try harder next time. This fictitious account provides for a typical example of how our emotional and behavioural reactions to difficult circumstances are determined to a large degree by the way in which we think about our circumstances, and not merely by those circumstances themselves. In other words, Joe’s emotional and behavioural reaction is determined by how he thinks about the fact that he failed, and not solely his failure.

Emotional responsibility

CBT theory proposes that if we are able to identify those thinking and behavioural patterns that are contributing toward our distress, restructure and alter these, then one would be better equipped to reduce or eliminate psychological distress. The CBT model thus encourages “emotional responsibility” by encouraging individuals to identify and alter the way in which they think so as to feel and react in a more appropriate way. This also provides for a more optimistic view regarding the potential for human beings to alter their emotional and behavioural reactions to difficult circumstances. The model proposes that individuals can effectively and successfully influence their own emotional well-being, irrespective of the situation with which they are confronted. 

CBT is practical, goal-orientated and based on objective, measurable concepts that have been verified scientifically (empirically). For instance, behaviour can be observed, measured and studied, as can thought, which we are typically able to articulate through language. Scientific investigation has shown that our thoughts are very much associated with our emotional states and behavioural reactions and that  restructuring of our thoughts typically alters the way we feel. Thousands of well designed, peer-reviewed research papers have verified the central tenets of CBT.

CBT-based intervention is based on what we now know works regarding the treatment of a wide variety of psychological disorders. There is ample scientific evidence that CBT is effective in the treatment of mood disorders, anxiety disorders, interpersonal problems, eating disorders, substance-related problems, psychotic disorders, impulse control disorders, insomnia and behavioural problems. Treatment is often based on a specific protocol, with brief, direct, and time-limited treatments for specific psychological disorders.

Written by Bradley Drake and Jaco Rossouw, Centre for Cognitive-Behaviour Therapy, Cape Town, South-Africa. For further details visit: (September 2011)

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