Cognitive Behavioral Therapy (CBT)

Cheatsheet Content

What is CBT? Cognitive Behavioral Therapy (CBT) is a common type of talk therapy. It helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. Focuses on the interconnectedness of thoughts, feelings, and behaviors. Goal-oriented and problem-focused approach. Typically short-term therapy. Core Principles of CBT Psychological problems are based, in part, on faulty or unhelpful ways of thinking. Psychological problems are based, in part, on learned patterns of unhelpful behavior. People suffering from psychological problems can learn better coping mechanisms, thereby relieving their symptoms and becoming more effective in their lives. The Cognitive Model Situation/Event $\rightarrow$ Thoughts $\rightarrow$ Emotions $\rightarrow$ Physical Sensations $\rightarrow$ Behaviors Situation: What happened? Thoughts: What went through your mind? What images did you have? Emotions: What did you feel? (e.g., sad, anxious, angry). Physical Sensations: What did you feel in your body? (e.g., tense muscles, racing heart). Behaviors: What did you do? (e.g., withdrew, confronted, avoided). Key Techniques in CBT 1. Cognitive Restructuring Identifying and challenging automatic negative thoughts (ANTs). Thought Record: Situation Emotions (rating 0-100%) Automatic Thoughts (rating belief 0-100%) Evidence For Thought Evidence Against Thought Alternative/Balanced Thought (rating belief 0-100%) Re-rate Emotions (0-100%) Socratic Questioning: Asking questions to help clients examine their thoughts (e.g., "What's the evidence for that thought?", "Is there another way to look at this?"). 2. Behavioral Activation Increasing engagement in positive, rewarding activities. Helps break cycles of withdrawal and low mood. Activity Scheduling: Planning and engaging in activities that bring pleasure or a sense of accomplishment. 3. Exposure Therapy Gradual confrontation of feared situations or objects. Used for anxiety disorders (e.g., phobias, PTSD, OCD). Hierarchy of Fears: Creating a list of feared situations from least to most anxiety-provoking. Systematic Desensitization: Pairing relaxation with gradual exposure. 4. Relaxation Techniques Managing physical symptoms of anxiety and stress. Deep Breathing: Diaphragmatic breathing exercises. Progressive Muscle Relaxation (PMR): Tensing and relaxing different muscle groups. 5. Problem-Solving Skills Breaking down problems into manageable steps and finding solutions. Steps: Define the problem. Brainstorm solutions. Evaluate pros and cons. Choose a solution. Implement and review. 6. Core Belief Work Identifying and modifying deep-seated, often rigid beliefs about oneself, others, and the world. Often developed in childhood and influence automatic thoughts. Common Cognitive Distortions Unhelpful thinking styles that can lead to negative emotions and behaviors. Distortion Description Example All-or-Nothing Thinking Seeing things in black and white categories. "If I don't get an A, I'm a complete failure." Overgeneralization Seeing a single negative event as a never-ending pattern. "I messed up that presentation; I'll never be good at public speaking." Mental Filter Picking out a single negative detail and dwelling on it exclusively. Focusing on one critical comment amidst many compliments. Discounting the Positive Insisting that positive experiences don't count. "Anyone could have done that; it's not a real achievement." Jumping to Conclusions Making a negative interpretation without solid evidence. Mind Reading Fortune Telling "They didn't text back, they must be mad at me." "I know I'm going to fail the exam." Magnification/Minimization Exaggerating the importance of negative things and shrinking positive ones. "My small mistake ruined everything!" / "My success was just luck." Emotional Reasoning Assuming that your negative emotions reflect reality. "I feel like a failure, therefore I am a failure." 'Should' Statements Criticizing yourself or others with "shoulds," "musts," "oughts." "I should always be perfect." / "They shouldn't have done that." Labeling Attaching a global negative label to yourself or others. "I'm a loser." / "He's a terrible person." Personalization Believing you are responsible for an external negative event. "It's my fault the project failed, even though I had a small role." Applications of CBT Depression Anxiety Disorders (GAD, Panic Disorder, Social Anxiety, Phobias) Obsessive-Compulsive Disorder (OCD) Post-Traumatic Stress Disorder (PTSD) Eating Disorders Substance Use Disorders Chronic Pain Insomnia Anger Management Effectiveness Extensively researched and evidence-based. Often as effective as medication for many conditions, especially depression and anxiety. Teaches skills that can be used long after therapy ends, reducing relapse rates.