What is Cognitive Behavioral Therapy? (CBT)

Why Cognitive Therapy? Because It Works!

Cognitive Behavioral Therapy (CBT) is usually a short term therapy based on examining how our feelings, mood, and behavior are interconnected and influenced by our thoughts, perceptions and views about the world. Simply stated, how we interpret a situation influences how we feel, our reactions to the situation and our behavior.

CBT is an empirically based treatment, meaning its effectiveness can be measured, has been measured and has consistently been found in more than 500 studies to have proven effectiveness.


How Does It Work?

Cognitive Therapy employs a goal-oriented, problem-solving approach to treatment which focuses on identifying and challenging the patterns of thinking that maintain problems, emotional distress or patterns of behavior that keep us “stuck.“ By engaging in the CBT process clients learn to:

  • Recognize, identify, challenge and modify their inaccurate and unhealthy beliefs.
  • Track occurrence of these thoughts and their influence on how you feel.
  • Find new ways to solve problems by learning new cognitive and behavioral skills.
  • Test these skills in the office, at home and at school with tasks designed specifically to reinforce the learning.


CBT – The Process

Our work in CBT begins by establishing a partnership focusing first on identifying your goals for treatment.

  • We then look at the barriers you’ve encountered in reaching those goals.
  • We jointly develop an agreed upon treatment plan.
  • We begin our work by identifying errors in your thinking and core beliefs which affect your behavior and coping abilities.
  • The process involves identifying “automatic dysfunctional thoughts” and evaluating their effect on your thinking and behavior. This is the first step in a process known as cognitive restructuring.
  • You, the client, are an active participant in the process and also work at home on assignments which reinforce the work we do in the office.
  • It is vital to participate in scheduled exercises at home to reinforce our office work and to change habitual thinking patterns.

Usually CBT for a primary problem is a time-limited treatment. Clients sometimes decide to address secondary issues which could lengthen the course of treatment.

What Treatment Methods Are Used by CBT Therapists?

In addition to providing Cognitive Therapy, Exposure and Response Prevention (ERP), Systematic Desensitization, Relaxation Training and Habit Reversal are some of the additional treatment techniques employed by trained Cognitive Behavioral Therapists like myself.

ERP is empirically tested and the treatment of choice for Obsessive Compulsive Disorder. ERP involves the identification of situations which trigger compulsions and then focuses on methods to build tolerance to the irrational fear associated with an anxiety provoking situation, object or thought.

  • The ERP process first involves psychoeducation.
  • A list of your fears is elicited and a fear hierarchy is then developed, ranking your fears.
  • Both In Vivo and Imaginal Exposures are used to help build tolerance to the emotionally charged object, thought or situation and aim to diminish anxiety.
  • When a feared situation cannot reasonably be replicated in the office or immediate environment (In Vivo), Imaginal Exposures are employed to simulate the fear and to gradually induce habituation. To recreate the imagined situation, we usually create digital recordings or scripts, constructed to capture some element of the client’s obsession and or rituals.

Over time, the outcome of this process results in diminished anxiety.

Systematic Desensitization and Relaxation Training, in addition to CBT, are typically used in the treatment of Anxiety Disorders. Clients are initially taught relaxation techniques to help cope when confronting distressing objects or situations. Over time, by using these techniques, fear is extinguished or diminishes markedly.

  • Systematic Desensitization and Relaxation Training techniques involving gradual exposure to feared objects and situations are also used in the treatment of Phobias.

CBT-I Cognitive Behavioral Therapy for Insomnia (CBT-I) is a form of CBT used to treat both Primary and Secondary Insomnia as well as chronic and acute Insomnia. You first learn about sleep hygiene habits, and then you are involved in monitoring your sleep patterns. A sleep diary is used to best determine which interventions are required. We then jointly develop an individual treatment plan. Cognitive Behavioral Therapy for Insomnia combines both behavioral and cognitive components.

Sleep Restriction

  • Following the assessment and psychoeducation, the behavioral component of treatment begins by introducing techniques to purposefully restrict sleep to reduce “conditioned wakefulness states .“
  • The purpose of this intervention is to help restore the homeostatic drive towards sleep. It also involves rebalancing the time spent in bed compared to the total sleep time. This phase of the treatment is based on the psychological theory of stimulus control.
  • Cognitive Therapy is additionally used to focus on “sleep effort” and the underlying assumptions about sleep effort or attempts to sleep, biases about threats to sleep, and overestimation of the negative consequence of insomnia.

Comprehensive Behavioral Intervention for Tics (CBI-T) is a modified form of CBT used to treat Tics and Trichotillomania. The treatment involves psychoeducation, awareness training, competing response training, habit reversal and relaxation techniques.

  • Habit Reversal – Clients are taught to recognize the sensation of the oncoming tic and to better manage its occurrence by performing a new and different behavior, prior to the tic’s onset. This new behavior is termed a competing response.

Behavioral Activation – commonly used in treating Mood Disorders,  focuses on interrupting the self-defeating downward cycle of feeling sad, withdrawing, and then experiencing social isolation-common to people with depression. By increasing the frequency and quality of the pleasurable activities you experience, the cycle is broken. The goal of this intervention is to increase one’s sense of mastery, decrease isolation, and improve mood. Techniques such as activity scheduling and self-monitoring of pleasurable activities are often utilized to promote or restore a feelings of accomplishment.


How Was CBT Developed

Cognitive Therapy was initially developed by Dr. Aaron Beck, a psychiatrist originally trained in psychoanalysis and who has worked at the University of Pennsylvania since the 1960’s. In studying depression he was unable to prove the effectiveness of some psychoanalytic theories and began to think about alternative approaches to understanding this condition. He developed a new view of how depressed patients viewed the world focusing attention on their underlying negative beliefs. Following her father’s first book on Cognitive Therapy, Dr. Judith Beck authored Cognitive Therapy, Basics and Beyond, which has since been translated into 20 languages, demonstrating the worldwide applicability of the process. The Becks’ also began their training center in 1994, The Beck Institute, to teach therapists how to effectively deliver Cognitive Behavioral Therapy.

Over the past 50 years their work has been researched and proven effective in hundreds of professional studies. Treatment professionals around the world are continually finding ways to effectively apply the basic tenets of CBT in treating a range of disorders.

Dr. Aaron Beck is currently in his 90’s and continues to pioneer the application of his theory in treating additional conditions such as Schizophrenia. In concert with his daughter Dr. Judith Beck, he recently presented his work at the Association of Cognitive Behavioral Therapy’s annual convention.


Is CBT Right for You?

You can feel better! To learn more about whether CBT is for you, the conditions or issues for which people seek treatment, which conditions are best treated with CBT, please visit the other pages of this website. Please View the Office Policies page and “About Us” to learn more about our practice. If you rely on insurance for your care, contact your insurance carrier to determine if you have out of network coverage, and the details of the coverage.

To request an initial evaluation contact me at: (908) 273-3133 and leave a message about where and when you can be reached. If you wish, you can also include your email address.