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Cognitive behavioral therapy

Cognitive behavioral therapy evolved from behaviorism.

It concerns the dimensions cognitive, behavior and cognitive-behavioral.

Often treatments are protocolized. This means that the counseling process is prescribed in a protocol. This protocol arose from evaluating what has the most optimal effect.

Unlike many other forms of counseling, behavioral therapy is not interested in the person’s history.
Any behavior is reduced to a response to stimuli from the environment. It is assumed that every behavior has a function for humans. In counseling, we look for the function of the stated behavior after which we introduce and practice other behaviors to achieve a new outcome.

Behavioral components

Concepts such as classical and operant conditioning belong in this guidance. Conditioning is making a connection between a stimulus and a response. These can be either negative or positive. Thus, behavior is an inescapable response or reaction to an observable stimulus. The function of the behavior is to evoke this stimulus or to escape it.

Likewise, learning psychology is covered here. In what ways do people learn? One of these is ‘modeling’. People learn by observing the behavior of others. Imitation plays an important role. What function do the learned behaviors serve? Are they still useful or are they better replaced by new, more functional behaviors.

In counseling, we are going to accurately identify the problems. What do you do in what situation? With this, we want to identify which triggers in which situations cause the problem behavior.

In a functional analysis, we look at possible relationships between the different symptoms (e.g., relationship problems and alcohol abuse)

Then together we determine new behaviors that will positively affect the outcome for you. This may involve unlearning certain behaviors and teaching other behaviors. Punishment and reward play an important role in this.

A specific form is habituation to stimuli present in the environment. Practically, this means “systematic desensitization” in which one learns step-by-step how to deal with more difficult situations (e.g., anxiety). Emerging tension is made controllable with relaxation techniques. In this way, the fear response is gradually extinguished.

Results are tracked and often presented visually. Based on these results, guidance is adjusted. At the end, a “before” and “after” result is drawn up. This is the behavioral therapy evaluation.

In the cognitive dimension, we argue that some thinking patterns lead to psychological problems. These thought patterns arise from our (early childhood) experiences that are internalized. We call these the inner scripts. It is an assessment of a particular context that involves a prescription of how we should feel and behave.
By changing these non-functional thought patterns and inner scripts into functional ones, we address the problems.

Irrational thoughts are transformed into tenable and useful beliefs. One can work with this and is thus at its core cognitive therapy.

So it is not so much the facts that determine how we behave, think and feel. However, our perceptions and beliefs about the situation or event do determine our functioning. An example is how we handle and live with the glass half full or half empty!

Also, how we see ourselves determines how we react to situations. Cognitive schemas are people’s fundamental beliefs or core beliefs regarding themselves, others and the environment.

Techniques used include:

  • Role-play that teaches new thinking patterns. By playing difficult situations, faulty thinking patterns are detected and corrected. A role reversal between therapist and client brings the insight to transform faulty thinking patterns into tenable and usable thinking patterns.
  • The client makes predictions in his or her mind about how a future situation will play out. It is then tested by the client in the practical situation. Since the thought experiment relies on unsustainable thought patterns, they will therefore not come true in practice. This undermines shelf life and replaces faulty thinking patterns with renewed useful and tenable thinking patterns.

Integrating both the cognitive and behavioral dimensions is more effective in results than the two separately.