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6 Types of Cognitive behavioral therapy

Reading time: 7 mins

Cognitive behavioral therapy (CBT) refers to a form of psychotherapy that helps people change self-defeating thoughts, feelings, and behavior. It is an evidence-based treatment that aims to reduce symptoms of a wide array of mental health problems. 

Because thousands of research trials have found CBT to be an effective psychotherapeutic treatment option, additional specialized CBT types that take different approaches have since emerged.

The types of cognitive behavioral therapy include:

  1. Cognitive Processing Therapy (CPT)
  2. Cognitive Therapy (CT)
  3. Dialectical Behavior Therapy (DBT)
  4. Rational Emotive Behavior Therapy (REBT)
  5. Self-Instructional Training
  6. Stress Inoculation training
Annoyed female sitting in front of someone else

1. Cognitive Processing Therapy (CPT)

Cognitive processing therapy (CPT) is one of the specific types of CBT. It is a 12-session psychotherapy that was originally designed to treat post-traumatic stress disorder (PTSD), which results from witnessing or experiencing traumatic events, such as serious accidents, physical or sexual assault, and military confrontation. CPT works by helping patients change upsetting thoughts about themselves or the world in relation to their trauma. For instance, PTSD patients may think that they are to blame for what happened or feel as if they are constantly in danger. These kinds of unhelpful thoughts can maintain or exacerbate PTSD symptoms. CPT helps the patient gain a new understanding of their trauma so that its ongoing negative effects can be reduced.

2. Cognitive Therapy (CT)

Among the cognitive behavioral therapy types, cognitive therapy (CT) is said to be one of the earliest therapies to be classified as CBT, as opposed to other traditional approaches for mental disorders. Cognitive therapy is a treatment process that was originally developed to treat depression. It operates on the assumption that thoughts influence moods; therefore, CT enables patients to discover and substitute healthy thoughts for false self-beliefs, which leads to an improved mood, behavior, self-concept, and physical state. Patients with depression often have better response rates following eight to 16 sessions of CT. 

3. Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a type of psychotherapy based on cognitive behavioral therapy (CBT) but has been specially adapted for people who suffer from extremely powerful emotions. ‘Dialectical’ means considering two opposite theories or ideas. DBT works by helping people accept who they are while encouraging them to change unhelpful behaviors at the same time. These might appear contradictory, but DBT allows you to achieve these two seemingly different goals together. DBT is known to be effective for treating a plethora of mental health conditions, such as borderline personality disorder (BPD), bipolar disorder, self-harm, and eating disorders, to name a few. A full DBT course takes at least six months to a year to complete. 

4. Rational Emotive Behavior Therapy (REBT)

Rational emotive behavior therapy (REBT) is a form of CBT that focuses on helping people identify and challenge irrational beliefs by replacing them with more rational thinking patterns. REBT has proven to be effective in treating individuals struggling with depression, social anxiety, disruptive behavior, and overwhelming feelings of anger. Although there is no set course for REBT, it is designed to be brief, and desired results may come in as little as five sessions or between a few weeks or months of treatment. 

5. Self-Instructional training

Self-instructional training is a form of cognitive behavioral therapy that was first developed to reduce impulsive behaviors in children with attention-deficit hyperactivity disorder (ADHD). It involves the use of inner speech to modify or regulate behavior. In other words, children talk themselves through the steps of an activity to complete an action, which teaches them to think and plan before executing a task. Self-instruction techniques have proved their efficiency in educational settings and have benefited children undergoing treatments for hyperactivity, impulsivity, and learning difficulties in general. 

6. Stress Inoculation training

Also known as SIT, it is psychotherapy for post-traumatic stress disorder (PTSD). In stress inoculation training, patients are taught coping strategies to manage PTSD symptoms before they even experience them. This may involve techniques such as deep muscle relaxation, breathing exercises, assertiveness skills, and self-guided dialogue – all of which help patients to be more prepared in handling stressful events in the future with minimal negative outcomes. Exposure to milder forms of stress helps individuals respond quickly to PTSD-related anxiety that may trigger their symptoms. SIT sessions often last for 90 minutes over several weeks. 

What is Cognitive behavioral therapy?

Cognitive behavioral therapy is a structured, time-limited form of talking therapy that explores the links between thoughts, feelings, and actions. Changing one of these can help alter your negative responses to stressful life situations. 

CBT primarily works by recognizing and modifying dysfunctional thinking patterns, beliefs, and emotions in order to eliminate problematic behavior. Patients also learn how to replace negative thoughts with more realistic and less harmful ones, so they can have better control over their behaviors. 

Cognitive Behavioral Therapy infographic

How do experts choose which types of CBT to use?

Experts choose the types of CBT to use by determining the maintaining factors that keep a patient stuck in their problems and targeting them. Because cognitive behavioral therapy is present-oriented, CBT therapists focus on what keeps the issue going and not what started it. 

Some actions that can cause more problems include avoidance, memory bias, unhelpful thinking patterns, and safety behaviors. These maintaining factors can come together and cause problems for the patient. By determining which of these factors keep a person’s problem going, the areas of life that need to be addressed are recognized, and the therapist gets to decide which types of CBT the patient gets. 

Where is Cognitive behavioral therapy used?

Cognitive behavioral therapy was originally developed and used by Dr. Aaron T. Beck to treat depression. However, due to its proven effectiveness, it was quickly adapted to manage symptoms of a range of mental and emotional health issues. Emotional problems where cognitive behavioral therapy is used are listed below. 

  • Anxiety: CBT is the most widely used therapy for anxiety disorders, such as generalized anxiety disorder, panic attacks, and social anxiety disorder. It helps address anxiety by changing the way someone thinks and behaves, so they can avoid triggering feelings that result in anxiety. Since CBT is a time-sensitive form of psychotherapy, overcoming anxiety may take about 20 sessions or fewer, but those with severe anxiety may need a bit longer than that.
  • Depression: Different types of CBT therapy may be used to help someone who is struggling with depression. These may help a patient become aware that they have negative or false thoughts that contribute to their mood and overall outlook on life. CBT will then help them change their destructive attitude, which ultimately changes their behavior and eases their depression. Treating depression with CBT usually lasts 10-20 sessions and may be in conjunction with other treatments, such as antidepressants.
  • Obsessive-compulsive disorder (OCD): CBT is one of the most common treatment methods for OCD. CBT for OCD is based on the principle that the latter stems from negative thinking patterns that cause afflicted individuals to respond to stressful situations in unhealthy ways, or by developing obsessions and/or compulsions. With the use of CBT, a person struggling with OCD learns more effective and healthier ways to respond to their emotions and physical sensations. Treating obsessive-compulsive disorder with CBT typically lasts for about 12 weeks with weekly 60-minute sessions. However, the duration of treatment may still vary depending on other mental health problems aside from OCD that the person may be dealing with.
  • Post-traumatic stress disorder (PTSD): CBT helps people struggling with post-traumatic stress disorder by challenging the unhelpful thought patterns and emotions that are associated with someone’s trauma. CBT also explores the patient’s responses to certain reminders of their trauma and helps them reduce the severity and negative impacts of their panic responses. Treating PTSD with the use of CBT frequently involves seeing a therapist weekly for up to four months.
  • Eating disorders:  CBT is a psychotherapeutic approach that is commonly used in adults with eating disorders, such as anorexia nervosa, binge eating disorder, and bulimia nervosa. CBT for eating disorders posits that understanding how unhelpful thoughts, feelings, and behaviors drive eating disorders is a big leap forward to developing strategies that would create a positive change for patients. For instance, changing behavior such as excessive eating can result in improved health. Individuals who suffer from eating disorders may be recommended to complete a minimum of 20 treatment sessions, with each lasting about 50 minutes on a weekly basis.

How long does it take for CBT to work?

For some people, CBT works only after a few sessions, while others may require a few months to see desired results. The length of time in which people will begin to see results may vary widely according to certain factors, such as the severity of their symptoms and other mental health conditions they may be struggling with. 

Cognitive behavioral therapy is performed by first assessing the patient’s mental health by asking them to fill out a questionnaire. This psychological evaluation and other questions that will be asked by the therapist are crucial in building a connection, customizing a treatment plan, and tracking the patient’s progress later on. 

Once the therapist has asked all the necessary questions, determined the patient’s goals, and identified self-defeating thought patterns, they will collaborate with the patient in picking the different types of CBT techniques to be used in order to eliminate those unhelpful thoughts. 

The patient will then attend an average of five to 20 treatment sessions, where exercises can be done in or out of the session through homework, including self-reflection tasks and readings. Things such as your and your CBT therapist’s availability and accessibility may also play a role in the duration of someone’s treatment. 

Which facilities provide Cognitive behavioral therapy?

Wherever your location might be, there are treatment centers that offer emotional support and understanding that you need to get better. The top facilities that provide cognitive behavioral therapy are listed below.

  • Mayo Clinic: The Mayo Clinic is a nonprofit health system that has built a world-renowned reputation as a center for difficult-to-treat conditions. Situated in Rochester, Minnesota, United States, the nonprofit academic medical center regularly lands at or near the top of the world’s best hospitals. It is also top-rated in around 14 specialties, including psychiatry and psychology, and has several doctors who are skilled in providing cognitive behavioral therapy to patients.
  • Massachusetts General Hospital: The CBT program at Massachusetts General Hospital offers advanced clinical care to patients of different ages with emotional and behavioral problems. The institution consists of highly experienced psychologists who specialize in the use of cognitive behavioral therapy for a wide range of psychological disorders and medical concerns. 
  • The Diamond Rehab Thailand: Located in Phuket, Thailand, The Diamond Rehab offers one of the best cognitive behavioral therapy residential programs in the country. With the help of fully qualified CBT practitioners, recovery plans are tailored to the specific needs and unique situation of the patient.  

Are Cognitive behavioral therapies effective?

Yes, cognitive behavioral therapies are effective. In fact, there is ample scientific evidence that CBT is as effective as, if not more effective, than other psychological treatment options or medications. 

Moreover, the efficacy of cognitive behavioral therapy has not only been proven in addiction and a plethora of psychiatric disorders, but also in distress due to medical conditions, such as hypertension, non-ulcer dyspepsia, chronic obstructive pulmonary disease, multiple sclerosis, and physical disability after a traumatic injury, to name a few. 

Another significant proof of its effectiveness is the development of the different forms of cognitive behavioral therapy, which are specific therapeutic approaches that address specific psychological disorders and other mental health issues in therapy clients.