- Anxiety
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Anxiety disorders such as social phobia, obsessive-compulsive disorder or posttraumatic stress disorder
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Depression
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Low self-esteem
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Uncontrollable anger
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Irrational fears
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Hypochondria
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Substance abuse, like smoking, drinking or other drug use
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Eating disorders
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Insomnia
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Marriage or relationship problems
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Certain emotional or behavioural problems in children or teenagers.
CBT is also used to help many more psychological problems. In some cases, other forms of therapy used at the same time may be recommended for best results.
The core philosophy of CBT is that thoughts, feelings and behaviours combine to influence a person’s quality of life. For example, severe shyness in social situations (social phobia) may stem from the person thinking that other people will always find them boring or stupid. This automatic belief causes the person to feel extremely anxious at social gatherings. Their behaviour may include stammering, sweating and other uncomfortable symptoms. The person then feels overwhelmed with negative emotions (such as shame) and negative self-talk (‘I’m such an idiot’). Their fear of social situations may become worse with every bad experience.
CBT aims to teach people that it is possible to have control over one’s thoughts, feelings and behaviours. CBT helps the person to challenge and overcome automatic beliefs, and use practical strategies to change or modify their behaviour. The result is more positive feelings, which in turn lead to more positive thoughts and behaviours.
CBT focuses on changing unhelpful or unhealthy thoughts and behaviours. It is a combination of two therapies: ‘cognitive therapy’ and ‘behaviour therapy’. The underlying belief of both these techniques is that healthy thoughts lead to healthy feelings and behaviours. Some of the underlying theories of these two approaches include:
Cognitive therapy – the aim here is to change the way the person thinks about the issue that’s causing concern. Distorted or unhelpful thoughts cause self-destructive feelings and behaviours. For example, someone who thinks they are unworthy of love or respect may feel withdrawn in social situations and behave shyly. Cognitive therapy challenges these unhelpful thoughts. Many techniques are available. One technique involves asking the person to come up with evidence to ‘prove’ that they are unlovable. This may include prompting the person to acknowledge the family and friends who love and respect them. This evidence helps the person to realise that their underlying belief is false. This is called ‘cognitive restructuring’. The person learns to identify and challenge unhelpful thoughts, and replace them with more realistic thoughts.
Behavioural therapy – the aim here is to teach the person techniques or skills to alter their behaviour. For example, a person who behaves shyly at a party may have negative thoughts and feelings about themselves. They may also lack social skills. Behavioural therapy teaches the person more helpful behaviours. For example, the person may be taught conversational skills which they practise in therapy and in social situations. Negative thoughts and feelings ease as the person discovers they can enjoy themselves in social situations. CBT has a good success rate because it combines the techniques of these two very effective therapies.