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Cognitive Behavioural Therapy (CBT) and Other Therapeutic Modalities

CBT and Other Therapeutic Modalities


Therapy is general term for counselling services offered by a variety of psychology professionals sought out by individuals dealing with mental health issues and emotional challenges to cope with daily life. It empowers you to deal with difficulties such as illness, trauma, and loss as well as mental disorders such as anxiety or depression. Therapy helps you control or eliminate troubling symptoms so you can enhance your healing and well-being and function fully.

Below is an overview of the most common therapeutic modalities.

Cognitive Behavioral Therapy (CBT)


CBT is a goal-oriented treatment method that takes a practical, hands-on approach to problem-solving. Its objective is to change your thought patterns and behaviour to improve your emotional regulation. CBT focuses on your thoughts, attitudes, beliefs, and images (cognitive processes) to change your behaviour and opinions, and how they relate to your strategies of managing emotional problems. It anchors on the notion that maladaptive behaviour and thought distortions advance the development and continuation of mental disorders. The fundamental idea is that learning new coping mechanisms and information processing techniques will reduce your symptoms.


CBT combines psychotherapy with behavioural therapy and applies the principles of active participation and a deep client-therapist relationship. Your active involvement produces a better understanding of how your cognition can correct your behavioural dysfunctions. You work together with your therapist to understand your problems and develop new strategies to tackle them. CBT is a short-term method that introduces you to a series of lifelong principles that you can apply whenever you need to. It emphasizes on adaptive thinking to prevent a relapse.


Dialectical Behavior Therapy (DBT)


DBT is a form of psychotherapy that uses cognitive-behavioral techniques with an emphasis on the psychosocial elements of treatment. The ideology behind DBT is that certain people’s reaction towards some emotional situations is more intense and extraordinary. DBT implies that in such circumstances, arousal levels of some people escalate more than in an average person, and take a considerable amount of time before returning to a normal arousal level.


DBT is a way of teaching you skills to cope with sudden, intense emotions. It draws heavily from the philosophical view of balancing opposites (dialectics). The principle elements of DBT are acceptance and change. The therapist works with you consistently to establish strategies of holding opposing views at once to promote balance. The goal is to avoid the black and white style of thinking and instead, encourage balance.


Emotionally Focused Therapy (EFT)


This therapeutic approach hinges on the presumption that your emotions are critical to your identity, individual decision making, and choice. EFT assumes that avoiding unpleasant feelings or lack of emotional awareness is harmful. It can render you unable to utilize the vital information that emotions provide.


Emotionally focused therapy is a form of short-term treatment that targets adult relationships and bonding. You actively collaborate with your therapist and examine patterns in your relation. You act to create a stronger bond and build more trust to steer your connection to a more positive and healthier direction. EFT views both you and the therapist as equal contributors, and you as the one who can best interpret your emotional experiences.


Motivational Interviewing


This person-centered therapy and counselling approach helps you commit to the strenuous change process. The process has two goals: To increase your motivation and for you to commit to making a change. Rather than merely stating your desire or need to change, hearing yourself express that commitment loudly will improve your ability to make the changes. Your therapist’s role is more of listening and affirming you and less of intervention.


Motivational interviewing can help you resolve conflicting insecurities and feelings to find the necessary internal motivation to change your behaviour. It is a short-term, empathetic and practical process that considers how challenging it is to make changes in your life. Motivational interviewing often works in combination with other intervention modalities such as stress management training and cognitive therapy.


Solution Focused Brief Therapy (SFBT)


SFBT concentrates on what you want from your therapy sessions rather than why you need therapy. Unlike traditional therapeutic modalities that focus on past occurrences and analyze problems, SFBT focuses on finding solutions for the present and exploring your aspirations for the future. The SFBT approach assumes that you are aware of what you must do to better your life, and with appropriate questioning and coaching, you can find the best solutions.


The core of SFBT is goal setting; you identify and define your goals. Your therapist will question you on what you expect to gain from the therapy and how taking steps to resolve your problems would specifically change your life. As you answer the questions, you think creatively, set goals and develop a strategy that involves life-changing solutions.


Acceptance and Commitment Therapy (ACT)


This psychotherapy technique comes from cognitive behavioural therapy and traditional behaviour therapy. In this action-oriented approach, you learn to stop denying, avoiding or struggling with your inner emotions. Instead, you recognize the deep feelings as appropriate responses to particular circumstances that should not interfere with your life. With this realization, you begin accepting your troubles and focus on making the necessary behavioural changes regardless of your feelings about the occurrences in your life.


The fundamental belief in ACT is that trying to suppress painful psychological experiences or emotions is both ineffective and counterproductive. Controlling these feelings will eventually result in more distress. ACT upholds the assumption that you can use various alternatives to try and change your thought patterns. You can consider personal values, mindful behaviour, and a resolve to act. By learning to accept your psychological experiences and taking the initiative to change your actions, you can ultimately transform your attitude and emotional responses.


Attachment-based Therapy


This type of counselling is short-term and process-oriented. The client-therapist connection centers on rebuilding or developing trust and expressing emotions. The attachment-based approach examines the relationship between an infant’s first attachment experiences with principal caregivers, mostly parents, and the baby’s ability to develop and form healthy physical and emotional connections in adulthood. Its goal is to create or rebuild a supportive, trusting relationship to treat or prevent anxiety and depression.


The rationale behind attachment-based therapy is that having a secure early attachment to one or more primary caregivers provides a child with a sense of security. The bond creates the supportive foundation necessary to freely explore, learn new experiences, interact with the environment and relate with other people. Without a solid, healthy foundation, children may become insecure, confused and fearful, and eventually become depressed or suicidal in adolescence. By developing a trusting bond with a parental figure or your therapist, you are better equipped to build stronger bonds with other people.


Gestalt Therapy


This client-centered approach helps you focus and understand the current reality in your life as opposed to perceptions that you may have based on previous experiences. Instead of purely describing your past, the therapist encourages you to experience those situations through re-enactment. You realize how your negative thoughts and behaviours are inhibiting genuine self-awareness, making you unhappy.


The principle guiding Gestalt therapy views humans as a complete entity comprising of the soul, mind, and body, and best understood by seeing them through their own eyes. The fundamental idea is to bring the past to the present. It emphasizes the active expression of unresolved pain, anger, resentment, anxiety, and other negative emotions to prevent the development of physical and emotional symptoms.


Gestalt therapy enhances your self-awareness and helps you understand how your choices affect your health and your relationships. You recognize that you do not have to live to other people’s expectations, nor should you expect them to measure up to yours. With this self-awareness, you understand the connection between your physical and emotional selves. You become more self-confident, deal with problems more effectively and live a fuller life.


Internal Family Systems (IFS)


This approach to psychotherapy identifies and tackles multiple families and sub-personalities in your mental structure. These sub-personalities comprise of painful emotions, wounded parts, and sections that control and protect you from the suffering of the injured segments. The elements often oppose each other and conflict with your core self, the compassionate, confident, whole person that makes each individual.


IFS premises on the theory of a faultless core self that forms the substance of your true self and additional, distinct types of sub-personalities that reside within you. These are:


1. The exiles which include the wounded or suppressed parts, such as anger or trauma

2. The managers, which are protective parts that repress the exiles

3. The firefighters that divert the true self from pain when the exiles are released, such as eating disorders or substance addiction

IFS aims at releasing your subpersonalities from their distinct roles, restoring confidence in the self, and achieving harmony among the parts. It seeks to have the self take charge.


A Single Modality Vs an Eclectic Approach


Some therapists use a single modality while others opt for an eclectic approach. The method a therapist uses depends on their style, personality, and training. Some prefer using one strategy with all their patients, some diversify, while others tailor their approach to your symptoms, needs, and personality.


A therapist who uses an eclectic approach varies their techniques throughout the treatment period. The flexibility of using multiple strategies is highly beneficial. However, the choice of method that your therapist will use is also dependent on the type of treatment program and the mental condition for which you are seeking treatment.


Way Forward


Regardless of the severity of your challenges, an experienced therapist will walk with you to your recovery. They will help you settle on a therapeutic modality or a combination that will work for your specific needs. Our goal is to get you well to start living a full life.

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