What is cognitive therapy?

A number of psychological therapies can be quite useful in helping to eliminate depression. The therapy that I feel has the most merit and support is cognitive therapy. In fact, cognitive therapy has been shown to be superior to antidepressant drugs in treating mild to moderate depression. In addition, whereas there is a high rate of recurrence of depression when drugs are used, the relapse rate with cognitive therapy is much lower. People taking drugs for depression tend to have to stay on them for the rest of their lives. That is not the case with cognitive therapy, because the patient is taught new skills to deal with depression.

Psychologists and other mental health specialists trained in cognitive therapy seek to change the way the depressed person consciously thinks about failure, defeat, loss, and helplessness. Cognitive therapists apply five basic tactics.

First, they help patients recognize the negative automatic thoughts that flit through consciousness at the times when the patients feel worst. Second, they dispute the negative thoughts by focusing on contrary evidence. Third, they teach the patient a different explanation, to dispel the negative automatic thoughts. Fourth, they help the patients to better control thoughts by learning how to avoid rumination (the constant churning of a thought in the mind). Fifth; they help patients to question negative thoughts and beliefs and to replace these with empowering positive thoughts and beliefs.

Cognitive therapy does not involve the long-drawn-out process of psychoanalysis. It is a solution-oriented psychotherapy designed to help the patient learn skills that will improve the quality of his or her life. If your thought processes are in need of rewiring, please consult a mental health specialist who practices cognitive therapy.

Cognitive therapy is one of the few forms of psychotherapy that has been scientifically tested and found to be effective in over four hundred clinical trials for many different disorders. In contrast to other forms of psychotherapy, cognitive therapy is usually more focused on the present, more time-limited, and more problem-solving oriented. Indeed, much of what the patient does is solve current problems. In addition, patients learn specific skills that they can use for the rest of their lives. These skills involve identifying distorted thinking, modifying beliefs, relating to others in different ways, and changing behaviors. 

Cognitive therapy was originally developed by a psychoanalytically (Freudian) trained American psychiatrist named Aaron T. Beck. Cognitive therapy is one of the therapeutic approaches within the larger group of Cognitive Behavioral Therapies (CBT) and was first expounded by Beck in the 1960s. It is a form of psychotherapy using imagery, self-instruction, and related techniques to alter distorted attitudes and perceptions.  Cognition (thinking) is seen as the most significant factor in psychological problems and their treatment.

Cognitive therapy is based on the work of Aaron T. Beck, M.D., a world authority on mood disorders. The word cognitive refers to how you think about things at any particular moment. Dr. Beck's thesis is simple: When you are depressed or anxious, you may be thinking in an irrational, self-defeating manner that limits your choices and your sense of hope. When you make an effort to retrain yourself and think differently about situations, you can reduce your physical and emotional symptoms and reduce your level of distress. This process is called a "mental tune-up."

Cognitive therapy gives you insight into sources of your stress and other triggers and the development of headache. Common sources of stress in children and adolescents include:

• problems at home/family conflict
• having overly permissive or overly strict parents
• not getting enough sleep
• rejection or harassment by peers at school
• having no close friends
• academic challenges
• joining too many extra-curricular activities
• sexual, physical or emotional abuse

Cognitive therapy involves three main steps. In the first step, counselors help patients recognize any negative thoughts associated with the stressors. Examples of negative thoughts could include: "That rotten teacher made the exam too hard," or "My headache is never going to go away."

The second step involves gaining insight into the negative thoughts and challenging the belief about the thought. For instance, the counselor will help patients realize that all past headaches have gone away so the next one will go away too.

The third and final step is to substitute positive thoughts for the negative ones and/or to teach patients to distract themselves so that they think about more pleasant thoughts. An example of a self-confidence-building statement might be, "I've had this type of headache before and I know how to handle it. I will beat this headache." Cognitive therapy teaches patients how to maintain a positive mood.