Practice in Clinical & Health Psychology
What is Cognitive-Behavioral Therapy?


Cognitive Behavioral Therapy (CBT) is based on the concept that changing negative thinking patterns and behaviors can have a powerful effect on a person's emotions. CBT helps identify, analyze and change counter-productive thoughts and behaviors, which helps to alleviate feelings of depression and anxiety.
How is Cognitive Behavioral Therapy different
from other therapies?
Years of clinical research and experience have shown that Cognitive Behavioral Therapy (CBT) is an extremely effective form of therapy. It relies on simple yet powerful interventions, not "trendy," unproven techniques. CBT is based on the scientific method, and the logic and belief in the power of the individual to "take charge" and change their negative thoughts, feelings,and actions. It is usually of relatively short duration and is action-oriented.
"We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world."
How does one develop a psychological disorder?
Early in life we develop cognitive "mindsets" or schemas which determine our patterns of behavior. These cognitive schemas often include dysfunctional, irrational beliefs which cause us to think and behave in negative ways. Negative thinking and behavior can lead to serious psychological problems such as clinical depression and anxiety disorders. It is important to remember that negative feelings such as deep sadness, fear and inappropriate guilt are actually created by dysfunctional thinking and behavior.
In his book, "The Biology of Belief", Dr. Bruce Lipton says, "Our positive and negative beliefs not only impact our health, but also every aspect of our life." And he goes on to say, "Your beliefs act like filters on a camera, changing how you see the world. And your biology adapts to those beliefs." 
How does Cognitive-Behavioral Therapy work?
Extensive scientific research has shown that changing the way a person thinks and behaves can have a profound effect on one's emotional state. CBT utilizes a very directive, action-oriented approach which teaches a person to explore, identify and analyze dysfunctional patterns of thinking and acting. Once these counterproductive patterns are identified, the therapist instructs the patient how to challenge and restructure their behavior and thinking. Behavior becomes based on rational, reality-based thinking. Negative emotional states such as depression and anxiety are soon alleviated.
A recent study at the Rotman Research Institute at Baycrest Centre in Toronto used fMRI brain imaging technology to compare ex-depressed patients who had responded to CBT to those who responded to antidepressant medications. The study authors concluded that patients who recover from depression with CBT show changes in brain functioning (increased activation) in the frontal cortex— areas associated with thinking— whereas, those who recovered with drugs showed changes (decreased activity) in the deeper brain structures associated with basic emotions.
Who can be helped by Cognitive-Behavioral Therapy?
CBT is based on a collaborative relationship between doctor and patient. It is most effective with highly motivated people who are determined to help themselves feel better. CBT has helped many people who are suffering from depression, anxiety, obsessive compulsive disorder, and other psychological disorders.
CBT has also been shown very helpful in the management of chronic pain syndromes, especially when combined with biofeedback and meditation training.
How well does CBT work?           
Numerous research studies over the last 30 years have concluded that CBT alone is at least as effective in the treatment of depression as medications— generally about 60% effective.
When combined with medications, CBT reduces the drop-out rate (about 25% for medications alone; about 9% for CBT alone) and reduces the likelihood of a return of depression after treatment ends.
But CBT requires a well-trained therapist, more commitment and time on the part of the patient, and is more expensive than medications.
A recent large scale treatment study at Brown University, Rhode Island, studied 681 patients diagnosed with chronic depression. A third of the patients were randomly assigned to receive an antidepressant drug— nefazodone (Serzone)— twice daily. Another third, received an hour-long session of CBT each week, and the final third received both treatments.
Among the patients who completed the 12 weeks of treatment, 85% of the combined treatment group obtained a significant reduction in their depression symptoms, compared with 52% in the CBT only group and 55% in the medications only group.