Cognitive Behavioral Therapy in Clinical Practice
Cognitive Behavioral Therapy (CBT) is a short-term, problem-oriented, psychosocial intervention. Evidences obtained from randomized controlled trials and meta-analyses, show that this is an effective intervention for depression, panic disorders, generalized anxiety disorder, and obsessive-compulsive disorder.
The model is fully compatible with the use of medication. A Cognitive Behavioral Therapy that is used together with antidepressant drugs, is far more effective than pharmacotherapy alone. Furthermore, CBT is known to be preventing any future recurrences.
General Cognitive Behavioral Therapy skills
General Cognitive Behavioral Therapy skills offer an easily accessible model for patient assessment and intervention, while providing useful knowledge for general clinical skills in daily practice. Cognitive Behavioral Therapy can be presented as an integrated part of the biopsychosocial assessment and intervention approach, yet there are specific conditions to be particularly taken into consideration.
Situations where Cognitive Behavioral Therapy is useful
We can list the situations where Cognitive Behavioral Therapy is useful, as follows:
- When the patient prefers using psychological interventions separately or together with medication;
- When there are target problems for CBT (excessive, useless thoughts, reduced activity, avoidance, or useless behaviors);
- No improvement or partial improvement with pharmacotherapy;
- When it is not possible to take adequate doses of medication for an adequate period of time, due to side effects;
- When there are significant psychosocial problems that cannot be dealt with sufficiently with medications alone (e.g. relationship problems, challenges at work, or unhelpful behaviors like self-harm, or alcohol abuse).
What makes Cognitive Behavioral Therapy so effective?
Effective psychosocial interventions share specific attributes: The current problems of the patient are focused on by a therapist; there is a specific model, as well as a plan, underlying the treatment offered. Therapist and patient jointly build an effective communication. Established on these principles, CBT is a form of psychotherapy that includes psychoeducation. The objective is to let the patients learn new self-management skills that they could put into practice later in their daily lives. Patients adopt a collaborative attitude that encourages them to change what they feel, by putting what they have learned into practice.
– Williams, C., & Garland, A. (2002). A cognitive–behavioural therapy assessment model for use in everyday clinical practice. Advances in Psychiatric Treatment, 8(3), 172–179. doi:10.1192/apt.8.3.172.