Dr. Darlene Elliott-Faust Clinical Child and Adolescent Psychologist

What is CBT?

CBT stands for cognitive behaviour therapy.  It is a psychological treatment that is research-based.  The premise of CBT is that our thoughts, feelings and behaviour are inter-related.  If you change one component, the others will change.  The research findings overwhelmingly support CBT as highly effective in the treatment of anxiety.   It is also used in the treatment of depression, eating disorders, pain management, anger management and social skills training etc.

CBT is active, collaborative and has a strong educational component.  The therapist initially takes a thorough history and has the client complete questionnaires to understand the nature of the presenting concerns (e.g., anxiety).  The therapist then teaches the client about the relationship between thoughts, feelings and behaviours and some key effective strategies (i.e., relaxation).  The therapist and the client work together to apply the knowledge, techniques and strategies to the client’s concerns.  Homework, which is practicing the new skills and recording progress, is assigned each session.  Typically, a client is initially seen for 6 to 10 weekly or biweekly sessions.  Sessions are then spaced out to once a month, then every few months and finally to an “as needed” basis.

Let’s look at an example:

A seventeen year old boy presents with concerns about “blanking out or totally freezing in a test situation”.  His marks are plummeting so that he feels he will not get into the college of his choice, which heightens his anxiety further.  He spends most of his time worrying about this problem and its impact on his future, and it is affecting his health.

After taking a history of the concern and reviewing his school records, the approach would be two-pronged.  The first step would be to look at his school habits, such as attendance, note taking, homework and studying skills. The focus would be to work on any areas that are weak.  Next would come the CBT.  He would be instructed in a relaxation technique to counter the anxiety and catch it early in the process.  He would be taught to look at his thoughts in the test situation and practice keeping them positive and realistic (e.g., “ I am prepared for the test.  I will do my best.  Remember to see how much the question is worth and use my time accordingly”).  Practice and success with controlling the anxiety, with the combination of strategic learning skills and CBT, would show the student that well-managed anxiety can be an asset!

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