Some misconceptions

There are often misconceptions regarding Cognitive Therapy (CBT), which are put into perspective below.

• CBT is focused on developing realistic thinking, rather than positive thinking.
• Psychopathology is created by a cycle of factors, in which biochemical abnormalities, life events, social interactions, and thinking play a role. Focusing on cognition plays an important point for intervention in the cycle.
• Doing CBT is complex, despite its logical theory, as humans are complex in nature.
• CBT does not instruct or correct someone’s thinking, but rather guides the individual collaboratively towards his own insights. This assists the individual to use his potential and develop his skills for the future.
• CBT’s focus is on cognition in relation to emotion and behavioural outcome, which is therefore addressed as a process.
• Past experiences are incorporated if indicated as playing a role in establishing certain beliefs which continue to affect the present. This includes early family and trauma experience.
• CBT can aim at superficial or deep issues, depending on the client’s goals. The client i.e. may want to focus on an Axis I problem, but may find that personality changes may ensue as well as a result of therapy. Personality Disorders have their own treatment protocols.
• A good therapeutic relationship is essential for trust and collaboration. The problem determines the type and nature of the therapeutic relationship.
• Sessions usually range between 12-20 sessions, but in some instances can be shorter, or last several years.
• CBT has proven to be effective on its own and in combination with medication for some disorders, and should be assessed on a case by case basis. A combination approach is recommended for those diagnosed with psychosis, bipolar disorder and severe depression.
• CBT consists of many techniques, which should be applied strategically based on the understanding of an individual case.
• Emotion is encouraged proportionally to the situation. In therapy client’s emotions are facilitated according to their circumstances. Often emotion is under or over expressed. Individuals sometimes require help in ‘getting in touch’ with their emotions.
• In all therapies, those motivated and insightful, progress more readily. For the more disadvantaged, emphasis in CBT is placed on behavioural intervention.
• CBT has proven to be effective for both in and out patient treatment.⁵
  

Ref. Freeman, A., PretzerJ., Fleming B., & Simon K. (2004). Clinical applications of cognitive therapy. NY:Kluwer/Plenum (chapter 1,  p. 32) & Springer. With kind permission of Springer Science + Business Media. (Copyright notice: No part of this work may be reproduced, stored or transmitted in any form without written permission from the publisher.)  

The therapeutic approach of trainees includes paying strong attention to the therapeutic relationship and the client/patient's emotions. Novice trainees may tend to over focus on technical aspects and are instead encouraged to integrate appropriate strategies flexibly with one's own natural style. CBT is associated with more inductive questioning rather than didactic and overly interpretive statements. Therapy is related to theory, creating a balance between the abstract and concrete. It is significant to consider the client/patient's whole "phenomenal world" when addressing single thoughts and experiences. Intellectual vs emotional insight is also discussed in further reading.⁷