Cognitive Behaviour Therapy – Can it change your view of life?

It is our interpretation of events in relation to our thoughts and emotions which determine how we deal with or react to these events. This is the cornerstone of Cognitive Behavioural Therapy or CBT as it is more commonly known. This CBT philosophy is currently used in coaching and termed CBC or Cognitive Behavioural Coaching.

Origin 

CBT is, in fact, an umbrella term for many different therapies that share some common elements. Two of the earliest forms of the model were Rational Emotive Behaviour Therapy (REBT), developed by Albert Ellis in the 1950s, and Cognitive Therapy, developed by Aaron T. Beck in the 1960s.

REBT is a type of cognitive therapy first used by Albert Ellis which focuses on resolving emotional and behavioural problems. The goal of the therapy is to change irrational beliefs to more rational ones (e.g. I must be “perfect” all the time) and subsequently persuades the person to challenge these false beliefs through reality testing.

Beck’s (1967) system of therapy is similar to Ellis’s but has been most widely used in cases of depression. Cognitive therapists help clients to recognize the negative thoughts and errors in logic that cause them to become depressed.

Applying the CBT concept 

As stated, CBT was introduced initially as a way of treating depression and is now used more commonly to treat anxiety, stress, phobias and other emotional or psychological blocks which clients face in both coaching and counselling. It aims to help people become aware of when they make negative interpretations, and of behavioural patterns which reinforce the negative or irrational thinking.

CBT is a time limited and goal directed therapy dealing mainly with issues in the present. It focuses is on how our thoughts determine how we feel and react to events in our lives that are challenging or stressful.

The coach or therapist also guides clients to question and challenge their dysfunctional thoughts, try out new interpretations of the event, and ultimately apply alternative ways of thinking in their daily lives. Below is a diagram which illustrates how what we think, feel and behave are all linked and connected to each other.

A situation or event happens which triggers a thought.

Thoughts / Beliefs 

What a person thinks or believes about the situation or event. This is how the individual interprets a situation.

Emotions 

This is how a person feels about a situation. Emotions are not necessarily based in logic, but they are influenced by thoughts and beliefs.

Behaviour / Response

The person’s actions and behaviours in response to their thoughts and feelings about a situation

Example of a situation to illustrate how CBT works. 

Both Harry and Jane both receive a negative evaluation at work.

Harry 

Negative Thought: My manager thinks I am useless, I will probably get told off

Emotion: Anxious and nervous

Behaviour: He avoids his manager and  feels nervous the next time he has a challenging task to do in work.

Jane

Rational Thought: I wasn’t even confident I would get a good appraisal this year

Emotion: Disappointed but motivated to do better

Behaviour: Asks her manager how she can improve and approaches next challenge with determination and motivation

Through using the CBT model, clients can learn to identify their own thought patterns, emotions and behaviours and come to understand how thoughts shape how we feel and impact their life in significant ways. The first step to changing thoughts and behaviour is awareness of them. Once clients become aware of their irrational or unhelpful thoughts, they can work to challenge their basis in reality.

Through examining and re-evaluating some of our less helpful thoughts we can develop and try out alternative viewpoints and behaviours that may be more effective in aiding our problem.

Unfortunately, many clients view their thoughts as true (facts) that cannot be changed (for example, I know I will not get that job when I go for the interview next week). The CBT model challenges this by saying that just because we believe our thoughts to be true does not make them facts. If clients think, for example, that they will never get a better job or a promotion at work, then this can become a reality if this belief is viewed as a fact. This is how powerful our thoughts are in dictating how we live our life and determine how we feel and ultimately our behaviours (e.g. the behaviour of not going for the interview job and staying in the same job or remaining unemployed leading to feelings of frustration and depression). Continually believing and accepting these negative or unhelpful thoughts as facts can cause stress and lead to problems which can in coaching act as psychological blocks. This can lead to unconscious self-sabotage.

Similarly, some clients come to therapy or coaching feeling unmotivated, anxious or depressed and are unsure of the origin of these feelings. Using the CBT model, clients are facilitated to identify their irrational thoughts or thinking patterns regarding themselves and others. Over a short period of time, CBT techniques can gently challenge the evidence for these thought or belief patterns with the aim of changing what they are doing, or in some cases not doing to improve how they are feeling.

CBT Techniques 

1. Thought/Belief Records or Exercises are used by clients to log negative or unhelpful thoughts. The next step is to identify the evidence for or against a thought or pattern of thoughts. Over a short period of time, clients can identify cognitive distortions and establish a more balanced way of thinking, i.e. what is true and not true based on the situation.
2. Journaling – like, but more detailed than thought records, the journal can be used to record in detail and describe the origin of thoughts, situations and responses or behaviours. Evidenced based research has proven the therapeutic benefits of journaling. The physical act of writing, thereby “downloading” unhelpful thoughts and feelings in relation to events, provides significant awareness and feelings of wellbeing.
3. Homework assignments help clients to learn or improve skills and integrate concepts discussed into daily life, e.g. reading an article, book, watching a

TEDTalk or YouTube video that illustrate use of a concept being worked on in coaching. Examples are in relation to preparing for interview, doing a presentation, going to a networking event to practice social and connection skills, practicing mindfulness mediation, etc.

4. Roleplay can be used with clients to assist practice in new responses or behaviours. It is a useful tool for learning new skills such as networking, assertiveness, presentation and communication.
5. Mindfulness meditation involves clearing the mind and focusing on the sensations and thoughts in the moment, observing them and allowing them to pass. Although it takes some practice, and it’s not for everyone, mindfulness can be beneficial as a technique in accepting our thoughts as just thoughts (not facts), not allowing them to impact us in the present moment.

Strengths of CBT 

1. The Model has widespread appeal due to its simplicity to apply and understand.
2. Evidenced based research has reported the use of the CBT model to be very effective in treating depression (Hollon & Beck 1994) and moderately effective for anxiety problems (Beck, 1993),
3. CBT challenges debilitating beliefs/thoughts and enhances motivation, self-worth and problem-solving abilities.
4. CBT is consistently goal orientated and aims to promote new thoughts and behaviours to the point where they become internalised as new helpful and healthy habits.
5. CBT techniques can be used to compliment the use of other coaching tools such as GROW and the Wheel for example.
6. Teaching clients CBT and promoting the use of its techniques, enables them to achieve independence in their ability to ‘coach themselves’ out of their troublesome and unhelpful thought patterns and habitual behaviour.

Limitations of CBT 

1. The cognitive model is viewed as simplistic and narrow in scope. Thinking is just one part of human functioning. Sometimes, broader more complex issues, often need to be addressed which often originate in the past.
2. Some thought patterns and behaviours seem to have been written into a person’s DNA and may be difficult to shift. CBT is sometimes viewed as a short-term “band aid” solution therapy which is not suited to some clients who may require long term psychotherapy for deep rooted trauma issues. Therefore, it is not appropriate or ethical to attempt to challenge or change thoughts in these instances.

Professional use of the CBT Model 

I have used CBT quite successfully with some clients in both coaching and therapy settings.

An example of how I used the model with a client who had debilitating thoughts around being a “bad mother”. She was feeling guilty and anxious about this and told me that she often shouted at her young children when they were fighting or disobeying her. We used thought records to examine the evidence for and against this belief/thought over a couple of sessions. At home, she recorded past and present examples of where she had exhibited patience and tolerance of her children’s sometimes challenging behaviour. After a few sessions, she reported that she was often dismissing her unhelpful thoughts and was remaining calm when dealing with her children. She told me in her last session that having the knowledge that she could do something to question and change her negative thoughts, was, she said, life changing. She reported that she now had the tools to dispute and change her irrational or negative thoughts and therefore was able to control her frustration and felt more content in her life.

Another client in his early 20’s, had been having issues in dealing with bullying behaviour from a manager at work whom he thought viewed him as a “soft touch”. The client told me he had been hurt and upset by this bullying behaviour.

I used the CBT model to firstly, gently examine what he meant by his manager’s view of him being easy to manipulate or, in his words, a “soft touch”. The origin of this thought pattern was in school, so we spend some time talking about his childhood. He used the journaling technique to record these experiences. We subsequently did some assertiveness exercises using “I statements” through role play and he devised a plan to confront his manager about his behaviour. In addition, I encouraged him to practice these assertiveness exercises at home with a trusted family member or close friend. He reported in his most recent session, to have had a conversation with his manager about his behaviour which has resulted in being treated with more respect at work.

Conclusion 

I believe that applying CBT in some circumstances can indeed change our client’s view of life. Clients can learn to identify and be aware of their negative or irrational thought patterns, emotions and behaviours so they can understand how they impact their life in a significant way. It is important to encourage client self-compassion for this to occur. Through the process of challenging and providing evidence to support or dispute some of our less helpful thoughts, clients can develop and try out alternative viewpoints and behaviours that can be effective in improving the quality of their life.

I have used the CBT model in my counselling and coaching practice and received positive feedback. Personally, it is the simplicity and ease of application which gives it appeal. In addition, CBT techniques can be integrated with other goal oriented coaching tools such as the Wheel and GROW, to form a tailored coaching approach for each individual client.

However, it is sometimes difficult to shift negative thought patterns which have been formed throughout a lifetime. Many people view their thoughts as true facts, thereby making it a hard concept for some to believe in. CBT is not a model that can be applied to any emotional difficulty, particularly those that are deep rooted requiring a longer-term therapeutic intervention.

References:

Beck (1967) Depression, Causes and Treatment University of Pennsylvania Press: Philadelphia: USA

Dryden, W (2010) Dealing with Clients Emotional Problem in Life Coaching Routledge: London, UK

Hollon, S. D., & Beck, A. T. (1994). Cognitive and Cognitive-behavioural therapies. In A. E. Bergin & S.L. Garfield (Eds.), Handbook of Psychotherapy and Behaviour Change Wiley: New York, USA

Myles, P. & Shafran, R (2015) The CBT Handbook Clays Ltd: London, UK

Neenan, M & Palmer, S. (2018) Cognitive Behavioural Coaching Research Gate

Palmer, S & Whybrow, A (2018) Handbook of Coaching Psychology Routledge: London: UK

www.TherapistAid.com CBT Practice exercises and Thought records

About the Writer

Carmel Woods is a business/life coach and psychotherapist in private practice  based in Dublin. She also works for the charity, Aware as a support group facilitator.  Carmel holds a BA in Counselling and Psychotherapy in addition to a BA (hons) in Business studies from the Metropolitan University in North London.  She has achieved an Advanced Diploma in Coaching from Kingstown College and is a pre-accredited member of Irish Association of Counselling and Psychotherapy (IACP).  Carmel has worked in both banking and business consultancy prior to starting a counselling and coaching career. She is planning to introduce online, walking in nature and home based coaching to her one to one coaching and counselling services in the coming months.

https://www.linkedin.com/in/carmel-woods