Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is one of the most effective psychotherapy treatments for depression and anxiety.

The theory behind cognitive behavioral therapy for depression focuses on two components: cognitive and behavioral theory.

Behavioral theory views depression resulting from decreases sense of pleasure and decreased sense of accomplishment (mastery) in life. As such, therapy focuses on reconnecting with and/ or identifying activities creating pleasure for the individual and activities that are consistent with the person’s values. Also, therapy focuses on increasing activities that provide the person with a sense of accomplishment. This occurs through daily monitoring and rating both on mastery and pleasure initially the activities the person engages in and then focusing on modifying and scheduling activities creating higher pleasure and mastery. Once rated often individuals find that they are actually accomplishing a lot on a daily basis and instead it is the thinking about their activities that is inaccurate. This is where the cognitive component of cognitive behavioral therapy for depression assists.

Cognitive theory views depression resulting from ones thoughts about themselves, others, and the world. These unhelpful thoughts impact how a person feels and how they behave. Therapy focuses on first identifying these surface thoughts and then moving into identifying the more unconscious thought patterns that negatively impact ones feelings and behaviors. Once the thoughts are identified they are categorized and labeled into certain types of thought patterns called cognitive distortions that commonly occur in individuals that are experiencing depression.

Cognitive distortions are errors in thinking that tend to be unrealistic and irrational. For example, one cognitive distortion is called “All or nothing thinking” where a person is thinking in “black and white” terms and having a hard time finding shades of grey. The person displays extremes in their thinking and has difficulty with more balanced thinking. An example of all or nothing thinking is “I always mess up” or “everything bad always happens to me.” Once identified and labeled the unhelpful thoughts are challenged and modified to more realistic and accurate thoughts. For example, “I always mess up” may be modified to “there are times when I make mistakes” as this thought may be more accurate and true for the person.

Cognitive behavioral therapy for depression typically occurs weekly for 12 to 16 sessions. It is important to find a treatment provider trained in the treatment approach.  Medications for depression can be beneficial in combination with therapy for depression that is more severe in nature.