Among the existing approaches in Psychology, cognitive-behavioral therapy techniques stand out for presenting excellent results both in clinical practice and in other areas of expertise. Its scientific basis and its strategies for direct intervention on problems are very attractive aspects for both professionals and those seeking therapy.
However, many times, the faculty is not sufficient for clinical deepening. This causes some recently graduated psychologists to seek more information about their work in this field with CBT in graduate courses or even in independent readings on the subject.
You are one of them? Do you want to know more about the use of CBT in clinical psychology? So, continue reading this post to learn about cognitive-behavioral therapy techniques and how to work with this approach in the office!
What does the cognitive-behavioral therapist do?
CBT is a clinical approach, that is, it is one of the theories that can base psychotherapeutic care. It stands out for its scientific basis – the precursors of cognitive-behavioral therapy started from the scientific method and considered knowledge about behavior and neuroscience.
It was with this background that the approach emerged, which seeks to analyze the relationship between our thoughts, feelings and ways of acting. That is, the CBT therapist understands that what a person does is based on what he thinks and how he feels in the face of life’s situations.
Initially, the therapist’s job is to identify the patient’s behavior patterns. His first objective is to know what were the problems that led the person to seek therapy and understand what thoughts, emotions and behaviors are involved in these situations.
The focus of therapy is the difficulties experienced in this relationship between emotion, thought and behavior. Thus, direct interventions are made to modify dysfunctional aspects and replace them with healthier processes. Therefore, cognitive-behavioral therapy techniques are fundamental parts of the practice in the clinic.
These particularities make CBT offer faster and more effective results. Thus, it has been very indicated to treat disorders such as anxiety , depression, eating disorder , among others. It is also highly sought after by people who want to overcome fears or improve their social skills.
What are the techniques most used by the cognitive-behavioral therapist?
After identifying the problems and understanding what is behind them, the cognitive-behavioral therapist makes use of the intervention techniques. For this, he considers both the particularities of the demands and the degree of suffering of the patient. Below are some of the most used techniques in CBT.
This technique is based on explaining important issues of psychological treatment to the patient. It should be done in the simplest and most didactic way possible, according to the language of each person. Psychoeducation deals with both data about the diagnosis and explanations about the activities that are used during the sessions.
Performing psychoeducation brings good results in the person’s adherence to therapy, as it offers relevant information for them to be actively involved in the treatment. In addition, the technique also helps to reduce the patient’s anxiety in the face of a difficult diagnosis or even the challenge of undergoing therapy. This is a strategy widely used also in hospital psychology .
Some people are referred to the psychologist after being identified with an emotional disorder, such as panic syndrome or obsessive-compulsive disorder (OCD). Often, these patients come to therapy with little information about the problem they face. Thus, the posture of the cognitive-behavioral therapist makes all the difference in the reception they receive and in the perspective of improvement they may have.
2. Record of dysfunctional thoughts
This is another very common activity in cognitive-behavioral therapy. As the focus of the approach is the relationship between thinking and behavior, it is essential to identify the dysfunctional elements. When using this technique, the therapist asks the patient to record the unpleasant thoughts that arise in certain situations.
For example, if a person has a social phobia, they should write down what they think when they are afraid or anxious about the possibility of exposing themselves. Sometimes, feelings, physical reactions and behaviors involved in the situation are also asked to register. This task helps the patient to become aware of himself.
The recording of dysfunctional thoughts has several uses in the clinic. The first of these is so that the patient realizes what he thinks and feels when he faces a problem, since, in many cases, people react automatically and cannot understand the situation. In addition, the therapist makes use of this record to direct the sessions and use other techniques that assist in the process of changing negative patterns.
3. Socratic questioning
This is also one of the most widely used cognitive-behavioral therapy techniques. The clinical performance of CBT is largely based on Socratic questioning. In practice, this means that the therapist will ask a series of questions in order to help the patient deepen his understanding of his own thoughts.
As we said, many people behave automatically, without realizing the thoughts and emotions behind it. In therapy, the patient is faced with questions that deepen reflection and make him think about the complex relationships that his mind establishes. Thus, it is possible to perceive and modify cognitive distortions.
The psychologist’s job is not to offer answers or to direct the way people think and behave. By asking questions, he builds possibilities for patients to better understand their thoughts and make their own decisions. With this technique, dysfunctional elements can be questioned and put in check.
4. Exposure techniques
Cognitive-behavioral therapy techniques are very effective for directly intervening in specific problems, such as phobias. This is the case with exposure activities, which can be used to treat fears and trauma that limit the patient’s life.
It is very common for people to seek therapy because they have excessive fear. Most of the time, this happens due to the generalization of anxiety experienced in a given situation. For example, someone who was stuck in an elevator a few years ago may face great difficulty in exposing themselves to this reality again.
When fear interferes with the patient’s life – if he leaves aside moments of work or leisure because he is unable to face the elevator, for example – the issue needs to be mediated in therapy. Exposure techniques are very useful for solving the problem, as they transport the person to what causes him anxiety, while teaching him ways to control negative emotions and deal with the situation in another way.
5. Systematic desensitization
This activity is a type of exposure technique widely used in the treatment of phobias and panic syndrome. It consists of exposing the person to the elements that cause him fear in a gradual, safe and guided manner by the therapist. By doing this in therapy, the patient has the possibility to replace feelings of tension with relaxation.
The exposure, in this case, is not physical. In general, the therapist leads the patient in his imagination. While thinking about the source of anxiety, he applies the relaxation techniques he has learned. When it is safer, the person can repeat this exercise in their routine outside the clinic.
6. Relaxation techniques
In the last few years, the number of cases of anxiety or fear disorders, such as generalized anxiety disorder, has grown a lot. People who have this problem and experience crisis situations face a lot of difficulty to calm their emotions and think rationally in extreme moments.
An anxious or panic attack patient experiences situations of extreme fear and suffers from physical symptoms, such as shortness of breath, tachycardia, body tremors and psychomotor agitation. Relaxation techniques are used during therapy and serve as a learning experience for the person to achieve self-control in critical periods.
The cognitive-behavioral therapist helps the patient to breathe slowly, following certain rhythms to increase the body’s oxygenation and regulate sensations. In addition, muscle relaxation techniques are useful to enhance your perception of yourself during the crisis, increase concentration and generate a feeling of well-being, thus reducing tension.
7. Social skills techniques
These are also among the most widely used cognitive-behavioral therapy techniques. It is not difficult to understand the reasons when we consider how much our society exposes people to the judgment of others. Many patients seek therapy to treat shyness or fear experienced in situations of social exposure.
This difficulty disrupts life in many ways, distancing success in educational assessments or in work situations, for example. Thus, it is a problem that needs to be addressed as soon as possible, as it usually has more serious consequences in adult life.
The therapist of the cognitive-behavioral approach is trained to help the person to develop mechanisms to overcome shyness by training social skills in individual or group therapy . It consists of simulating scenarios in the relationship with the therapist so that the patient can develop and express social skills first in the clinic and then in his routine.
In addition to cases of social phobia, this technique is also very valid for patients who face difficulties in developing aspects such as empathy and communication skills. Many people find it difficult to express their emotions efficiently – some cry at the first sign of a more tense conversation, for example. Thus, the techniques are not only used to have more security when speaking in public, but also to initiate and conclude private or intimate dialogues.
8. Coping with stress
Many patients are exposed to stressful situations and are unable to mobilize healthy efforts to deal with the emotions generated in these moments. It is necessary to build coping strategies when the external context presents few possibilities for change to reduce overload.
This may be the reality of professionals with a high level of stress or people who need to care for sick loved ones, for example. Some life scenarios generate negative emotional responses that are difficult to deal with. Cognitive-behavioral therapy techniques help the patient to understand the elements that generate stress, identify the feelings involved and find coping alternatives.
Strategies focused on the problem can be developed, such as modifying the stressful event, performing physical activity or increasing the hours of rest to reduce tension. There are also learnings focused on emotions, in order to control negative responses to external situations that cannot be modified.
9. Spectator or distant observer
Often, patients have great difficulty in overcoming their problems because they are unable to analyze them efficiently. After all, for those who are experiencing a complicated situation, the solution may seem far away and even impossible.
A popular thought states that those who are not experiencing the problem can see aspects that the person involved does not see. You’ve probably heard someone talk about it, haven’t you? In fact, it is common for the vision of friends or family to help expand the possibilities and find ways to overcome difficulties.
We can say that the psychologist’s mediation is also part of this scenario, especially when we talk about the strategy of the distant spectator or observer. This is one of the cognitive-behavioral therapy techniques and consists of stimulating the patient to use his imagination to visualize his problems as if they were a play or representation.
In doing so, it is possible to decrease emotional reactions and provide a more lucid analysis of life experiences. As the patient begins to narrate the situation as if it did not happen to him, new visions about the same event may arise, making it easier to circumvent obstacles.
10. Exchanging roles
This is another technique that makes use of imagination or creative visualization to provide greater awareness of certain experiences – especially interpersonal conflicts. In the exchange of roles, the therapist encourages the patient to put himself in someone else’s shoes, trying to assess the context from their point of view.
Thus, the patient must manifest himself in therapy as if he were that person, evaluating what he would think and what he would say in relation to the existing conflict. This exercise can be very useful in developing empathy and improving social relationships. Thus, it is widely used in social skills training.
There is also another clinical strategy related to these aspects – role-playing. The operation of this technique is similar to that of switching roles, but in this case, the activity goes beyond imagination. A kind of simulation is done, in which the therapist participates by imitating the behavior of a person close to the patient.