Commonly referred as CBT, Cognitive Behavioural Therapy is a psychotherapeutic approach through which people change the way they think (cognitive) and what they do (behaviour) 1 . These changes come through changes resulting from setting goals and achieving them.
In treating depression, CBT has found wide application due to its satisfying positive results. Instead of dealing or addressing the causes of depression, CBT concerns itself with coming up with ways that would address depression here and now. It is only concerned with finding solutions to the present state of depression. CBT owes its roots to Aaron beck and Albert Ellis who designed it in late 1950s. Nemade, Reiss, and Dombeck 2 note, “Cognitive behavioural therapy is founded on the single basic idea that cognition, in the form of thoughts and preconceived judgments, precedes and determines people’s emotional responses.” Principally, depression results from people viewing situations from a negative point of view and this disposition leads them to act in a particular manner hence their behaviour.
CBT works on the principle that positive thoughts and behaviour heralds positive moods and this is something that can be learned; therefore, by learning to think and behave positively, someone may substitute negative thoughts with positive ones and do away with depression.
As aforementioned, depression is a product of maladaptive practices and dysfunctional thoughts arising from the way someone views a situation. “These maladaptive thought patterns are also known as negative or maladaptive schemas, or core beliefs. Core beliefs are fundamental assumptions people have made that influence how they view the world and themselves.” 2 As people think in a given way for prolonged time, these thoughts become habits and people stop questioning them as they become part of life. With time, people accept these core values as realities for they govern their life. Because these core behaviours are only perceptions, not necessarily reality, CBT seeks to fix them and change them from negative thoughts to positive thoughts.
By substituting these negative thoughts with positive ones, the core values changes and people start viewing themselves from another perspective. Feeding the mind with positive thoughts continuously makes these positive thoughts automatic and every time someone is in a given situation, these thought occur effortlessly thus enabling one to deal with life stresses and hassles effectively.
How it Works
CBT works in a simple manner by breaking down problems into small fragments and addressing them one at a time. A psychologist identifies a problem, that is, the depressing situation. From this situation, a psychologist monitors one’s thoughts, emotions, feelings, and actions. After this identification, the therapist helps the patient to come up with positive thoughts that would enable him/her view the depressing situation from a positive perspective. CBT utilises the principle that thoughts determine feelings and feelings determine actions 3 . CBT thus holds that, a situation evokes given thoughts, which in turn arouse given feelings leading to given actions.
Therefore, by correcting one’s thoughts to look at every situation positively, one changes his/her feelings thus changing actions leading to changed behaviour. In other words, CBT focuses on changing the cognitive, which in turn changes the behaviour. As aforementioned, the process of dealing with depression using CBT is quite simple. A depressed person meets with a therapist for some time according to agreed time usually weekly and the patient, with the help of the therapist breaks down a problem into small parts. After this, the therapist lists different positive thoughts, which the patient may utilize every time he/she is faced with the depressing situation. The patient embarks on dealing with one problem at a time and this involves keeping a dairy of what to do when, coupled with goal setting both short-term and long-term. Through analysis of patient’s different thoughts to determine how they would affect him/her, the psychologist helps the patient to replace bad or negative results with good and positive ones.
Given the fact that it is easier said than done, the psychologists assigns the patient some homework whereby he/she applies these thoughts in the depressing situation. Another meeting ensues where the therapist evaluates how a patient is doing to see whether to add or remove some activities from the list. With time, depressed people realize the things that were depressing them were things of their own creation, and in some instances, they are not real. For instance, someone may think he/she would be happy only if everyone liked him or her and failure to this leads to depression. However, by replacing these negative thoughts with positive thoughts as ‘I am happy regardless of whether people like me or not, changes the situation. In this case, this situation was not realistic; it only existed in the mind of the individual.
In contemporary times, there are computerised CBT programs that enable depressed individuals deal with depression without the help of a therapist. However, this new form of CBT requires one to be responsible and accountable to his/her actions to ensure that the program runs smoothly and successfully. CBT works as efficiently as antidepressants 4 . With the introduction of computerised CBT, which replaces a therapist, people can now access this psychotherapeutic intervention more easily at a cheaper price. This is the preferred form of treatment instead of using antidepressants, which may have some side effects 5 . The basic principle of this treatment is that situations evoke thoughts, thoughts determine one’s feelings, and feelings result into actions, which in turn define one’s behaviour. Therefore, by changing one’s thoughts through systematic replacement of negative thoughts with positive thoughts changes ones feelings, feelings change actions and these actions define one’s behaviour hence the name cognitive behavioural therapy. In most cases, people are depressed by things of their own creation and by changing their perception their behaviours.
CBT is a psychotherapeutic approach that seeks to change ones thinking patterns to conform them to the desired results. This approach works behind the principle that thoughts (cognition) determines ones feelings, which in turn directs ones behaviour. Depression is a product of unproductive, negative, and distorted thinking pattern where an individual builds his/her perceptions regarding a given situation. With time, these perceptions turn into beliefs (core values) that govern ones perception of different situations. In most cases, depressing conditions are not real; they are only created perceptions that exist only in the ‘world’ of the perceiver. CBT addresses this issue from the perspective that thoughts determine ones feelings. Given that depressed people are only victims of negative thoughts, CBT seeks to replace these thoughts with new positive thoughts.
As positive thoughts regarding the depressing situation take root in the depressed person’s mind, depression fades away but it requires efforts either from a therapist or computer programs as guide on the way out.
1 Butler AC, Chapman JE, Forman EM, Beck AT. The Empirical Status of Cognitive-Behavioural Therapy: A Review of Meta-Analyses. Clin Psychol Rev. 2006; 26(1): 17–31. 2 Nemade R, Reiss NS, Dombeck M.
Cognitive Behavioural Therapy for Major Depression. 2007; [cited 2010 May 8]. Available from:
Psychiatric Rehabilitation Journal. 2005; 19(1): 63–71. 4 Burns D. The Feeling Good Handbook.
New York: Plume Books, 2006. 5 McCullough JP. Treatment for Chronic Depression: Cognitive Behavioural Analysis System of Psychotherapy (CBASP). Guilford Press, 2003.