Cognitive Behavioral Psychotherapy (CBT)
Current use of cognitive behavioral therapy aims to alter maladaptive thinking in order to create change in behavior and feeling. Some new ideas on CBT attempt to help people change their relationship to maladaptive thinking rather than change the deep-seated thinking itself. The goal of cognitive behavioral therapy is to support shifts in thinking to more positive approaches. The goal is to look at the person’s needs, strivings and goals in order to suggest healthy directions.
Therapists use CBT techniques to help individuals challenge their patterns and beliefs and replace mistakes in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing with more functional and optimistic thoughts, thus decreasing emotional distress and self-defeating behavior. Mistakes in thinking are known as cognitive distortions. Cognitive distortions can be either a negative (glass half empty) or an over-generalization of some thought process. The CBT process is a series of gentle questions asked by the therapist to help the client consider more positive, affirmative and often realistic strategies and perspectives. Techniques may be used to help individuals take a more open, mindful, and aware posture toward cognitive distortions so as to diminish their hurtful effects on life and relationships. CBT encourages people to challenge discouraging thoughts and actions to become more adaptive, inspiring and encouraging. CBT therapists motivate clients to go into real-life situations to try out some effective ways of thinking and behaving.
Currently there are forms of CBT techniques that are productively used in therapy: exposure exercises, stress inoculation, cognitive processing therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy.
Psychotherapists who use Narrative Therapy believe that people create stories about their life and others’ lives in order to make sense out of factors and events. The stories that human being create can be life-giving and affirmation or may have become biased by hurt, anxiety, pain, trauma, rejection and depression. Psychotherapists help people speak and write their life story and stories of those people who are meaningful in their life, with compassion, accuracy, empathy and realistic appraisal. Practitioners of narrative therapy believe that simply telling one’s story of a problem is a form of action toward change. Narrative therapists help to objectify problems, frame them within a larger social context and get ready for more of life’s stories. Jointly, therapist and client, identify and build upon more optimistic and accurate storylines that exist beyond the problem story. They co-construct a story that is a better fit with life; we all need help to accomplish this task. Positive narratives provide contrast to overwhelming problems and can reflect a person’s true nature and offer the chance to re-organize one’s story. In this way, people move from what is known in one’s life to a narrative that is balanced and reasonable.
The therapist also helps people to see what is missing or patently obvious (either choice or both) in the presentation of a problem. By exploring the impact of the problem, it is possible to identify what is truly important and valuable to a person in the span of life, much beyond the problem. This can help a person identify patterns, family threads and assumptions to connect his or her actions and choices throughout life. In other words, many extraneous experiences and memories from life are “unacknowledged but implicit” as people navigate new events and activity. This process can help a person better understand his or her experience of life and gain efficacy for addressing difficult times in the future.
Motivational Interviewing (MI) Treatment
Motivational Interviewing (MI) can help facilitate change. It is a strength-based approach that highlights people’s ability to change harmful behaviors. For clients seeking psychotherapy treatment, two of the most common obstacles are ambivalence and the fear of change. Frequently individuals struggling with disorders are aware of the problems and mistakes of their choices but continue to behave that way anyway. These experiences are normal and despite the health risks and consequences of repeating life patterns, client feelings of ambivalence arise. For most people with emotional issues, there is an internal struggle of wants and needs as opposed to rational choices. Uncertainty about the severity of their hurtful choices may be related to the client’s motivation to change. Entering treatment programs, many individuals claim their problems are “not all that serious”, despite medical problems, inability to remain employed, etc. Individuals experience these natural disparate feelings regardless of their state of readiness. Ambivalence should not be interpreted as denial or resistance and utilizing MI can facilitate exploration of stage-specific motivational conflicts that can potentially hinder further progress.
Substance abuse can leave lasting damage on the mind, body, and spirit. Substance abuse is challenging for many people. Studies by the Center for Disease Control and Prevention (CDC), SAMHSA, and American Diabetes Association all report that people with addiction and mental health disorders there are greater chances of morbidity and mortality compared to the general population. Furthermore, these increased rates are mostly attributed to preventable medical conditions such as diabetes or cardiovascular, respiratory, or infectious diseases (including HIV).
For all people, learning to take care of one’s body, mind and spirit is an essential part of living. Many people would do better if they were to take seriously problems related to the mind-emotional and social issues. Moving people toward better health and physical well-being is essential and fundamental to emotional stability. Becoming mindful and thoughtful helps us care for our spiritual needs.