Cognitive behavioral therapy (CBT) provides a combination of behavioral and talk therapy to help individuals reframe their negative thinking patterns. The goal of CBT is to help turn those negative patterns into positive thoughts. When this shift in perspective is achieved, then positive behaviors and actions express themselves during difficult moments or choices in that person’s life.
Several issues affect people each day, from loneliness to anxiety to depression. Each person seeks comfort during these times in their own way. Some choices may lead to destructive behaviors, while others, like an eating disorder, may trigger long-term health concerns if left unresolved.
During a CBT session, a patient works with their therapist to find the source of their negative thinking. Then they work to change that perspective toward a growth-based mindset. With enough time, many patients can find coping mechanisms which are healthy, allowing them to identify the thoughts, emotions, and behaviors which hold them back.
These are the significant pros and cons of cognitive behavioral therapy to review.
List of the Pros of Cognitive Behavioral Therapy
1. It is as effective as medication to treat some mental health disorders.
About 7% of adults in the United States suffer from a major depressive disorder each year. The symptoms of this health issue include a loss of interest in things previously enjoyed, lower energy levels, physical disease development, and isolation. Severe issues with major depressive disorders can become life-threatening if not treated. When CBD is followed, the negative thought patterns are reconstructed, which can help to relieve moderate cases when under the care of a professional just as effectively as medication does.
2. CBT does not take much time to complete compared to other forms of talking therapy.
Patients who undergo cognitive behavioral therapy will usually meet for an individual session which lasts for 30 minutes, going up to 60 minutes, depending on the issues involved. You’d meet with your therapist about once per week or once every other week, depending on the situation involved. People who receive exposure therapy usually have more extended sessions.
Most CBT series last for 20 weeks or less. Some patients finish with their cognitive behavioral therapy in just five weeks. Compared to other talkative therapies which can last for years, or be an ongoing treatment service, CBT allows you to experience results right away.
3. The focus of CBT takes on different formats, depending on the issues presenting themselves.
Problems are broken into five primary areas within cognitive behavioral therapy: situations, thoughts, emotions, physical feelings, and actions. The goal of the sessions is to show patients that these sections are interconnected with one another in the brain. If you face a difficult situation, then you have a thought generated from it. That thought leads to an emotion. The emotion leads to a physical expression of those feelings. Then the expressions lead toward decisions or actions.
CBT creates opportunities to take on different formats of expression based on where the errors occur in a person’s life. Exposure therapy deals with phobias and obsessive-compulsive disorder. Patients can identify negative thought cycles. Whatever your current problems are, you’ll look at how you thought and acted in the past to change what you’d do in the future.
4. Different therapy session types and tools are available through CBT.
Talkative therapy is the most common way to begin engaging with cognitive behavioral therapy. There are multiple tools available for patients to use when working to restructure their thinking patterns too. You can read books that discuss the issues which you feel are most important to your current needs. There are group sessions used sometimes to help you see that you’re not alone. Videos, computer programs, and even road trips are sometimes included as therapy options. That’s because the goal is to help you work in ways that feel natural and comfortable to you.
5. The skills learned through each CBT session offer useful real-world skills.
When you’re working with a cognitive behavioral therapy counselor, what you are doing is skill-based practice. You are identifying coping strategies which can be used in any situation you find yourself. By finding ways to cope with anxiety and stress, the impacts which it makes become less influential on your life. You become more resilient because of that action, creating positive cycles which promote progress toward a solution.
This identification of coping skill mechanisms makes it possible for you to deal with chronic self-negativity, high-stress environments, or challenging situations because you understand the bigger picture through CBT. You’re no longer trapped in the acute thoughts, feelings, and behaviors which get triggered by the negative stimuli.
6. CBT is a collaborative effort.
When going through cognitive behavioral therapy, your therapist isn’t going to tell you what to do. They work with you instead to find a solution to the difficulties you face at the moment. That means you identify issues on a personal level, then invest in yourself to make the changes which are necessary. It is this process which becomes helpful when reacting to different situations.
Because CBT is a collaborative effort, there is more accountability to the process. When you have a partner, you’re vastly more likely to find success.
7. Medication can work with cognitive behavioral therapy.
CBT isn’t a treatment option which must be used by itself. Many doctors recommend cognitive behavioral therapy when medication alone isn’t working. Some people suffer from more than a chemical imbalance with their mental health concerns. Their thinking patterns become negative through outside stimuli, including their home environment, which no meds can touch. The success rate of medication and CBT is very high in several demographics, providing a realistic path of hope to overcome this obstacle for many.
8. CBT is useful for almost any age group.
Children and adults benefit from cognitive behavioral therapy when correctly used. The expectations are the same in any age group. As long as there is a capacity and will to create changes in one’s life, then CBT offers a solution which can treat the problems which exist. Even taking the time to talk about a situation is enough to provide some results because many people keep difficult situations internalized, making them fester because they don’t share their concerns with others.
CBT is a way to create trust in others and oneself while working to break negative cycles and their destructive influences in life. The probability of completing a goal when you’re accountable to someone for it is 95%. If you only hear of cognitive behavioral therapy and that’s as far as the treatment idea goes, then your probability of success drops to just 10%.
List of the Cons of Cognitive Behavioral Therapy
1. Cognitive behavioral therapy relies on the will of the patient.
Each person must be invested in themselves for cognitive behavioral therapy to work. During the therapy session, you’ll be asked about what you hope to gain from the work you’re doing. You must review the urges, triggers, and stressors which cause you discomfort. The therapist will listen to your concerns, but it is up to you to put in the work that must be done to create change.
If you’re unwilling to put together a plan or work on homework for the next session, then the results of your CBT experience will become limited. Everyone participating in cognitive behavioral therapy must fully cooperate with the process to produce results.
2. It takes a lot of time to complete CBT with the extra work between sessions.
Homework is arguably the most crucial element of cognitive behavioral therapy. The assignments you’ll complete during your time in CBT come from a development between yourself and the therapist helping you. Most of the work requirements involve the rehearsal of new skills first practiced during a therapy session. Coping strategies are developed and practiced too, along with time spent in the restructuring of destructive belief systems.
Expect to spend at least 1-2 hours per day working on these therapeutic elements. Some patients may need to double their time commitment. Each session requires completed assignments to be the most useful, which means most of your free time could be taken by your cognitive behavioral therapy responsibilities.
3. CBT is not useful for individuals with specific learning difficulties.
Experiential therapy is the primary format which cognitive behavioral therapy uses to treat individuals with specific learning difficulties. By taking a hands-on approach, the cognitive challenges faced by the person involved are overcome through the element of actual practice. This approach doesn’t work for everyone, however, because it relies on an environment perceived to be safe by the individual. There are some learning difficulties which eliminate all safe environments, limiting the effects CBT creates.
4. People with complex mental health needs may not benefit from CBT either.
Cognitive behavioral therapy works to restructure issues like anxiety by changing how thoughts are processed. With complex phobias or mental health concerns, CBT isn’t useful because there are specific elements of risk which always apply sometimes.
Take someone who fears flying as an example. Someone is statistically safer flying than driving, yet if a plane drops from 30,000 feet and crashes, you’re 100% dead. Some people walk away from high-speed head-on collisions. You might be statistically safer in a plane, but if an incident occurs, the individual with the phobia would say they’re statistically safer in the automobile. Being cognitive about thoughts is not always a guarantee that improvements are made.
5. Cognitive behavior therapy often makes people feel worse before they feel better.
CBT requires individuals to confront the issues which create difficult feelings for them. During the initial sessions and homework completed by the patient, the initial confrontation of fear, anxiety, or other issues creates a surge in negative thoughts and feelings. It is not unusual for physical actions to become worse too. Someone who struggles with loneliness and copes by eating might find themselves regularly checking the fridge for a snack during this phase.
The results of cognitive behavioral therapy begin to show themselves after the first couple of sessions and the related homework. If someone decides to give up during the initial phase when symptoms are often worse, it could place the patient in a position which is even more vulnerable than before.
6. CBT addresses current issues only instead of addressing some underlying causes.
The goal of cognitive behavioral therapy is to address issues which face an individual right now. That perspective seeks to break the patient out of their negative thinking cycles, restructuring their thoughts toward something more positive. There are times, however, when chronic issues create negative cycles and CBT doesn’t always address the issue.
Take a childhood filled with constant travel and movement. Then a parent leaves the family at a young age, trapping the patient in a cycle of poverty until their teen years. Now they struggle with obsessive-compulsive issues because everything holds value to them. They cannot let things go because they are emotionally attached to each item. Addressing the attachment through cognitive behavioral therapy won’t change how the individual copes with the parent who left them, which could be the core issue driving the negative cycles in the first place.
7. It focuses on the individual capacity to change.
People must be willing to change for cognitive behavioral therapy to work correctly. There must also be an individual capacity to change for CBT to offer useful results. If someone is told to use a computer program as part of their therapy, but they don’t have access to that technology, then it won’t be a practical pursuit. The tools recommended for homework, group sessions, or 1-on-1 therapy must offer availability to the patient for thought restructuring to take place. Nothing happens without this access.
The pros and cons of cognitive behavioral therapy work to find helpful ways to react to situations instead of relying on unhelpful methods. Instead of accepting that you are a failure because of what happens to you, trapped in a negative cycle, CBT encourages you to look for a positive future. It makes your problems more manageable, even if there are situations when it may not be the correct therapeutic option to choose.
Natalie Regoli is a child of God, devoted wife, and mother of two boys. She has a Masters Degree in Law from The University of Texas. Natalie has been published in several national journals and has been practicing law for 18 years.