About cognitive-behavioral therapy
Cognitive behavioral therapy (CBT) is a scientifically based form of psychotherapy that has gained great popularity in the past few decades due to its effectiveness. Cognitive behavioral therapy was developed in the 1960s by Aaron T. Beck as an alternative to previously dominant therapeutic approaches. Therefore, the goal of cognitive behavioral therapy is not to delve deep into the past and influence the sources of unpleasant thoughts and undesirable behaviors, but rather to empower a person through various exercises to independently manage their thoughts, emotions, and behaviors in the current situation.
Cognitive behavioral therapy is based on the assumption that mental health problems are caused by maladaptive patterns of thinking and behavior - patterns that may have once been beneficial to the individual, but today cause much more harm than good. Therefore, the key to solving mental health problems lies in changing maladaptive patterns of thinking (and experiencing) and behavior. Accordingly, most cognitive-behavioral therapists rely on the ABC model during situation analysis (illustrated below). The first component of this model is the event (antecedent, A). The characteristic of the event is neutrality - it does not have to be universally good or bad. In other words, the same event can be interpreted differently by different people. This stage of event interpretation represents the second component (belief, B). Each interpretation of an event is based on our previous knowledge, experiences, attitudes, values, and other characteristics of our identity - it is always subjective and does not have to be completely accurate (and not the best for us or the people around us). However, the interpretation of an event causes certain consequences (consequences, C): if we judge that a barking dog wants to play, we will pet it, but if we judge that it is aggressive and wants to chase us, we will not approach it. This example also shows the connection between thought and behavior on which other principles of cognitive-behavioral therapy are based.
Cognitive behavioral therapy principles are used in counseling to address a wide range of mental health and well-being issues, including depression, anxiety, phobias, eating disorders, and stress management. The use of these techniques is particularly effective for people with low self-esteem or those who are frequently stressed due to irrational beliefs and negative thought patterns. Also, during cognitive behavioral therapy, clients apply specific techniques and exercises to change thoughts and behaviors in everyday life, which contributes to long-term change and maintenance of mental health and well-being.
Scientific research consistently confirms the high effectiveness of CBT in reducing symptoms of anxiety, depression, and other mental health problems, and the results are often long-lasting. The results of a meta-analysis by Hedman-Lagerlöf et al. (2023) confirm that (guided) online cognitive-behavioral therapy produces equally good results as face-to-face therapy.
For example, Reinecke et al. (1998) conducted a meta-analysis of the effectiveness of cognitive-behavioral therapy for depression and depressive symptoms in adolescents. To reach their general conclusion, they searched all scientific literature published in peer-reviewed medical and psychological journals between 1970 and 1997. The authors focused on literature that explicitly mentioned psychotherapy (i.e., whose description of the intervention corresponded to the principles of cognitive behavioral therapy), and the results of (young) people in treatment were compared with the results of people who were not in treatment, after therapy and several months later. In total, only six studies met their strict criteria, and their summary results showed that cognitive behavioral therapy led to a very noticeable reduction in depressive symptoms in adolescents, both in the short term and after several months of delay.
More recent research confirms these findings. For example, Karyotaki et al. (2021) tested the effectiveness of online cognitive behavioral therapy for the short-term and long-term reduction of depressive symptoms in their meta-analysis. To reach a general conclusion, they searched all scientific literature on the online application of cognitive-behavioral therapy published in peer-reviewed medical and psychological journals up to 2019, published in four large databases of scientific journals. In doing so, the authors focused on literature that explicitly mentioned cognitive-behavioral therapy (that is, whose description of the intervention corresponded to the principles of cognitive-behavioral therapy), and the results of people in online treatment were compared with the results of people who were not in treatment. The results of the participants were compared after treatment and several months later. Of the 2552 published scientific papers reviewed, 42 met all the conditions for meta-analysis, of which 39 provided insight into change at the individual level. The summary results showed that online cognitive behavioral therapy led to a very noticeable reduction in depressive symptoms in people with moderate to severe depression, with guided approaches (approaches in which a specialist trained in the application of cognitive behavioral therapy guides the client through the process) proving to be somewhat more effective than unguided approaches (approaches in which the client independently applies the principles of cognitive behavioral therapy without the guidance of a specialist).
However, it should not be forgotten that cognitive behavioral therapy is an effective solution for other mental health difficulties. Fordham et al. (2023) conducted a review of reviews and meta-analyses on the effectiveness of cognitive behavioral therapy in alleviating various mental health problems in different populations and contexts. The summary results of the 494 reviewed reviews and meta-analyses indicated positive short-term and long-term effects of cognitive behavioral therapy on health-related quality of life, anxiety, and pain.