Elizabeth Jerison Terry, PhD

Pediatric Neuropsychologist • Licensed Psychologist PSY 20657

Cognitive Behavioral Therapy

What is Cognitive Behavioral Therapy? And Why Would I Care?

Cognitive behavioral therapy (CBT) is a form of talk therapy that research shows can help a variety of problems as well or better than other forms of psychotherapy or psychiatric medications (although often a combination of medication and CBT is most effective).

But what about my feelings? Where do they fit into Cognitive Behavioral Therapy? Feelings are the third and equally critical component of the CBT triangle. Thoughts affect feelings and behavior; feelings affect behavior and thoughts; behaviors affect feelings and thoughts. Feelings are real, important AND sometimes they are not helpful team players. Sometimes, actions based on feelings interfere; one goal might be to help you make more conscious decisions about behavior rather than letting difficult feelings decide for you (e.g. making a phone call even though you are anxious).

CBT Can Help Treat:

  • Depression
  • Anxiety disorders
  • PTSD (CPT)
  • Insomnia (CBT-I)
  • Executive functioning (and AD/HD)
  • Learning disabilities
  • Head injury
  • Seizure disorders

CBT is “evidence-based.” In other words, we don’t just say that CBT can help you improve your quality of life – careful research studies demonstrate that CBT produces actual change and researchers continue studying and adapting CBT to improve our effectiveness.

Better Together

My approach is collaborative: we will both have responsibilities. We will define and set goals together and our work will not be limited to our sessions. You will have activities to complete during the week that we will decide on together (and practice) in our sessions.

Together, we will try to change your patterns of thinking or habits of thought.

CBT Strategies

Some strategies might include:

  • Learning to live in the “what is” rather than “what ifs” by helping you recognize unhelpful patterns of thinking that result in problems, and then reevaluating them based on real life experiences. 
  • Gaining more realistic and helpful perspectives on the behavior and motivation of others.
  • Using specific problem-solving techniques to cope with difficult situations.
  • Learning to be more confident in your own abilities.

In general, core tenets of CBT include the beliefs that:

  1. Sometimes experiences lead to patterns of thinking, feeling, and behavior that become problematic as our lives change.
  2. You can learn better ways of coping with psychological and emotional problems which will help reduce your symptoms and become more effective in your life.
  3. Psychological and emotional problems are based, in part, on unhelpful ways of thinking: sometimes feelings distort thinking.
  4. Psychological and emotional problems are based, in part, on learned patterns of unhelpful behavior.

Changing Patterns of Behavior

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:

  • Avoiding avoiding: Learning more effective coping strategies to give you the skills to face roadblocks to progress on your goals.
  • Practicing: Role-playing to prepare for anticipated difficult situations or conversations.
  • Learning mindfulness techniques to calm your mind and relax your body.

Not all CBT uses all of these strategies. Rather, we will collaborate to understand what is getting in your way and a treatment plan to move you on.

Progress

CBT is goal-oriented and, often, time-limited. During sessions, we will focus on specific goals (e.g. improving relationships, reducing anxiety or depression, improving self-care, better managing temper). By the time we end therapy, you will have a toolbox of specific skills and strategies which we will have practiced together. Between sessions, you will have the opportunity to evaluate each skill in your daily life so that we can tweak them, if necessary. Eventually, “future you” will apply the tools you have learned on your own. One client described thinking, “What would Dr. Terry say?” as they made a better choice.

Our focus will be the “what is”: what is going on in your current life, rather than what has led up to your difficulties. A certain amount of information about your history will help us understand some of the “why” behind your current behavior, but our focus will be primarily on moving forward in life.