Many behavioural therapies have been formed and are practised with varying results. Here we will look at the ones that are available in practice today with a brief description.
CBT Cognitive Behavioural Therapy
This is the most widely acknowledged behavioural therapy and is available on the NHS. CBT’s main goal is to change the patterns of thinking or behaviour that are linked to people’s difficulties and feelings.
Aaron T. Beck coined the term ‘internal dialogue’ and found that his patients were talking more to themselves, and that it was that ‘internal voice’ that ruled their thinking, emotions and subsequent actions or behaviour.
The term ‘Cognitive’ derives from cognition, which is the mental process of awareness and knowing, perception, judgement and reasoning. A cognitive process will involve your thoughts, images, beliefs and attitude.
In CBT you focus on the present as opposed to the past. The past is considered in how thinking patterns have developed and how they affect you now. What we think affects our behaviour. Thinking is the focus. CBT uses behavioural techniques. It requires that you complete homework and the process is structured. It is also time-limited in some cases.
There have been many scientific trials in the application of CBT for a varying number of psychological problems. It is widely used and offered on the NHS and is a preferred treatment for behaviours such as OCD, anxiety, lack of motivation, relationship problems and work issues. You could be offered between 10-12 sessions.
REBT Rational Emotive Behavioural Therapy
Created in the 1950s by Albert Ellis in New York, this therapy has the same principles as CBT, that its not the event itself that happens in your life, but your beliefs about it that cause emotions and behaviours. Ellis believed that we all wanted some basics in life and that happiness was a constant desire or goal. When that goal is blocked you can behave in unhelpful and unhealthy ways. Therefore the new goal would be to work on changing irrational beliefs into rational ones, hence Rational Emotive (emotions).
The process involves 3 basic concepts which are Disputing the irrational beliefs; Insight, which helps to eliminate the frequency of the irrational thoughts or beliefs; and Acceptance of the problem, be it unpleasant or pleasant.
A. Activating Event. Something happens.
B. Belief. You have a belief about the situation.
C. Consequence. You have an emotional reaction or/and a behavioural one to the belief.
There have been some clinical trials involving the application of REBT to help with many different problems. The research found that it probably works best with clients who are willing to conceptualise problems within the ABC framework. And also with those who would be willing to take action in identifying and changing irrational beliefs and challenge them. Like CBT, homework is involved and consistency in session attendance keeps up momentum.
DBT Dialetical Behavioural Thearpy
A psychology researcher in Washington, USA developed this system of therapy to treat people with borderline personality disorder (BPD). It combines cognitive-behavioural and emotional regulation or reality testing of the persons distress tolerance and an acceptance. It also incorporates a mindful awareness (mindfulness). This therapy is very involved and requires a full-time commitment.
Marsha Linehan (DBT inventor) suggested the following as a standard:
weekly individual therapy sessions
weekly group sessions
crisis telephone coaching with a one-to-one therapist
a therapists’ consultation group.
Although mindfulness is a primary aspect of the therapy and meditation in acceptance of the emotions being experienced is required, DBT is not a religious or ‘spiritual’ concept. Paying attention is the goal. Being in the present moment and experiencing assists in acquiring a new perspective.
Already I’m sure that you can see the common ground these therapies share. Let’s take a look at the last one:
MBT Mentalization Based Therapy
Mentalization based therapy is a specific type of psychodynamically-oriented designed to help people with (BPD) borderline personality disorder. Its focus is helping people to differentiate and separate out their own thoughts and feelings from those around them.
Although this therapy does not use the term ‘behaviour’ in it’s name, it very much engages cognitive processes in understanding a person’s behaviour.
Mentalization is the capacity to understand both behaviour and feelings and how they’re associated with specific mental states, not just in ourselves, but in others as well. In mentalization-based therapy, the concept of mentalization is emphasized, reinforced and practised within a safe and supportive psychotherapy setting. Because the approach is psychodynamic, therapy tends to be less directive than cognitive behavioural approaches, such as dialectical behaviour therapy (DBT), as stated above.
MBT is being widely used on the NHS for many types of mental health problems from depression to addictions.
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