Cognitive Behavioral Therapy


CBT Therapists Chicago

CBT Therapist Chicago

Cognitive Behavioral Therapy (CBT) is a popular therapy for treating anxiety, depression and PTSD. It is an empirically supported treatment that usually yields results after a short few months.

​CBT explores the relationships between thoughts, feelings and behaviors. CBT is a very practical treatment aimed at helping individuals identify and alter dysfunctional thinking patterns and change their maladaptive behavioral patterns.

​If you struggle with some of the common “faulty” thinking patterns below, you will probably benefit from some CBT strategies such as cognitive restructuring.

What Principle Underlies Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an evidenced based treatment modality used to treat a wide variety of diagnoses. CBT posits that there is a powerful connection between thoughts, emotions, and behaviors, and encourages people to learn more about those connections to live the most fulfilling life possible. 

Often thoughts and emotions lead to behaviors that are not in alignment with the individual’s values or beliefs. Examples of this can include excessive substance use, self-injury or maladaptive interpersonal behaviors such as lying and manipulation. A primary underlying principle of CBT is that people can change their life by changing their behavior patterns that are not effective, and the way they do that is by first changing their thoughts. CBT suggests that mental health concerns are based in large part on unhelpful ways of thinking as well as unhelpful behavior patterns that are tied to those ways of thinking.  

For example, if a person is having the thought “I bet no one likes me”, they might feel insecure, and therefore isolate themselves. In this example, CBT would encourage the individual to target the thought “I bet no one likes me”, which will then shift the emotional state and open the door for that person to make friends and socialize. In turn, that person will gain evidence to counteract the original thought “I bet no one likes me”, which means the thought will lose its power and lessen in frequency. 

A significant underlying principle of CBT is the hope that people can change. It is possible for thought patterns to change, for behaviors patterns to change, and therefore for a person to live a more purposeful and fulfilling life. With the right awareness and the right support, anyone can improve their life. 

Common components of Cognitive Behavioral Therapy (CBT)

cognitive distortions

Catastrophizing: Immediately assuming the most catastrophic outcome. For example: You notice you have a headache and then immediately assume it must be a brain tumor.

Personalization: Taking full blame for a situation that in reality involved multiple factors: For example: Your parents get divorced and you are convinced it is entirely your fault when in reality there were likely many different factors leading to their divorce.

Polarized Thinking: Also known as “black and white” thinking or “all or nothing” thinking. For example: If you’re usually a straight A student and you receive a B on a test, you conclude that you are stupid.

Emotional Reasoning: Believing that feelings are facts. For example: I feel worthless therefore that must certainly mean that I am actually worthless.

Cognitive Restructuring

Cognitive restructuring is an intervention that comes from Cognitive Behavioral Therapy (CBT). It involves identifying ineffective thoughts and adjusting them to be more effective. At the end of the exercise, the goal is to restructure the thought to a point where it elicits less of an emotional response and is more in alignment with goals and values. Listed below are the steps and processes of cognitive restructuring:

  1. Identify the situation

Writing out the details of the situation (what is happening, what emotions are coming up, and what thoughts are present) is an important first step. Choose a situation that feels particularly activating or distressing. 

  1. Choose a thought to focus on

Based on the thoughts that came up in step 1, identify one thought that feels especially linked to distress. Often this thought will be an automatic thought, something that just comes to mind without intention. Examples can include “I’m not good enough”, “it’s all my fault” and “nobody cares what I have to say”. 

  1. Develop different perspectives

Consider evidence for and against the chosen thought. Consider the pros and cons of allowing this thought to dictate actions. CBT encourages people to use Socratic questions in this phase of the process, which are questions that are probing in nature and are aimed at getting to alternate viewpoints and deeper beliefs. Examples of these questions include:

  • Is this thought based on facts or my emotions or both?
  • Is there another way of looking at this situation?
  • What are the pros and cons of believing this thought?
  • What would change if I didn’t believe this thought?
  • What would I tell my friend who was in this situation?
  • What is the worst thing that could happen? Would I survive it?
  1. Establish an alternative response

The final step in this process is to actually shift the thought itself and create an alternative response. This is a thought to bring to mind whenever the previous automatic thought comes up and it should be much more in alignment with values and goals. Allowing an alternative thought to exist at the same time as the automatic thought promotes cognitive flexibility and can create separation between the person and the automatic thought so it doesn’t seem as factual. An example of an alternative response to the example above of “nobody cares what I have to say” could be “I have evidence to show that my friends and family are interested in what I have to say”.

Cognitive restructuring is an intervention that can be very useful to gain awareness and shift perspectives when it comes to automatic thoughts. In turn, this can shift long-held beliefs about the self, improve mood and increase the ability to be present in a fulfilling life.

Behavioral Activation

One of the effects of depression, a common mental health concern treated by CBT, is feeling immobilized. It’s hard to push yourself to do normal self-care activities, and pleasure might seem all but absent from your life.

Feeling immobilized/stuck is not only a symptom of depression – it’s a cause. The fewer activities you engage in, the more depressed you feel; and the more depressed you feel, the less you do and want to do. It’s a negative spiral that maintains avoidance and prolongs depression.

The solution is to push yourself to higher levels of activity-even though you don’t feel like it. You can’t wait to feel motivated to get out of bed, or go to school, or go hang out with your friends, but rather, you need to act first (opposite action and behavioral activation) and in doing so, the motivation will eventually follow. Activity scheduling can help you identify what activities you can engage in to re-energize yourself and offer significant help in overcoming depression.

It’s important that you engage in a variety of activities that will bring you both a sense of enjoyment and a sense of mastery – feeling like you’ve accomplished something as this will raise your self-esteem and belief that engaging in activities can help to relieve your depression.

While the above paragraph discusses the use of CBT in the treatment of depression, CBT is a highly effective treatment for anxiety, OCD, trauma, eating disorders and various other mental health issues.

What is a Behavioral Therapist?

A behavioral therapist is a type of therapist who is going to focus on identifying and then changing the maladaptive behaviors of their clients with the goal of improving their overall wellbeing. The idea of behavioral therapy is that when a client engages in behaviors that are maladaptive, they accrue suffering, and will then likely continue to engage in those maladaptive behaviors. This in turn will result in some negative consequences for the client. A behavioral therapist will aim to assist the client with identifying these maladaptive behaviors, understanding the consequences of them, and then making changes so the client can act more in alignment with their goals and values. 

Unlike other types of therapy, like psychodynamic which focuses more on building insight and looking into a person’s past, behavioral therapy is driven by action. A behavioral therapist cares about the client’s past and emotions because they influence behavior. That information is assessed and explored with the purpose of understanding why the maladaptive behaviors are present, and then intervening with the goal of eliminating them. A primary strategy for accomplishing this is to identify the function that the maladaptive behavior is serving, and then find a way to serve that function in a more effective way. An example of this could be a client who is abusing alcohol with the purpose of lessening the intensity of their emotional experience. This is a maladaptive behavior because while it achieves the goal in the short term, it comes with many consequences in the long-term including financial, social, cognitive, and medical. A behavioral therapist would focus on the substance abuse itself and aim to help the client to reduce that behavior, therefore reducing the consequences, and replace it with more effective strategies. In this example that could include healthier forms of distraction when emotions feel too heightened, as well as some process and connection-oriented strategies including journaling, art or mindfulness that would aim to improve the client’s emotional tolerance, so they feel less of a need to avoid. 

Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT) and Exposure Response Prevention (ERP) are all types of behavioral therapy that help a client become aware of the behaviors they are engaging in that are not serving them well, and then make more effective choices. These therapies are used to treat every mental health diagnosis and can be successfully adapted to meet the specific needs of each client.

Cognitive Behavioral Therapy (CBT) Books

Cognitive Behavioral Therapy (CBT) is a complex treatment modality, so utilizing books is an effective tool to learn more and deepen understanding. Listed below are the top 10 books about CBT and how it can be used to treat various mental health diagnoses.

  1. Cognitive Behavior Therapy – Basics and Beyond by Judith S Beck

This book provides a comprehensive look at CBT, diving deep into its principles and interventions. It has various exercises and case examples to offer that help to deepen understanding. 

  1. Culturally Responsive Cognitive Behavior Therapy: Practice and Supervision by Gayle Y Iwamasa and Pamela A Hays

This book is for therapists to better understand how CBT can intersect with various cultural backgrounds so they can most ethically serve their clients. 

  1. Deliberate Practice in Cognitive Behavioral Therapy by James F Boswell and Michael J Constantino

This is another book geared towards therapists and its purpose is to help therapists feel more confident bringing CBT into their practice. This book offers case examples so therapists reading can see how CBT principles are applied to real cases. 

  1. Cognitive Behavioral Therapy by Michelle G Craske

This book is geared toward therapists and provides a wealth of information that is broken down into a few sections which include assessment, case conceptualization and application. 

  1. Overcoming Unwanted Intrusive Thoughts by Sally M Winston and Martin N Seif

Intrusive thoughts can be very distressing and are present in several mental health conditions. This book provides a practical and compassionate guide for how to find relief from intrusive thoughts and gain more cognitive peace. 

  1. The CBT Journal for Mental Health: Evidence-Based Prompts to Improve Your Well-Being by Jordan A Madison

This is a journal for anyone to use and provides a wide variety of journal prompts, affirmations and exercises rooted in CBT principles. 

  1. The CBT Workbook for Mental Health: Evidence-Based Exercises to Transform Negative Thoughts and Manage Your Wellbeing by Simon Rego and Sarah Fader

This workbook is meant to accompany the journal listed above. It helps readers to navigate CBT exercises aimed at reducing cognitive distress. 

  1. The Generalized Anxiety Disorder Workbook: A Comprehensive CBT Guide for Coping with Uncertainty, Worry and Fear by Melisa Robichaud and Michel J Dugas

Generalized Anxiety Disorder (GAD) is a diagnosis that comes with symptoms of excessive worry, restlessness, fatigue, difficulty concentrating, irritability and sleep disturbance. This workbook guides the reader thought CBT focused exercises to help them learn to reduce these symptoms and cope effectively. 

  1. The CBT Workbook for Perfectionism: Evidence-Based Skills to Help You Let Go of Self-Criticism, Build Self-Esteem, and Find Balance by Sharon Martin

This workbook uses CBT principles to help the reader find strategies for reducing perfectionism tendencies and gain more flexibility. 

  1. The CBT Couples Toolbox: Over 45 Exercises to Improve Communication, Navigate Problems and Build Strong Relationships by John Ludgate and Tereza Grubr

CBT is a great treatment modality to utilize in couple’s therapy. This book can be utilized by therapists or couples and offers exercises that will help couples to learn effective communication skills to strengthen their relationship.

Cognitive behavioral therapy (CBT) chicago

​Our CBT therapists at Cityscape Counseling in Chicago incorporate cognitive behavioral treatment interventions to address classic depression and anxiety symptoms. CBT for anxiety, CBT for depression, and other interventions such as CBT for OCD and CBT for insomnia, are aimed at helping individuals identify unhelpful thought patterns, evaluate data for and against the conclusions your mind has drawn, monitor how these thought patterns are influencing your moods and behaviors, and reconstruct more helpful thinking patterns.

if you’re looking for a CBT therapist in chicago, Cityscape counseling would love to work with you.

We know that seeking out therapy can be a daunting endeavor so we’re dedicated to helping you each step of the way. Start by calling or emailing us to set up your first appointment.