Cognitive Behaviour Therapy

In
Indian Context

Name – Foram Shah

Roll No – 34
CBT – REBT
Date – 30/09/2021
 CBT is a type of psychotherapy which has evidence, structure and is directed towards

modifying our unhelpful or dysfunctional thoughts and behaviour. CBT is a family of

interventions for depressive and anxiety disorders that shares the basic constituents of CBT

model that focus on the significance of cognitive processes and behaviors for emotion

regulation process. Even though the word Cognitive in CBT signals that treatment focuses a

considerable degree on thought processes, the therapy is not limited to cognitive modification

alone. Effective CBT has to deal with all aspects of an emotional disorder including

intellectual aspect of cognitions, experiential aspect of emotions and maladaptive behaviours.

India is considered to have impact in various areas and have had rapidly growing

economy. It is said that psychotherapy in India has been there but submerged as there is no or

less awareness about it so it is long lost. CBT in the Indian context has not been accepted as

its as people in India believe that any procedure requires a long time so the approach of being

short-term, focused and its directive approach is not accepted and is said to be westernized.

The Indian Culture by the western people has been criticized as it been too simplistic,

language issues, etc.

Our country has one of the oldest civilisations in the world. The country has huge variations

of sub-cultures, populace, language, religion, customs, socio-economic aspects as well as

lifestyles The old saying “Unity in Diversity” is the hallmark of all aspects of life in this

country – and mental health services are no exception. Indian society is characterised by

deeply ingrained traditions and belief systems despite fast changing lifestyles and

modernisation. In addition, while one section of society is becoming increasingly modernised

embracing globalisation and having the resource advantage, the majority (mostly living in

rural areas) still struggle for needs of daily living and basic amenities. There are obviously

then huge variations in access to health and educational services as well. People in our
country has their own traditions and belief systems so there is a huge difference in the way of

having their viewpoint towards the health system in our country.

In India, spirituality plays an important role in the lives of the majority of people. It is

said that the thinking is more spiritual than psychology and people might themselves might

not have the awareness. So in the indian context, it is suggested that along with western

concept of CBT there has to be components of spirituality for it to work for the people here

specially in the rural areas. However, there has been a change in the approach of the people in

urban areas for the mental health areas. So research in the mental health field has been

increased and carried out by many individuals as they have realised that the main component

with major issues in life is our thought process and mind so research of the therapy with the

Indian culture and component is carried out.

CBT is a collaborative process that requires commitment from the client for their own

self. India is a collectivist society where people do not think much about their own being and

own mental health so working with them with CBT approach becomes difficult. As in the

Indian context, the concept of teacher-student relationship and the respect of the relationship

is impossible in the same way in CBT the counseling works with the client for us betterment.

We dont have the concept of talking out issues, there is a lot of stigma attached so working

with CBT creates a lot of hurdles.

In Indian context, CBT alone cannot work by itself it has to be collaborated with our

Indian cultures as well. The awareness must also be spread about the therapy as it helps in

cognitive restructuring which helps in the betterment of the client. Spirituality should be

imbibed in the techniques and collectivist nature of our society should be taken into

consideration. Indian culture when imbibed with some small changes in the CBT practise will
work wonders with the client and have more awareness and response towards the therapy.

Our Indian culture also has its own uniqueness and some scientific reasons behind the

practise. Yoga practise along with CBT helps in great ways and brings effective results. In

short, CBT with spirituality and cultural differences these minor changes will be helpful.

As a personal experience, I had a chance to see the counselling session in a setup in

Gujarat. There is no specific structure to the sessions but the most important part was the

thought process that was conveyed in a way which is understood by the people there. The

sessions taken were acknowledged and were helpful to the clients so there was no fallback

much. The sessions taken according to the requirement of the people living in the locality

helps in creating more awareness and people looking out to seek help. As some people were

not much educated, the local language was Gujarati and education was majorly done in

Gujarati language only so not acquainted with the English words were in contact with the

terms that we might use in the CBT structure. Awareness and seeking-help is the most

important thing that is required in India which suits according to the culture and locality. In

the Indian culture, yoga along with therapy is found to have wonderful effect on the Mental

Health of the individual as well as it has great scientific base. Cognitive Behavioral Therapy

in India is used widely but has its own various according to the culture where it is practised.

There are many practised who still doesn’t have proper training and certification.

 
 References

1)     Jaiganesh Selvapandian (2019), Status of Cognitive Behaviour Therapy in India:

Pitfalls, Limitations and future directions – a systematic review and critical

analysis, Asian Journal of Psychiatry 41.

2)     Dr Nimisha Kumar, Ms Parul Gupta (2012), Cognitive Behaviour Therapy in

India: Adaptations, Beliefs and Challenges ,Chapter-6, Nova Publishers.

     

  Tool kits

Elicit Emotions

For the emotions, in a diary we can ask the clients to make bubbles of various colors when

they are experiencing certain emotions. So when they are sad they can color the bubble as 
dark blue, when happy they can color yellow, when they feel excited they can color light blue

and when they feel love they can color pink.

We can say the client to do this activity daily so that they can understand their emotions

throughout the day and can evaluate them.

We can ask clients to give credits for the emotions that they feel. Credit system helps gaining

an insight to the client which emotions get what credit. When they make a list of emotions

and the credit-log they can themselves see which emotions is felt the most by them

throughout the day. If emotions that make them sad gets the more credit, working towards

reducing them will be the goal and the step ahead. If happy and productive emotions get

highest credit, they can reward themselves by a small travel trip or gift themselves.

Elicit Thoughts 

When the negative thoughts pop up in the mind of the clients, we ask them to make a list of

all the negative thoughts. Ask them to make a chart of all the thought and write them one

each in one column. They can keep the chart in front where its easily visible. We make a

weekly chart for the start and write one negative thought in each column. Whenever during

the week that thought comes in the mind the client can just tick them and make a note. At the

end of week, it can be noticed by client that how many times they have this  thoughts and

how it affects them.

For automatic negative thoughts, we tell clients to maintain a diary, where in whenever

unhelpful
and unhealthy thoughts they can replace them with the positive statements. When they will

see the amount of positive statements they will automatically start feeling good. They can see

the amount of positive statements and will themselves have cognitive restructuring and the

amount of negative thoughts might reduce overtime.

Elicit Behaviour 

For the bad behaviour experienced by the client, we can ask them to journal. Journaling helps

in understanding the behaviour elicit them, and then work towards improving them. When the

client get angry, they can journal that behaviour by sticking a picture of an angry object by

cutting from the newspaper in their journal. For example- an angry face, fire or people

fighting. For the positive behaviour experienced by them, they can stick happy faces, people

dancing, images of flowers etc.

Journaling our behaviour will help in channeling something good and doable which will be

noticeable by the client itself.

Ask them to do a small colouring session whenever they get angry. Ask clients to have a

small colour book and whenever they experience bad or upsetting behaviour they can engage

in a small colouring session and help them in relaxation as well from the behaviour. The

coloring sessions and the number of drawings will help the client in understanding of thier

behaviour through it.