UNIVERSITY OF NURSING, MANDALAY

DEPARTMENT OF MENTAL HEALTH NURSING

Cognitive Behavioral Therapy

Group -3
Roll No-155 to 216
Date - 5.2.2024
Cognitive Behavioral Theory (CBT)

Definition
Cognitive behavioral therapy (CBT) is a form of psychological
treatment that has been demonstrated to be effective for a range of
problems including depression, anxiety disorders, alcohol and drug use
problems, marital problems, eating disorders and severe mental illness
 Numerous research studies suggest that CBT leads to significant
improvement in functioning and quality of life
 In many studies, CBT has been demonstrated to be as effective as,
or more effective than, other forms of psychological therapy or
psychiatric medications
Principle
CBT is based on several core principles, including:
1. Psychological problems are based, in part, on faulty or unhelpful
behavior
2. Psychological problems are based, in part, on learned patterns of
unhelpful behavior
3. People suffering from psychological problems can learn better ways
of coping with them, thereby relieving their symptoms and
becoming more effective in their lives
Strategies (thinking patterns)
 Learning to recognize one's distortions in thinking that are creating
problems and then to reevaluate them in light of reality
 Gaining a better understanding of the behavior and motivation of
others
 Using problems solving skills to cope with difficult situations
 Learning to develop a greater sense of confidence in one's own
abilities
Strategies (behavioral patterns)

These strategies might include:

• Facing one's fears instead of avoiding them
• Using role playing to prepare for potentially problematic interactions
with others
• Learning to calm one's mind and relax one' s body
Three Main Goals of Cognitive Behavioral Therapy

• Establishing Problem Solving Skills

• Adopt and Adjust Negative Thinking Habits
• Getting Back to A Daily Routine
Types of CBT
The types of cognitive behavioral therapy include:
1. Cognitive Processing Therapy (CPT)
2. Cognitive Therapy (CT)
3. Dialectical Behavior Therapy (DBT)
4. Rational Emotive Behavior Therapy (REBT)
5. Motivational Interviewing (MI)
6. Acceptance and Commitment Therapy (ACT)
7. Mindfulness-Based Stress Reduction (MBSR)
8. Mindfulness- Based Cognitive Therapy (MBCT)
Cognitive Behavioral Therapy Techniques

Here are just a few examples of techniques used in cognitive behavioral

therapy.
• Identifying Negative Thoughts
• Practicing New Skills
• Goal-Setting
• Problem-Solving
• Self-Monitoring
Identifying Negative Thoughts

• It is important to learn what thoughts, feelings, and situations are

contributing to maladaptive behaviors.
• This process can be difficult, however, especially for people who
struggle with introspection
• But taking the time to identify these thoughts can also lead to self-
discovery and provide insights that are essential to the treatment
process
Practicing New skills

• In cognitive behavioral therapy, people are often taught new skills

that can used in real-world situations.
• For example, someone with a substance use disorder might practice
new coping skills and rehearse ways to avoid or deal with social
situations that could potentially trigger a relapse.
Goal-setting

• an important step in recovery from mental illness, helping to make

changes to improve the health and life.
• therapist can help to build and strengthen the goal-setting skills.
• involve teaching how to identify the goal or how to distinguish
between short and long-term goals.
• include helping to set SMART goals, with a focus on the process as
much as the end outcome
Problem-Solving

• Learning problem-solving skills during cognitive behavioral

therapy can help to learn how to identify and solve problems that
may arise from life stressors, both big and small.
• It can also help reduce the negative impact of psychological and
physical illness.
Problem-solving in CBT often involves five steps;
1. Identifying the problem
2. Generate a list of potential solutions
3. Evaluate the strengths and weakness of each potential solution
4. Choose a solution to implement
5. Implement the solution
Self Monitoring

• an important technique
• involves tracking behaviors, symptoms or experiences over time and
sharing them with the therapist
• can provide the therapist with the information they need to provide the
best treatment
Examples of CBT techniques might include the following:

• Exposing to situations that cause anxiety, like going into a crowded

public space
• Journaling about the thoughts throughout the day and recording the
feelings about the thoughts
• Engaging in mindfulness, meditation where the clients tune into the
thoughts that come into the client's mind and let them pass without
judgement
• Looking at overwhelming tasks in a new way by breaking them up
into smaller, more manageable pieces
• Scheduling activities that make the client nervous or give anxiety
• Role playing to practice social skills or to improve the client's
communication skills
Length of Therapy
The course of treatment usually lasts for between 6 and 20 sessions,
with each session lasting 30 to 60 minutes. Factors to consider include:
• Type of disorder or situation
• Severity of symptoms
• How long the patient had symptoms or has been dealing with
situation
• How quickly the patient make progress
• How much stress experiencing
• How much support the patient receive from family members and other
people

Uses for CBT

• Bipolar disorders
• Borderline personality disorder
• Eating disorders
• Obsessive compulsive disorders
• Panic disorder
• Phobias
• Post traumatic stress disorder
• Psychosis
• Schizophrenia
• Sleep problems
• Problems related to alcohol misuse
• Depression
• Substance use disorders
• Sexual disorders
CBT is also sometimes used to treat people with long term
health conditions, such as:

• Irritable bowel syndrome

• Chronic fatigue syndrome
• Fibromyalgia
• Chronic pain
Contraindications

• there is no absolute contraindications

• it is reported that clients with comorbid severe personality disorders
such as antisocial personality disorders and subnormal intelligence
are difficult to manage through
• special training and expertise may be needed for the treatment of
these clients.
 Contraindications(CON'T)

• Patients with severe depression with psychosis and suicidality might

be difficult to manage with CBT alone and need medications and
other treatment before considering CBT.
Advantages of CBT

• Research has shown CBT can be as affective as medicine in treating

physical conditions, like low back pain, as well as mental health
conditions, like depression.
• CBT can be completed in a relatively short period of time compared
with other types of talking therapies.
Advantages of CBT(CON'T)

• Because CBT follows a structured format, it can be done in many

ways, including in groups, and with self-help books or computer
programs.
• The skills that learn in CBT can be added into everyday life to
help in coping better with future problems
Disadvantages of CBT

• To benefit from CBT, need to commit to the process_ a therapist can

advise the patients, but they can't make the problems go away unless
the patients do their part.
• CBT is not always suitable for people with more complex mental
health needs or learning difficulties because it's so structured.
Disadvantages of CBT(CON'T)

• Because CBT only addresses current problems and focuses on

specific issues, it does not address the possible underlying cause of
mental health conditions like an unhappy childhood.
• CBT focuses on the patient changing theirselves, but it does not look
at the impact of other factors on the patient's health and wellbeing.
Intake Assessment

• Identify the patient's current feelings.

• Identify the problematic behaviors. These problematic behaviors
both flow from and in turn reinforce Sally's dysfunctional thinking.
• Third, hypothesize about key developmental events and how the
enduring patterns of interpreting the events that may have
predisposed to their symptoms.
Roles of Nurses in CBT

• Nurses may conduct assessments and monitor individuals with

mental health conditions to identify changes in symptoms or
behaviors.
• Nurses can use CBT techniques to help clients manage
psychological distress and develop coping skills to improve their
mental health.
• Monitor the progress of individual clients and the group as a whole,
and provide feedback and guidance as needed.
Roles of Nurses in CBT (CON'T)

• Focus on making changes in current ways of thinking and

behavior.
• Evaluate outcomes and assess the effectiveness of CBT techniques
and exercises in managing symptoms related to mental health
conditions.
• Encourage participation and create a safe environment for clients
to share their thoughts and feelings.