The Acronyms in Therapy pt1
Oh the acronyms in therapy. Therapists do love them!There are so many 'initial'-based therapies out there and it seems there are new ones appearing every month. I studied CBT for 3 years and I find it all a little bewildering at times. So I thought I would do a brief and basic overview of some of them just in case you're considering therapy, starting with CBT, REBT and CRT
CBT (Cognitive Behavioural Therapy) is probably one of the best known acronyms in the therapy business. CBT is an approach based on "concepts and principles derived from psycho social models of human thoughts and emotions"* that addresses dysfunctional emotions, maladaptive behaviours and cognitive processes through a variety of goal-orientated, explicit systematic procedures. Or, more approachably put, it's a talking therapy that helps manage your problems by changing the way you think and behave using exercises and homework.
As a more 'now' orientated therapy that helps clients work on negative, unhelpful thinking and behaviour,it is helpful for people finding negative patterns affecting their relationships, work and life in general. As such, CBT is commonly used to treat anxiety, depression, chronic and persistent pain and OCD.
REBT (Rational Emotive Behavioural Therapy) is a form of psychotherapy created by Albert Ellis in the 1950s. The basic principle of REBT is that it is your beliefs about events that cause you to become depressed, anxious etc. rather than the events themselves. Ellis used an ABC model to illustrate this.
He then goes on to add 'D' to this in the form of the disputed belief system, where the client questions and challenges their ingrained belief system. This questioning promotes the movement of these core beliefs from the unconscious to the conscious mind to make proper examination possible and so increases the potential for change.
So, What REBT does is encourage the client to consider and analyse the beliefs behind their responses to counter the powerful ingrained 'auto-pilot' response. The therapist will use a variety of techniques to achieve this, such as NLP (more acronyms!-in case you're not sure, Neuro Linguistic Programming), self-hypnosis, gradual desensitisation, role-play and visualisations. As far as possible, a good therapist will empower the client to choose within these techniques in order to prevent simply replacing one set of inflexible responses with another. It's important to note that the very nature of REBT can be somewhat blunt and as such can be inappropriate for certain types of client, in particular (for the purposes of this blog) for severe Eating Disorders.
CRT (Cognitive Restructuring Therapy) was developed by Aaron Beck in the 1960s and indeed, cognitive restructuring is an important component within CBT practice. Beck focused primarily on the area of depression and his philosophy changed the emphasis, saying that it is the meaning we place on an event which will govern our feelings about the situation and , ultimately, our reaction to it.
Central to the practical techniques used in CRT is 'confrontation'. There are a number of forms of confrontation that can be used with the appropriate client once a level of trust and understanding has been established. Among these is 'making it specific' which involves guiding the client to consider, for example, precisely what is frightening them. If the client in this example is frightened by a social event, such as a school reunion, the goal would be to specifically identify what is frightening them in order to begin examining it using different techniques. Another type of confrontation is 'extent realism', where the therapist would guide the client into considering how bad any projected outcome could, in reality, be.
Cognitive Restructuring techniques used separately as a process, have been found to be effective in the treatment of anxiety disorders and Binge Eating Disorders.