CT in Action

How does Cognitive Therapy work?

The Therapist

Cognitive Therapy views patients and their disorders principally from the perspective of the patient's cognitions. At the same time, the cognitive therapist understands that thoughts are not the original cause of all problems. The therapist will examine the patient's thoughts, moods, behavior, medical status, and general environment in order to develop an understanding of the patient's problems. Whatever the original cause of a patient's problem, thoughts play an influential role in allowing dysfunctional behavior to persist. As a result, the cognitive therapist will focus therapy on the patient's thoughts, and coordinate therapy with a medical doctor or psychiatrist when and where this is appropriate. The cognitive therapist will also use techniques from other psychotherapeutic orientations, such as behavioral therapy, where these are appropriate or the best means to address the patient's dysfunctional cognitions; these are always, however, conceived and employed in the context of the Cognitive Therapy Model.

The Patient

Cognitive Therapy depends on a strong and healthy therapeutic alliance between the therapist and the patient. Both must be committed to the therapeutic process and achievement of the desired outcomes. Further, the patient must understand that the success of the therapy depends on their active involvement and participation. An important purpose of the therapy is to teach the Cognitive Therapy process to the patient. The patient is taught to identify, analyze, and modify irrational or dysfunctional thoughts. The patient should learn to apply the therapy to any future problems and also to prevent relapse.

The Therapy Session

Cognitive Therapy focuses on resolving problems and accomplishing goals. Whatever the diagnosis may be, the therapy will begin by focusing on the patient's presenting problems. The Cognitive Therapy process is expected to last for a limited time, often for a period measurable in weeks or months. Sessions are structured and maintain their structure throughout the evolution of the therapy.