What is a Therapeutic Approach Anyway? Understanding CBT

You may have noticed that some therapists, counselors, and social workers use a lot of different acronyms. For example, maybe you have seen CBT, DBT, ERP, etc. and you have no idea what that means because they don’t elaborate.

So, what do these acronyms mean and what do they say about the therapeutic approach used by therapists? This post will be the first of a series to describe and explain the differences between therapeutic approaches.

The therapeutic approach is a fancy phrase to describe the set of beliefs a therapist has towards how they conceptualize their clients, how humans work, and what is needed for their client to make a change. The most common acronym you will see is CBT which stands for cognitive behavioral therapy.

This approach is all about how thoughts, behaviors, and emotions are closely connected. For example, our thoughts impact our behavior which impact our feelings or vice versa, our feelings can impact our behaviors and thoughts. This connection is often referred to as the CBT triangle.

A CBT therapist believes that our problems stem from negative thoughts and behaviors. If those can be changed into positive thoughts and behaviors, then clients will heal.

Let’s walk through an example of a CBT therapist in action. A client may be feeling anxiety towards a relationship with their partner, such as noticing the partner is being extra quiet during dinner. The client might be thinking “he is quiet because he is mad at me.” This could lead them to the emotion of feeling anxious and the behavior of compensating by being extra talkative.

The therapist may target that thought of “he’s mad at me” and encourage those thoughts to be evaluated. Is there evidence that he is mad at you? Is there evidence he is not mad at you? Alternatively, is there another reason behind him being extra quiet?

Ultimately, it’s ok to not believe the alternative. Therapists are not trying to force a different belief or to say clients are wrong. A CBT therapist is trying to have clients understand there are different ways to interpret a situation in order to change thoughts and behaviors.