Behavioral and cognitive therapies are based on observation and modification of the problem behavior of an individual.Contents of this article
- Origin of behavioral and cognitive therapies
- Principle of behavioral and cognitive therapies
- Why consult a therapist in CBT?
- How does one practice behavioral and cognitive therapies?
- Cons-indications to CBT
- What happens during a first TCC session
- How to choose a CBT therapist?
- Duration and price of CBT session
- Books on behavioral and cognitive therapies
- Websites devoted to cognitive and behavioral therapies
Behavioral and cognitive therapies are the result of the combination of cognitive therapy and behavioral therapies, conducted in the years 1970-1980 in order to optimize therapeutic efficacy.
Behavioral therapies are based on the observation of the behavior of an individual and the study of stimuli that condition. When behavior is problematic, the therapist acts on these stimuli to change the behavior. This form of psychotherapy has been enriched with cognitive therapy, which no longer considers only the behavior of subjects in understanding the problem, but also their thoughts and emotions.
In a June 2007 report entitled Long-Term Psychiatric disorders - Anxiety disorders serious, the High Health Authority recommended cognitive behavioral therapy as a "treatment option in anxiety disorders."
Cognitive behavioral therapies are psychotherapies that rely on an experimental scientific process and learning theories. Inadequate or problematic behavior is often learned in specific situations and reproduced in our daily environment. For new learning, the patient can override this behavior by another, better suited to his daily life. The therapist guides the patient until its purpose by promoting new learning by constructing an appropriate strategy, which takes into account all elements of its environment.
Behavioral and cognitive therapies are recommended to help people with disorders such as:
- Anxiety disorders, panic attacks, social phobias or simple, agoraphobia;
- Obsessive compulsive disorder, depression, stress;
- Bulimia, withdrawal;
- Sexual disorders, marital or relationship problems.
CBT have also proven effective in the rehabilitation of chronic psychotic patients.
The TTC is engaged in weekly individual session and usually last less than a year. They are called "active" because there is participation therapist and the patient also trains outside the session. The patient is asked to reproduce exercises at home or in the street in order to progress in solving its problems.
The CBT therapist has diverse techniques he chooses according to the patient's pathology. For example :
- Systematic desensitization Wolpe: first the therapist leads the patient to relax and then lists the stimuli by theme and by level of anxiety they generate. Once the relaxed patient, the therapist asks him to represent the least anxiety provoking stimulus. When the patient will be able to represent him without feeling anxiety, it may move to a slightly more alarming stimulus until all situations is addressed;
- Exposure with response prevention: the patient is exposed to anxiety-provoking stimulus, but the therapist asks him not to repeat the usual behavior that follows, to substitute another behavior. Gradually, the therapist gives the patient keys for it overcomes the situation anxiety, tolerates his usual behavior and gets rid of completely;
- RPGs: they often act as technical staff development, including improving self-confidence. The therapist asks the patient to play himself and the therapist cues based. This is mostly to raise awareness of the patient's way of being and communicating, to correct it if necessary;
- Modeling and coping: the therapist is often used as reference for the patient. The latter can then copy the appropriate behavior that is offered by the therapist, to substitute its former pathological or problem behaviors.
But one can also cite biofeedback, breathing control or cognitive restructuring which consist in adopting the patient of alternative thoughts to those who usually do suffer or cause his inappropriate behavior.
There are no cons-indication to the practice of tax.
A first meeting of TTC always begins with a collection of information about the patient's problem. This information relates to their behavior, their consequences, emotions, relationships with others, vis-à-vis thoughts of the problem but also the reasons for his coming, his expectations and his overall health.
Before the patient engages in CBT, it is preferable that the therapist reminds him of the "active" side of this kind of psychotherapy. Indeed, the work is not done only during the sessions. The therapist can give the patient the goals to be achieved before the next meeting. For example: to speak at a meeting, approach a person on the street. These outdoor exercises are essential to confront the person to his problems, in real situations. The therapist can then evaluate the patient's progress from a behavioral perspective.
Following this first meeting, the therapist and patient establish a calendar of meetings and define working themes. The therapeutic work begins during this same meeting, involving the practices of deconditioning and reconditioning, cognitive and behavioral inspiration.
Initially, the patient is asked to confront their behavior through role plays or scenarios. By pointing out the problem behavior, the therapist discovers the origin of internal or external conflicts of the patient.
Then the cognitive part of the therapy is to analyze the mental mechanisms responsible for the deviant behavior. The therapist does not dwell on the unconscious, as is the case for psychoanalysis, but rather on current and identifiable causes of problematic behavior. This part is as a method of re-learning mechanisms related to good behavior.
At the end of the session, the therapist gives instructions and exercises to do for the next session and request feedback to the patient. The patient then expresses his feelings and insights on the work done.
CBT is practiced by psychiatrists and psychologists trained specifically. But some people with no serious training sessions also offer CBT. We must therefore be careful in choosing his therapist.
It is advisable to meet at least two therapists and choose the one with whom you feel most confident. Avoid trendy approaches that promise to solve your problems quickly, requiring to cut ties with those around you or join a closed group. Do not hesitate to ask for details of your therapist's training and way of working. This will help you determine if it can help you solve your problem.
You can consult the directory of members of the French Association of behavioral and cognitive therapies, the majority consists of practitioners.
On average, a session lasts 45 minutes TCC and its price ranges from 30-140 euros, depending on the qualifications of the therapist.
Behavioral and cognitive therapies are reimbursed by Social Security when performed with a psychiatrist. Some mutual partially reimburse CBT sessions. Check with your affiliate organization.
- "The behavioral and cognitive therapies: to free themselves of psy disorders," Jean-Louis Monestès and Claudine Boyer, ed. Milan 2006: a book presenting the foundations of the TTC and their applications in different pathologies.
- "Exercises of behavioral and cognitive therapies for Dummies", Rhena Branch and Rob Willson, ed. First, 2010: a book that provides tools and techniques to be more comfortable in everyday life and regain confidence.
- "The checklist CBT", co-written by Professor Stephane Rusinek, éd.Dunod, 2011.
- French Association of behavioral and cognitive therapies
- French Association for training and research in behavioral and cognitive therapy
- French Psychological Society