How To Tell if Your Therapist Uses Cognitive Behavioral Therapy
By Ernest Schmidt, LCSW
One of the most frequently asked questions that I get, as both a certified cognitive therapist and as an advocate of Cognitive Behavioral Therapy (CBT), is how to tell if a therapist uses CBT. To be honest, I also find this distinction difficult, since so many therapists claim that they use this form of therapy in their practice. I rarely meet a therapist who doesn’t proclaim to practice CBT. While I am not implying that therapists lie about what they do, often they have been exposed to a small amount of CBT and not fully trained. On the surface, cognitive behavioral therapy is relatively simple, as it’s basically changing your thoughts and behavior to feel better emotionally, but in reality it takes a great deal to be fully trained in how to effectively use this with clients. Although there is no fool-proof way to tell whether your therapist truly is using CBT with you, there are some characteristics to watch for that will make you an informed consumer.
CBT Characteristic #1: Addresses Your Thoughts and Behaviors
A true CBT therapist is going to spend much of your session reviewing the behaviors, thoughts, and emotions that are connected to your main concerns. Often they will use what’s called a thought record or, as David Burns, author of the best selling self-help book Feeling Good, calls it, a “Daily Mood Log” to help you capture and then work on your negative thoughts. Almost all therapists will discuss your emotions, but what sets CBT therapists apart is their additional focus on your thoughts and behaviors. Rather than assuming all your troubles stem from early childhood problems or a traumatic past, CBT therapists will look to your thoughts to determine what to do next. Often your thoughts and behaviors will be automatic or somewhat hidden in nature, and working to draw them out and address them provides substantial relief and great life improvements.
CBT Characteristic #2: Focused and Agenda Driven Therapy
Many therapists who don’t use CBT often will give advice and be generally supportive, but this can lead to an endless review of your feelings and limited progress. Cognitive behavioral therapists, although supportive and geared towards your interests as well, differ in that they will set an agenda each session to make sure progress is being made or at least set some structure to make as much movement as possible with each session. This usually involves a short recap of the week, review of homework that was assigned and areas that still need to be addressed, time for practicing techniques, and feedback about the therapy. Although all good therapists will be flexible to some degree depending on what is happening for you in the moment, too much flexibility, combined with the lack of an agenda, often leads to disappointing results.
CBT Characteristic #3: Tracks Your Symptoms of Depression & Anxiety
CBT therapists usually monitor your symptoms, or the problems that brought you to counseling, in some sort of organized manner. Rather than just asking you how you are feeling, they tend to use standardized tests or scales to keep a close eye on the problems that you are looking for help with. By using such tools, CBT therapists are able to spot trends and quickly react by adapting their therapy to suit your immediate needs. This regular monitoring also allows the therapist and the client both to examine how counseling is going and make decisions about how to proceed.
CBT Characteristic #4: Gives You Helpful Counseling Homework
Homework is a hallmark of CBT therapists – and of any good therapists, in my opinion. The research is clear that if you do homework as part of your therapy, you will get better faster and make more progress during your time in counseling. Homework is a requirement of cognitive behavioral therapy since so much of the counseling is about learning and practicing new skills. Imagine how much more you can do in the week outside of the 50 minutes that you spend with your therapist, and when that work is guided by your experienced therapist, the results are all the more powerful. This being said, not all homework is created equal and an experienced CBT therapist will be able to explain why certain homework is beneficial or needed.
CBT Characteristic #5: Learning and Developing New Therapy Skills
Another unique aspect of cognitive behavioral therapy is the skills you will learn to help yourself. Much of the power behind CBT therapy is that it’s self-help in nature. You probably have heard of the idea that it’s better to teach a person to fish for life then give them fish for a day. Well, CBT in most cases represents teaching one how to overcome their problems for life rather than giving a quick fix that only the “doctor” knows how to do. By using the strengths and the ability of the client, CBT therapists teach you how to be your own therapist. You will be guided and taught how to apply the proven methods and techniques of CBT without being overly dependent on your therapist.
CBT Characteristic #6: Has Received Cognitive Therapy Certification
One clear, but more recent, way to determine if your therapist has some solid CBT skills is to check whether he or she is certified by the Academy of Cognitive Therapy (www.academyofct.org). This is an organization that was created for just this purpose: to demonstrate clinical competency in cognitive therapy for clients seeking treatment. Becoming certified requires a great deal of training in CBT, letters of recommendation from colleagues, and an extensive description of how you use CBT in your practice, including an audio tape of an actual client session (don’t worry, permission must be given by the client).
Seeking therapy is a great way to improve your feelings of anxiety, depression, and stress, and knowing who to see makes it all the easier. If you’re looking for time-tested and effective treatment such as cognitive behavioral therapy, the list above can set you in the right direction and help you find a qualified therapist to improve your life.
Contact us to schedule an appointment or a free initial phone consultation by calling 650-461-9026.