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Cognitive Behavioral Therapy vs Old-School Talk Therapy

Cognitive behavioral therapy is structured.

CBT Therapy sessions are often planned out. There’s a tentative agenda for each session, with a focus on specific skills and information for you to learn and practice. Cognitive behavioral therapy is a very knowledge and skill-based type of therapy. It follows a predictable 10 step process, so you can understand the intention behind what you’re doing, in and out of sessions, and how it will help you to feel better.

This is a bit different from traditional “talk therapy” which varies more from week to week, often discussing whatever particular trouble is "front and center" on your mind, and focusing more on understanding why you're feeling the way you're feeling, with less emphasis on what to do with those feelings and situations. This is an ideal approach for someone who is concerned that therapy may be a “waste of time just talking” as it forces both therapist and client to really hone in on the problem and begin chipping away at it in a systematic fashion.

CBT is evidence-based.

Just like other types of therapy, it has been subjected to a great deal of research to determine whether or not it’s actually effective. Researchers want to answer questions like: "If you do CBT, are you more likely to get better than if you do nothing? How much better? How long does feeling better last?" Unlike many other forms of therapy, however, because CBT is structured, it's much easier for researchers to see if it’s “working.” For example, in CBT we often rate the severity of symptoms on a scale of 0-100, also known as a SUDS scale. You might say, "My anxiety was at a 60 the last time I drove to the store, then when I did it today it was only a 40." In this way, we can see if symptoms are improving.

CBT therapy has more evidence-based support to date than any other form of talk therapy – particularly in the treatment of depression, anxiety, and other common conditions. Studies have also shown that cbt delivered online via video sessions appears to be just as effective.

Treatment is time limited.

CBT does not typically go on for years. In fact, most clients find they start to notice a change in their mood after only a few weeks. This is possible partly because of the approach and partly because of the emphasis on practicing skills outside of session (where you spend most of your time). Even in cbt, we still find some clients who prefer longer-term therapy, usually because they have multiple concerns they wish to work on or they are looking to work on “deeper rooted issues” such as unresolved pain from childhood.

CBT is goal & problem oriented.

In cognitive behavior therapy, you’ll set a list of goals you would like to accomplish or problems you would like to resolve while in treatment. CBT therapy sessions are strategically focused on dealing with these issues and much less about “let’s go wherever the hour takes us.” If urgent issues come up that need to be addressed, you might take a short break from your regular path, but then return to your goals and re-focus.

Common goals that bring clients in to therapy include things like:

  • decreasing worry or depressed mood

  • decreasing the intensity or frequency of physical symptoms

  • improving assertive communication

  • challenging unhelpful patterns such as perfectionism, procrastination, or avoidance

CBT is focused on the present, with a nod to the past.

CBT focuses on what is going on in your life now and how to make changes to help you feel better in the present. If you have a history of trauma that is affecting your ability to use the skills of cbt, then it's worth spending some time to take a look at those experiences for a bit to see how they may have affected you and how they may be coming up for you in the present. For clients with a history of trauma, we often incorporate elements of Emotion Focused Therapy and Mindfulness Training to assist in working through these areas where strict CBT can be limited.

CBT Therapy is cognitive.

As its name suggests, treatment focuses on your thoughts (your beliefs and your perceptions) and how these affect your mood. Through CBT you can learn to track your thoughts and challenge them so that you can begin to change the way you think, the way you see things, and thus the way you feel about them. Over time, CBT has also been shown to change your underlying beliefs that may be contributing to your troubles.

Some clients have difficulty identifying their automatic thoughts at first or difficulty catching them “in the moment” as they’re happening. For these clients, we’ve found mindfulness techniques to be particularly helpful in learning to identify their thoughts. Many of our clients report that the work they’ve done on changing their perspectives was key!

CBT Therapy is behavioral.

CBT focuses equally on your behaviors – your actions and reactions, which often contribute to your mood as well. You get a chance to practice changing the way you act and react in various situations, which can have profound effects on the way you feel.

For example, anxiety often gives us the urge to avoid. With CBT therapy, we work on identifying what tactics you might be using to avoid certain things. We explore how avoiding certain situations may be contributing to feeling even more anxious next time. Then we come up with a plan to take action, facing the situation one step at a time, until your anxiety reduces.

Common behavioral techniques we teach include:

  • Diaphragmatic breathing

  • Progressive muscle relaxation

  • Facing triggering situations to challenge feared outcomes

  • Assertive communication

  • Mindfulness

The ultimate goal of CBT is for you to become your own therapist!


We can help.

If you or someone you love is struggling with anxiety, depression, or the effects of trauma, please reach out. We offer CBT in Orlando and online throughout the state of Florida. Call today or send us your info and we’ll reach out for a free consultation to see if one of our CBT Therapists would be a good fit.

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