COGNITIVE BEHAVIORAL THERAPY (CBT)

It is a psychological therapy that involves understanding how one thinks about oneself, about
other people and the world around him, and how what one does affects their thoughts and
feelings. CBT can help you change the way you think ("cognitive") and how
acts ("behavioral"). These changes can help you feel better. Unlike some
Unlike other "talk therapies", CBT focuses on problems and difficulties of the "here and now".
"now". Instead of focusing on the causes of their distress or symptoms in the past, seek
ways to improve your mood right now.

IT HAS BEEN PROVEN TO BE USEFUL IN TREATING:

• Anxiety and depression.

• Panic, social phobia, agoraphobia, and other phobias.

• Bulimia.

• Obsessive-compulsive disorder.

• Post-traumatic stress disorder.

• Schizophrenia.

• Anger, pain, and fatigue.

HOW DOES IT WORK?

CBT can help you understand complex problems by breaking them down into smaller parts.
small. This helps you see how these parts are connected to each other and how they affect you.
These parts can be a situation, a problem, a fact, or a difficult situation. From it
Thoughts, emotions, physical sensations, and behaviors can be derived. Each one
these areas can affect others as thoughts about a problem can
affect how one feels physically and emotionally.

This is a simplified way to understand what is happening:

This 'vicious circle' can make one feel bad; it can even create new situations.
that make them feel worse and start believing unrealistic (and even unpleasant) things about themselves
same. This happens because when we are distressed, we are more likely to reach
conclusions and to interpret things in an extreme and negative way.

A PRACTICAL EXAMPLE

There are different ways to react to most situations, depending on

how one thinks about them:
Have you had a bad day, are you fed up, and decide to go out of
SITUATION: shopping. When he is walking down the street, an acquaintance, apparently, tells him

ignore.

Harmful Favorable

Thoughts I've been ignored - he doesn't care You seem self-absorbed

I make a good impression. questions if there will be any
problem.

Feelings Sadness and rejection Concern for the other

person

Physical reactions Stomach cramps, None - feels good.

little energy, nausea.

Behaviors He/She goes home and avoids that one. He greets you to ensure that
person that's fine.

The same situation, depending on how one thinks about it, has led to two outcomes.
very different, that is to say, their way of thinking has affected how they have felt and what they have
done.

In the examples in the left column, you have reached a conclusion without much
tests for this; and this matters, because it has led him to a series of uncomfortable feelings
there is a harmful behavior.

If he goes home feeling sad, he will probably think about what has happened and feel
worse. If you greet the other person, it is very likely that in the end you will feel better about yourself.
If you don't do it, you won't have the opportunity to clarify any misunderstandings about what
they think of you and probably feel worse.

CBT can help you break this vicious cycle of thoughts, feelings and
negative behaviors. When the parts of the sequence are seen clearly, it can
change them and thus change how one feels. CBT aims to reach a point
where you can "do it yourself" and create your own ways to face these.
problems.
 THE EVALUATION OF THE 'FIVE ZONES'

This is another way to connect the five areas mentioned above. It is based on
our relationships with other people and helps us see how they can make us
let us feel better or worse. Other issues such as debts, work, and difficulties in the
Housing is also important. If an area improves, it is likely that they will improve as well.
other parts of his life.

WHAT DOES CBT INVOLVE?

The sessions

CBT can be done individually or in a group. It can also be done with a book on
self-help or a computer program.
If you receive individual therapy:

• Se reunirá con un terapeuta entre 5 y 20 sesiones, semanales o quincenales.

Each session will last between 30 and 60 minutes.

• In the first 2-4 sessions, the therapist will study whether this type of treatment
It is appropriate for you, and you will see if you feel comfortable with the therapy.

• The therapist will also ask you questions about your past. Although CBT is
focus on the here and now, sometimes it may be necessary to talk about it
past to understand how it is affecting him now.

• You decide what you want to address in the short, medium, and long term.

• Por lo general, usted y el terapeuta comenzarán cada sesión llegando a un

agreement on what to discuss that day.

The therapy

With the therapist, you will break down each problem into parts, like in the previous example. To facilitate
during this process, your therapist may ask you to keep a journal. This will help you identify your
patterns of thoughts, emotions, bodily sensations, and behaviors.

Together they will study their thoughts, feelings, and behaviors to determine if not
are they realistic or are they detrimental, how they affect each other and how they affect you.

The therapist will then help him determine how to change thoughts and
harmful behaviors.

It is easy to talk about doing something, the difficult part is making it a reality. So, after having
identified what can change, your therapist will give you 'homework' to practice these
changes in your daily life. Depending on the situation, you could start to:

• Question a self-critical thought that makes you feel sad and

replace it with another positive (and more realistic) that you have learned in the
TCC.

• Recognize that you are about to do something that will make you feel worse and, in your
place, do something more positive.

In each session, they discuss how things have been going since the last one. Your therapist can help you with
Suggestions if some of the tasks seem too hard or if on the contrary they help you.
You will not be asked to do things you do not want to do; you decide the pace of the treatment and it
what you are going to try or not. The best thing about CBT is that you can continue practicing and developing
the techniques that he has learned, even when the sessions have ended. This makes less
likely that your symptoms or problems will return.
 HOW EFFECTIVE IS CBT?

• It is one of the most effective treatments for disorders where anxiety or the
depression is the main problem.

• It is the most effective form of psychological treatment for mild and moderate cases of
depression.

• It is as effective as antidepressants for some types of depression.

WHAT OTHER TREATMENTS EXIST AND HOW ARE THEY IN COMPARISON?

CBT is used for many disorders, but mainly as treatment for disorders
anxious and/or depressed. It is important to take into account some of the following aspects:

• CBT is not for everyone and another type of therapy may work better for
you.

• It can be slightly more effective than antidepressants in the treatment of

anxiety.

• For severe depression, CBT should be used as an adjunct to medication.

antidepressants. When you are very depressed, it can be difficult to change the
the way one thinks until the antidepressants have started to work
one feels better.

• Tranquilizers should not be used as long-term treatment for anxiety.

CBT is better than tranquilizers in the long term.

POSSIBLE PROBLEMS WITH CBT

If you are feeling depressed and having difficulty concentrating, it may be difficult at first.
get the hang of CBT - or, in fact, any psychotherapy - This can make you
feels disappointed or overwhelmed. A good therapist will be the one who establishes a good rhythm.
to its sessions in order to tackle the task we have at hand. Sometimes it can
resultar difícil hablar de sentimientos de depresión, ansiedad, vergüenza o enfado.

HOW LONG WILL THE TREATMENT LAST?

It can last between 6 weeks and 6 months, depending on the type of situation being addressed.
front and how the evolution of each one. The availability of the TCC varies among the different
regions and there may be a waiting list to receive treatment.
 WHAT HAPPENS IF THE SYMPTOMS RETURN?

There is always the risk that anxiety or depression may return. If they do, the techniques that
having learned with CBT, they should make it easier for you to face those
symptoms in order to control them. Therefore, it is important to maintain the practice of these
techniques, even after you feel better. There are some studies that suggest that
CBT may be better than antidepressants in the prevention of recurrence of the
depression. If necessary, you can receive "update sessions."

SO, WHAT IMPACT WILL CBT HAVE ON MY LIFE?

Depression and anxiety are unpleasant. They can seriously affect your ability to
work and enjoy life, being truly debilitating and limiting. CBT can
help control the symptoms. It is unlikely to have a negative effect on your life,
apart from the time he has to invest in it.

WHAT WILL HAPPEN IF I DO NOT RECEIVE TCC?

If you are not convinced about starting CBT at this time, you can talk about different.
alternatives with your doctor such as buying a self-help book or CD to see if it helps you.
It convinces to wait and see if it improves.

TCC FOR YOUNG PEOPLE

Its aim is to help you understand how your problems started and what they are.
maintains. CBT helps you relate the way you think (your thoughts,
beliefs and assumptions), with how it feels (its emotions) and what it does (its
behavior.

What problems can CBT help with?

Cognitive-Behavioral Therapy (CBT) has proven to be effective in helping young people with
a wide range of problems, including low self-esteem, anxiety symptoms and
depressive, obsessive-compulsive disorder, and post-traumatic stress disorder.

There is increasing use and evidence that CBT works well for other issues such as
dream, fatigue and chronic pain.
 HOW CAN I ACCESS THE CBT?

You can access CBT through trained CBT therapists who usually work in
specialized teams such as CAMHS (specialized mental health services for children and
adolescents.
Some may work independently, in schools or organizations of
volunteering. For older children, there may be online TCC available for
specific situations such as anxiety/low mood.

The self-help CBT manual or online CBT can be useful when one is well.
motivated and has problems that may "not be too serious".

WHAT CAUSES THESE CONCERNS AND ANXIETIES?

Our thoughts and emotions often cause us problems.
For example: Situation: Your friend doesn't call you.

Useless thoughts Useful thoughts

I didn't like them. Something is going wrong

Feelings It feels
You feel sad Worried about your friend

Physicist Physical
You feel unwell Do you feel well?

Action Action
You are not going to your friend's party Llamas: they have lost the mobile

The key point is that sometimes our thoughts are not helpful and sometimes they are not accurate.
This pattern of thinking can cause many problems.

The goal of CBT is to help you learn a more balanced way of thinking and to change
any pattern of thought and behavior that is not useful.

HOW DOES CBT WORK?

CBT helps you understand the relationship between your thoughts, emotions, and
behavior. This is important because, sometimes, when you talk about difficult things, you can
feel worse.
CBT will help you discover skills such as:

• Better understand your individual problem, as you are the expert in your problem.

• Identify the links between your thoughts, emotions, and behavior.

• Reaching an individualized formulation of what sustains the problem.

• Try different ways to solve the problem.

CBT does not consist of thinking more positively, as thoughts are not facts, but rather
that helps improve how one feels about what one thinks and does. By being able to
approaching situations in a more balanced way is expected to be more effective in the
resolution of their problems and feels that they have more control over their life.

IF I AGREE TO PARTICIPATE IN THE TCC, WHAT WILL I HAVE TO DO?

If you agree that CBT is the appropriate treatment for you, you will need to meet with your therapist.
regularly. To help your therapist understand your difficulties, you will be asked to
complete some questionnaires or worksheets. These questionnaires may be repeated as to
length of the treatment. Your progress in the treatment will be monitored and discussed with you.
regular form, since their opinions are important.

The therapist will help you understand your problems and to discover ways to cope with them.
In addition, they will be encouraged to put them into practice outside of therapy (for example, in the
school or at home). This means that tasks or homework will be assigned at the end of the meeting. It is
It is possible for him to be given worksheets to help him remember what he has to do.

Why do I have to do homework?

Unfortunately, you cannot learn to ride a bike by reading a book. Any

Any skill you want to learn requires practice. CBT will help you learn to

• how to overcome negative thoughts (I'm not likable)

• absurd behaviors (not going to the party),

• difficult emotions (feeling sad).

It is important to practice the skills of CBT that you are taught.

• to be sure that you understand them;

• to check that you can use them when you need to (for example, when you ...
he/she feels upset about something

• so that the problems you may have with the use of these skills can be
worked on your therapy.
 INFORMATION FOR PARENTS

It is very important for parents to actively participate in their child's therapy. Not always
it is easy to learn new skills, so they will need a lot of support, not just from
therapist, but from the family/caregivers

What we ask is for parents to be part of the therapy as 'co-therapists' with a

shared understanding of the problem, a clear understanding and belief in the therapy,
shared objectives, helping parents understand the formulation and maintenance of
problem, but not to blame, but to be part of the treatment experiments, to supervise the
progress, understanding the confidentiality and privacy of sessions.

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