Evidence-Based Practice in Cognitive Behavioral Therapy

Instructor: Karin Gonzalez

Karin has taught middle and high school Health and has a master's degree in social work.

In this lesson, you will learn the definitions of cognitive behavioral therapy (CBT) and evidence-based practice (EBP). We'll look at the ways that CBT is classified as evidence-based using examples throughout the lesson.

What Is Cognitive Behavioral Therapy?

Mental health therapists are as diverse as the fish in the sea. For example, a practicing mental health therapist could be a licensed clinical social worker (LCSW), a licensed mental health therapist (LMHT), a licensed marriage and family therapist (LMFT), or a psychologist with a doctorate in counseling or clinical psychology (PhD). One only needs to pull up a list of the mental health therapists on their insurance panel to see the wide assortment of educational backgrounds and credentials.

In addition to that, therapists use different treatment approaches in their practice. There are a wide range of theoretical orientations in treating those with mental disorders, such as dialectical behavioral therapy, compassion-focused therapy and humanistic therapy. The list goes on!

Cognitive behavioral therapy (CBT) is one of these approaches, and it entails examining the relationship of emotions, behaviors and thoughts. The rationale behind CBT is that a person's negative thoughts produce negative emotions and behavior; if a client is able to see this link, they can start replacing negative ways of thinking with more positive ones.

For example, Lee-Lei, age 10, suffers from low self esteem.

  • Lee-Lei's thoughts: 'I am so ugly.' 'Nobody would ever want to be my friend.' 'I'm stupid.'
  • Lee-Lei's resulting emotions: shame, embarrassment, anxiety, sadness
  • Lee-Lei's resulting behaviors: avoidance of social interaction (for instance, isolating herself on the playground) leading to even more sadness and feelings of depression

A counselor who uses CBT as their treatment method would help Lee-Lei change her negative thoughts, which would in turn ameliorate her feelings of sadness and depression.

CBT is a popular and widespread treatment approach because it produces results! It is also evidence-based.

What Is Evidence-Based Practice?

Evidence-based practice (EBP) , simply stated, is practice that has been proven to actually work and efficiently produce desired results. In mental health, this means that the theoretical orientation in use has been tested in research experiments and studied in real world settings. This research, in turn, has produced evidence that it is successful in producing desired results and outcomes for clients with mental health disorders.

EBP therapy approaches are considered 'Best Practice' and are the recommended treatment methods by the American Psychiatric Association and the American Psychological Associations.

Reasons CBT Is an Evidence-Based Practice

CBT is evidence-based for a variety of reasons.

First of all, part of evidence-based therapy is gathering data and evidence throughout a client's treatment; this, in turn, can prove that the therapy is really working. Mental health therapists will monitor negative emotions and behavior by doing logs or charts to make sure that they are decreasing as the therapy progresses.

For example, two techniques in CBT are journaling and homework. A major reason that these are helpful techniques is that they can gather evidence of a client's behavior when they are not in session. If a client journals and logs their negative behavior over the time period they are in therapy, the therapist would have objective evidence that the client's negative behaviors were indeed decreasing, meaning that the treatment was working.

Second, CBT is goal-oriented in nature. When a therapist meets with a client at the beginning of CBT treatment, goals are established. Goals in CBT are very clear and objective; this means that they can be measured.

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