Cognitive Behavioral Therapy (CBT) Cognitive behavioral therapy (CBT) is a psychotherapeutic approach that addresses dysfunctional emotions, maladaptive behaviors and cognitive processes and contents through a number of goal-oriented, explicit systematic procedures. The name refers to behavior therapy, cognitive therapy, and to therapy based upon a combination of basic behavioral and cognitive principles and research. Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioral therapy.This technique acknowledges that there may be behaviors that cannot be controlled through rational thought. CBT is “problem focused” (undertaken for specific problems) and “action oriented” (therapist tries to assist the client in selecting specific strategies to help address those problems). CBT is thought to be effective for the treatment of a variety of conditions, including mood, anxiety, personality, eating, substance abuse, tic, and psychotic disorders.Many CBT treatment programs for specific disorders have been evaluated for efficacy; the health-care trend of evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments. CBT was primarily developed through an integration of behavior therapy (the term “behavior modification” appears to have been first used by Edward Thorndike) with cognitive psychology research, first by Donald Meichenbaum and several other authors with the label of cognitive-behavior modification in the late 1970s.This tradition thereafter merged with earlier work of a few clinicians, labeled as Cognitive Therapy (CT), developed by Aaron Beck, and Rational Emotive Therapy (RET) developed by Albert Ellis. While rooted in rather different theories, these two traditions have been characterized by a constant reference to experimental research to test hypotheses, both at clinical and basic level. Common features of CBT procedures are the focus on the “here and now”, a directive or guidance role of the therapist, a structuring of the psychotherapy sessions and path, and on alleviating both symptoms and patients’ vulnerability.CBT TREATMENTS 1. Anxiety disorders CBT has been shown to be effective in the treatment of all anxiety disorders. A basic concept in some CBT treatments used in anxiety disorders is in vivo exposure, a term describing a technique where the patient is gradually exposed to the actual, feared stimulus. The treatment is based on the theory that the fear response has been classically conditioned, and that avoidance of it negatively reinforces and maintains the fear. This “two-factor” model is often credited to O.Hobart Mowrer. Through exposure to the stimulus, this harmful conditioning can be “unlearned” (referred to as extinction and habituation). 2. Schizophrenia ; psychosis Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. The American Psychiatric Association Practice Guidelines (April 2000) indicated that, among psychotherapeutic approaches, cognitive behavioral therapy and interpersonal psychotherapy had the best-documented efficacy for treatment of major depressive disorder.In long-term psychoses, CBT is used to complement medication and is adapted to meet individual needs. Interventions particularly related to these conditions include exploring reality testing, changing delusions and hallucinations, examining factors which precipitate relapse, and managing relapses. Several meta-analyses have shown CBT to be effective in schizophrenia, and the American Psychiatric Association includes CBT in its schizophrenia guideline as an evidence-based treatment. There is also some (limited) evidence of effectiveness for CBT in bipolar disorder and severe depression.