Cognitive Behavioral Therapy Exercises

In this article, we will answer the important question, “What are the exercises used in Cognitive Behavioral Therapy?”, and also examine the characteristics of this therapy.

What are the exercises used in Cognitive Behavioral Therapy?

Following are some of the exercises used in CBT

Cognitive Restructuring

Roleplay

Relaxation techniques

Mindfulness

Reframing

Exposure technique

Guided Imagery

Thought recording. 

Cognitive Behavioral Therapy 

Cognitive-behavioral therapy (CBT), is a type of psychotherapy.  Throughout the past few decades, it has emerged as one of the most effective and sought-after psychotherapies. Contrary to the other therapies CBT has a shorter duration of treatment which can last anywhere between a few weeks to months for the outcome to appear. 

Though some theories predominantly focus on the past, which is indeed important, CBT chooses to focus on making the person capable of solving problems that they are facing at present. 

Types of Cognitive Behavioral Therapy

CBT consists of a lot of techniques, approaches, and strategies that control, and modify thoughts, emotions, and behaviors. CBT is a vast treatment with a combination of behavioral and cognitive approaches and principles. Over time many different approaches developed based on the foundation and formulating ideas of  Cognitive-behavioral Therapy. They are as follows:

• Cognitive therapy

It focuses on identifying and changing unreasonable, baseless, or distorted thinking patterns and also the emotional responses, and behaviors that arise due to them. Cognitive memory is a precursor to CBT.

• Dialectical behavior therapy (DBT)

In this therapy, emotional regulation and mindfulness are utilized to modify thoughts and behaviors.

• Multimodal therapy 

This therapy proposes that seven modalities that are distinct yet interconnected can be used to deal with mental health issues. The seven modalities are behavior, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.

• Rational emotive behavior therapy (REBT) 

In this approach, irrational beliefs are assessed to challenge them and substituted with rational thoughts to change the thought and behavior patterns 

Important Steps of Cognitive Behavioral Therapy 

• Understanding and identifying negative events or situations in life

The events occurring in our lives impact our thoughts and feelings in the present and the future. To avoid or overcome any issues, we first need to identify the events that caused the changes in our thought processes. We need to identify such events that left a lasting impact on us. These events could be an elocution competition where you were required to speak in front of a huge crowd. Perhaps your performance was not up to the mark, and it left an impression on your mind. Try to recollect the thoughts and emotions that were revolving in your mind during that event. Relive that event now and attempt to understand how that makes you feel even today.

• Identifying Automatic Negative Thoughts.

The most crucial step is to identify NAT (Negative Automatic Thoughts), which hinder our development by creating mental distress in our minds. They are thoughts such as, “I am hopeless,” “I cannot do it,” “I am unlovable,” etc. These thoughts pop automatically in our minds (hence the name negative automatic thoughts). We are often accosted by such thoughts when we are going through a distressing situation or an event. 

To identify these thoughts, we need to think back to a situation that left us feeling down. It could be anything, such as feeling socially anxious in large crowds. Try to recollect what were the emotions you were experiencing at that time. 

Also, try to pinpoint the thoughts that were associated with these negative emotions.

If the thoughts were for, eg., “I am worthless, and so one would like me” or “I am not good enough,” these thoughts can be identified as negative. 

• Challenging the Negative Thought Processes

Now comes the essential step of negating the negative thoughts and replacing them with positive ones. This could be done by rational analysis of those thoughts. If we have the thought, “I am not good enough,” then we should ask the question of “What makes us think that?” We should find evidence to support this unhelpful thought. Most of the time, we think of such thoughts without really thinking about the reasons behind them. But when we start to raise questions and reason, we realize that we have little evidence to support such thoughts.

Thus with three simple steps, cognitive behavioral therapy helps us navigate the unhelpful thinking processes.

Exercises in Cognitive Behavioral Therapy

Cognitive Restructuring

Cognitive restructuring has been a part of the diverse methods and techniques of Cognitive Behavioral Therapy. It proposes that changing or remodeling our thought process into a constructive and productive cognition can result in positive and ideal behavior. Often our negative thinking can result in bad moods or worrisome behavior. These bad moods can further exacerbate severe problems. 

Cognitive restructuring enables the person to remodel or reconfigure their thoughts in a way that disperses confusing thought processes and replaces them with stable, positive, and helpful thoughts and beliefs. By doing so, the individual is freed from the negative consequences occurring due to the dysfunctional thoughts and beliefs that prevent them from leading a stable and uncomplicated life.

To obtain cognitive restructuring following steps are followed. 

• Understanding your negative thought process 
• Evaluation of the maladaptive thoughts
• Negating the thoughts through rationalization
• Replacing them adaptive thought process

Mindfulness

Mindfulness is an approach that places importance on focusing on the present moment by being aware of one’s senses and thoughts. It also reinforces the importance of changing one’s attitude towards negative thoughts instead of changing those thoughts. For example, if a person is feeling angry because they think they are being ignored and isolated. In mindfulness training instead of thinking that perhaps what they are thinking might not be true and they are not being ignored the person might be encouraged to change their attitude towards the situation. The person would be encouraged to accept the situation for what it is and try to be unperturbed by that while deciding the best course of action based on the current circumstance.

Relaxation Exercises

Relaxation exercises have been proven to be very effective in dealing with episodes of anger. Breathing techniques and PMR help calm down the disturbing feelings and aid in alleviating the unpleasant symptoms caused by anger. The progressive muscle relaxation technique is a very helpful technique that helps in releasing the tension and stress accumulated in the body through systematic contraction and relaxation of the muscles. Thus, relaxation exercises work wonderfully to release pent-up frustration and tension in our bodies calmly and healthily.

Exposure therapy

Exposure therapy is utilized to confront fears and overcome them. This technique might be difficult at the beginning as the client is slowly exposed to the things or events and elicit fear and anxiety within them but it is done in a safe setting and the client’s well-being is ensured at all times. 

Through this technique, the client learns ways to cope with their situation and also helps them lead a life without anxiety.

The client is exposed to their fears slowly and the exposure is increased in small increments to ensure that the client does not suffer from any excessive distress. Over time due to continued and systematic exposure the client overcomes their fear.  

Guided Imagery

In this CBT technique, the therapist attempts to familiarize and understand your perspective to help you change unhelpful thoughts. The therapist would do this by asking specific questions, directed at changing your unhelpful viewpoint. 

The therapist might also employ evidence testing to help you understand the fallacy of your beliefs and thoughts 

This method helps us to change our perspective or to look at things from different points of view, making us realize that there are various ways to look at things and situations. Thus, guided discovery helps you in making informed decisions 

Roleplay

Roleplay is a very effective exercise that aims to help clients identify negative automatic thoughts and to rehearse appropriate responses to those thoughts. It can also assist in acquiring new social skills such as assertiveness that can help them conquer difficult social situations. In the roleplay exercise, the client could be told to enact an imaginary scenario that they are afraid to deal with in real life. During the enactment, they can realize their trigger responses and also their tolerance towards their fears. It also works as a practice session for the client and this helps them in dealing with the situation if it ever occurred in real life. 

Reframing

Reframing helps in breaking the negative cycle of dysfunctional thoughts by replacing them with functional thoughts. This helps in eliminating the negative influence of those thoughts on a person’s actions and emotions. It is quite is easy to get carried away in negative thinking patterns but through reframing the negative thoughts are replaced with positive thoughts as soon as they occur thereby preventing a person from forming a negative thought pattern. 

Thought records

Thought recording is a great method of getting acquainted with one’s thoughts and ideas.

Writing is a time-honored way of getting in touch with your thoughts. It also helps us keep track of our emotions to trigger events and analyze them unbiased at a later time when we aren’t heavily influenced by our feelings or emotions. Thought recording is an exercise that needs to be maintained regularly for it to be effective 

Conclusion 

Thus, this article helped us review different types of exercises used in Cognitive Behavioral Therapy to treat or deal with various mental health issues or disorders. 

Frequently asked Questions

How can I do CBT on myself?

CBT can be conducted upon self requires extreme patience and time to master. A person can try a few of the techniques in CBT such as confronting negative thoughts with evidence, relaxation techniques, and various other types of activities to ground themselves in the present and reconfigure their thought process. 

What are the problems with CBT?

Cognitive Behavioral Therapy is a systematic and structured therapeutic process and hence requires employing complex thought processes and techniques. This might not be suitable for people who have complex mental health needs or learning or intellectual disabilities. Also as CBT insists on confronting our fears and anxieties to resolve them it can be emotionally daunting during the initial stages.

How is CBT different from other therapies?

Cbt is vastly different from some of the other psychotherapies. It is because CBT focuses and works on resolving the present conditions and problems arising due to them. According to CBT the way we perceive an event and interpret it determines the outcome and direction of the consequences arising out of it. 

Why is the concept of automatic thoughts so important in CBT?

In most instances, automatic thoughts play the largest role in determining or influencing our feelings instead of the situation itself. So the automatic thoughts that pop into our minds due to an event in a certain way maneuver our behavior based on those dealings. Hence CBT emphasizes identifying, analyzing and, evaluating these thoughts before they can negatively influence our behavior. 

Does CBT work for children?

CBT can be adapted to suit the needs of the child and work with them to help them develop coping skills. 

References

15 core CBT techniques you can use right now. Mark Tyrrell’s Therapy Skills. (2019, July 11). Retrieved January 29, 2022, from https://www.unk.com/blog/15-core-cbt-techniques-you-can-use-right-now/

Cognitive behavioral therapy exercises Los Angeles: CBT interventions. Cognitive Behavioral Therapy Los Angeles. (n.d.). Retrieved January 29, 2022, from https://cogbtherapy.com/cognitive-behavioral-therapy-exercises

Pietrangelo, A. (2019, December 12). CBT techniques: Tools for Cognitive Behavioral therapy. Healthline. Retrieved January 29, 2022, from https://www.healthline.com/health/cbt-techniques