real time with jacob

What is CBT?

CBT, a Cognitive Behaviour Therapy. For me, it’s all about action. Well, of course, it’s more than that but to me, it’s making a plan and sticking to it. A plan of action not simply of feelings and thoughts. A plan to act and accomplish no matter how minuscule. A plan of action to change the way you think, how you may view things, and challenge your beliefs.

My apologies, but further notes about CBT will be a little textbook.

Traditional CBT treatment usually requires weekly 30- to 60-minute sessions over 12 to 20 weeks. The one I’m on is weekly sessions for 12 weeks. I have no exact time allowance per session as it is virtual and continuous, but it is a gradual process that helps me take incremental steps toward a behavior change.

The key principle behind CBT is that your thought patterns, beliefs, and attitudes affect your emotions, which, in turn, can affect your behaviors.

For instance, CBT highlights how negative thoughts can lead to negative feelings and actions. But, if you reframe your thoughts more positively, it can lead to more positive feelings and helpful behaviors.

CBT may include the following depending on your issue and your goals:

  • identifying specific problems or issues in your daily life
  • becoming aware of unproductive thought patterns and how they can impact your life
  • identifying negative thinking and reshaping it in a way that changes how you feel
  • learning new behaviors and putting them into practice

The nine common CBT techniques used are

1. Cognitive Restructuring or Reframing

This involves taking a hard look at negative thought patterns and identifying them. You may over-generalize, assume the worst will happen, or place far too much importance on minor details. Once aware of the negative patterns, the goal is to reframe those thoughts into positive and productive thoughts.

Ex.: “I blew the report because I’m totally useless” can become “That report wasn’t my best work, but I’m a valuable employee and I contribute in many ways.”

2. Guided Discovery

The therapist becomes acquainted with your viewpoint. He will ask questions designed to challenge your beliefs and broaden your thinking. He may ask to give evidence that supports your assumptions, as well as evidence that does not. In the process, you’ll learn to see things from other perspectives, especially ones that you may not have considered before.

3. Exposure Therapy

May be used to confront fears and phobias. It’s exposure to the things that provoke fear or anxiety in small increments, while the therapist guides how to cope with them at the moment. Eventually, exposure can make you feel less vulnerable and more confident in your coping abilities.

4. Journaling and Thought Records

Writing is a time-honoured way of getting in touch with your thoughts. The therapist may ask you to list negative thoughts that occurred to you between sessions, as well as positive thoughts you can choose instead. Another writing exercise is to keep track of the new thoughts and new behaviors you put into practice since the last session. Putting it in writing can help you see how far you’ve come.

5. Activity Scheduling and Behaviour Activation

If there’s an activity you tend to put off or avoid due to fear or anxiety, getting it on your calendar can help. Once the burden of decision is gone, you may be more likely to follow through. Activity schedules can help establish good habits and provide ample opportunity to put what you’ve learned into practice.

6. Behavioral Experiments

Behavioral experiments are typically used for anxiety disorders that involve catastrophic thinking. Before embarking on a task that normally makes you anxious, you’ll be asked to predict what will happen. Later, you’ll talk about whether the prediction came true. Over time, you may start to see that the predicted catastrophe is not very likely to happen. You’ll likely start with lower-anxiety tasks and build up from there.

7. Relaxation and Stress Reduction Techniques

Progressive relaxation techniques include deep breathing exercises, muscle relaxation, and imagery. You’ll learn practical skills to help lower stress and increase your sense of control. This can help deal with phobias, social anxieties, and other stressors.

8. Role Playing

Role-playing can help you work through different behaviors in potentially difficult situations. Playing out possible scenarios can lessen fear and can be used for:

  • improving problem-solving skills
  • gaining familiarity and confidence in certain situations
  • practicing social skills
  • assertiveness training
  • improving communication skills

9. Successive Approximation

Taking tasks that seem overwhelming and breaking them into smaller, more achievable steps. Each successive step builds upon the previous steps so you gain confidence as you go, bit by bit.


So, what happens during a CBT session? In my first session, I had to define my problem and establish a goal that I want to achieve during my CBT program. The most popular tool used, which I had to use, is the SMART goals. (Specific, Measurable, Achievable, Realistic, and Time-limited). Based on my situation and SMART goal, I was recommended individual therapy, but for others, it may be family or group therapy based on their problems and SMART goals. And of course homework. Homework is the fundamental part of the process including filling out worksheets, keeping a journal, or performing other tasks between sessions.

The risks. Therapy in any form is a very individual thing, but in the beginning, some people might find it stressful or uncomfortable to confront their problems. Some types of CBT, like exposure therapy, can increase stress and anxiety while you’re working your way through it. Therapy, as I mentioned before, doesn’t work overnight. It takes commitment and willingness to work on new techniques between sessions and after therapy has ended. It’s helpful to think of CBT as a lifestyle change that you intend to follow and improve upon throughout your life. It doesn’t have a snap end, it’s never-ending.

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