Cognitive Counseling Techniques

Cognitive psychology is based on the idea that thoughts influence emotions. Distorted thoughts cause anxiety, depression and other forms of psychological distress. Cognitive counselors teach clients how to identify distortions in their thought processes and how to replace distorted thoughts with more rational, accurate thoughts. Clients are expected to take an active role in their treatment, including completing homework assignments to practice the techniques they have learned.

Identifying Cognitive Distortions

• Cognitive therapists teach clients how to identify distortions in their own thoughts. This usually involves the client's using a worksheet and writing down a brief description of an upsetting event, how he felt at the time, and what, specifically, he was thinking. He then compares his thoughts to a list of cognitive distortions. An example of a common cognitive distortion is what psychologist David Burns calls "mind reading," where you assume that other people are thinking badly of you. For example, if a friend doesn't answer an email, you may jump to the conclusion that your friend must be mad at you.

Disputing Cognitive Distortions

• Cognitive counselors help clients "talk back" to their distorted thoughts by looking for evidence and by becoming more objective. For example, if you were sure that a friend was mad at you because she didn't answer your email, the counselor will encourage you to consider whether other possibilities might exist, such as your friend not having received the mail. The idea is that you will feel better if you don't automatically assume the worst. Clients practice identifying distortions during counseling sessions and at home between sessions.

Behavioral Changes

• Many cognitive counselors combine cognitive and behavioral therapy approaches. In fact, cognitive therapy is often called "cognitive-behavioral" therapy (CBT). Behavioral approaches work especially well with anxiety and phobias. People with phobias may be able to get over their fears by gradually exposing themselves to the feared stimulus, starting with situations that cause the least amount of anxiety and working up to scarier situations. For example, someone who is afraid of heights would go somewhere that caused a slight degree of anxiety, such as a second-floor balcony. Once that fear is faced and extinguished, the next step might be to go up to a higher floor, and eventually to a place, such as the edge of a cliff, that caused the most anxiety.

Mindfulness

• Some counselors combine mindfulness training with cognitive therapy. Mindfulness techniques are based on Buddhist meditation and awareness techniques. Mindfulness training works well with cognitive therapy because both involve learning how to look at your own thoughts and emotions as if you were an outside observer. Some counselors also borrow the notion of compassion from Buddhism and teach clients how to become more compassionate to themselves. Clients learn to be aware of the way harsh self-criticism is counterproductive. They may be encouraged to treat themselves with the same respect they would show a friend.