What Are the Dangers of CBT?

Cognitive-Behavioral Therapy is used by many mental health professionals, such as psychologists and clinical social workers, to help people overcome destructive or negative patterns of thought or behavior. The therapist uses a combination of talk therapy, mental imagery, relaxation techniques and journal-keeping to help patients overcome specific problems. CBT has been scientifically proven to be safe and usually effective, if the patient is consistent in applying what he learns. The possible danger of CBT is its exclusive use in cases where other types of therapy -- such as medication or deeper psychoanalysis -- would be more effective, either in conjunction with CBT or in its stead.

What is Cognitive Behavioral Therapy?

• Cognitive Behavioral Therapy (CBT) is an umbrella term for a variety of treatments for psychological disorders such as depression or anxiety. It is usually completed in under 20 sessions and focuses on identifying how the client's thoughts, emotions and behavior are interconnected. Through talk therapy, guided imagery, relaxation techniques and journal-keeping, the client learns to interrupt destructive cycles -- for example, by meditating when anxious rather than smoking, or eating before getting home to avoid snapping at family members out of hunger, or reframing certain events so they lead to positive thoughts rather than negative ones.

  Both cognitive and behavioral therapies are goal-oriented and seek to empower the client by showing her that she has choices about how to feel, think, and act. Cognitive therapies focus on helping clients distinguish between thoughts and feelings and become more self-aware of how they interpret events around them. Behavior therapies focus on helping people change how they react to emotional stimuli; for example, helping someone who is anxious about taking elevators to overcome the anxiety and take the elevator anyway, rather than take the stairs all the time.

Advantages of CBT

• When it comes to depression and other mental disorders, CBT has been proven in scientific studies to be a successful treatment most of the time -- even as successful as medication. It has the benefits of being short-term, with flexibility; the therapist can employ not only talk therapy in office meetings but also "homework" such as self-help books to read, journals to write and interactive computer programs to use.

  Since CBT is goal-oriented, you can measure for yourself whether it has been successful. For example, if your goal is to stop yelling at your kids, you can see after a few months whether the therapy has helped you stay more calm. It also teaches skills, such as relaxation techniques, that you can apply to other areas of your life.

Disadvantage: Structure

• Since CBT is designed to tackle a specific problem in a short amount of time, if your mental health needs are complex it cannot, by itself, address all your problems. If you have learning disabilities or a disorder that includes a lack of emotional awareness, CBT might be frustrating for you. Finally, CBT requires lots of participation on your part; you won't get much out of it unless you do the "homework" assigned by your therapist.

Disadvantage: Focus

• CBT does not address systemic problems within groups of people. It can help you, for example, change the way you respond to criticism from your mother, but it does not replace the type of family therapy that might stop the criticism itself. Also, CBT helps you identify your thought patterns and interrupt them, but it does not seek to help you understand where those patterns originate. For example, if the goal is to help you overcome your fear of flying, CBT can help you get into the air, but it won't necessarily lead to information about what happened in your childhood that caused your fear.

Disadvantage: Need for Consistency

• Since CBT helps you manage problems, such as depression or anxiety, but does not address the problems' underlying causes, CBT cannot prevent the problem from recurring, though studies show that in many cases it does act as a preventive measure. With practice, you can use what you have learned in CBT to manage the problem when it returns, or to decrease its effects, but by itself CBT does not always make mental disorders "go away," it only helps you manage them so you can function better.

Danger: Inadequately Trained Therapist

• Before embarking on CBT, it is essential that you make sure your therapist is reputable and trained in CBT techniques. Get referrals from your doctor and find out what certifications your therapist has. Don't stay with a therapist who does not take your cultural background into consideration, or who isn't disciplined -- for example, if he does not check your "homework" or does not remember the details of your case from week to week.