CBT: The Best Therapy For Millennials

Cognitive Behavioral Therapy (CBT) is short-term psychotherapy for a wide range of psychological problems. The focus of therapy is on how you are thinking, behaving, and acting in the present, rather than examining your past experiences. CBT operates on the idea that our thoughts, feelings, and behaviors are all connected and can be pinpointed and modified. 

Aaron Beck was an American psychiatrist regarded as the father of cognitive behavioral therapy, who was a professor in the department of psychiatry at the University of Pennsylvania. 

This model hypothesizes that a person’s emotions and behaviors are affected by their perceptions of events. Beck proposed, “It is not a situation in and of itself that determines what people feel, but rather the way in which they construe a situation” (Beck, 1964). 

 Numerous studies have demonstrated that CBT is as effective as medication for depression, anxiety, and obsessive behaviors such as OCD and other fears. A 2012 meta-analysis published in the Journal of Cognitive Therapy and Research identified 269 studies that supported the use of CBT.

After reviewing 11 review studies comparing improvement rates between CBT and other therapy treatments, they found that CBT showed higher response rates than the comparison treatments in 7 of the 11 reviews (more than 60%). 

Negative Thoughts and CBT

Cognitive Behavioral Therapy can help you learn to recognize negative thoughts that you might be struggling with, and the underlying belief system that might be driving those thoughts. CBT teaches you how to cope with these thoughts, feelings, and behaviors. Outside of therapy, you practice techniques that will build your confidence to restructure and challenge them. 

Who Can CBT Help?

CBT is helpful for adults and adolescents who struggle with various disorders including:

• Depression/Mood disorders
• Anxiety Disorders
• Obsessive-Compulsive Disorder
• Stress
• Substance Use Disorders
• Eating Disorders
• Medical Disorders/ Chronic Pain 
• Stress
• Personality Disorders
• Major Life Transitions
• Post-Traumatic Stress Disorders
• Low self-esteem
• Grief and loss 

The Role Of A CBT Therapist

CBT therapists discuss “here and now” experiences and aim to reduce negative, unwanted symptoms a person is experiencing. The therapist and client work together to pinpoint what the client feels are their main problems. Then, the client and therapist can work on effective coping strategies.

You and your therapist will work together to develop a therapy plan. This might include how often you need to come; the relevance of medication; your diagnosis; your goals; obtaining skills tailored to your problems; needed changes in the way you think, behave, and communicate; and so on.

 An important part of CBT is helping clients figure out what is most important to them in life. This requires helping them move toward achieving their goals. Goals should be “SMART,” specific, measurable, achievable, realistic, and time-limited. Read more about SMART goals here.

For example, a goal for a client with a generalized anxiety disorder may be to reduce the time they spend chronically worrying. For example, “I will work to reduce my worry thoughts with relaxation skills I learn, from 8 hours per day to 1 hour per day by the end of 6 weeks of therapy.” This goal is specific and there is a set timetable.

A therapist with CBT training will outline the key cognitive behavioral therapy concepts and techniques. They will have you establish goals based on what is important to you and even help you figure out what that is if you cannot identify this yourself.

Depending on the severity of your symptoms, it is important to establish a trustworthy experience with a therapist (which takes time) and to experience symptom relief through collaborative work between you and your therapist. 

What Does This Collaborative Relationship Look Like? 

Not only does the client have to be a key participant, but the therapist will develop a treatment plan along with the client that they’ve agreed upon and will carry out.

Your therapist will also hold you accountable for following through with assignments and helping you process what went well or didn’t in your practice and what you can do to achieve better results.

In my opinion, being a behavioral therapist myself, CBT is not meant to be life-long therapy. CBT aims toward reducing symptoms that brought the client into therapy in the first place. Ideally, a client will have new skills and ways of coping that help them maintain a healthy existence. 

The most important thing to understand is that cognitive-behavioral therapists believe it is important to have a good, trusting relationship. However, the work the client does, especially outside of therapy in their everyday life, is what will ultimately help them become a person with a healthier thought pattern.

Also, how the client acts and behaves is as essential as their thought pattern because one (thinking and behaving) play off of the other.

The Ultimate Goal of CBT

The ultimate goal of CBT is to replace negative thoughts and actions with productive behaviors that make the individual feel they have the tools to challenge any difficult moment. 

When clients understand the emotions and beliefs connected to the source of their discomfort, they are better able to reframe their negative thoughts by practicing positive self-talk. Individuals assess how they feel in real-world situations that trigger unwanted thoughts and emotions and create ways to respond productively. 

Some other forms of therapy are unstructured, but in cognitive-behavioral therapy, you and your therapist will set an agenda for each meeting. Having a structure to the therapy means there is an identifiable beginning, middle, and end to therapy. 

 The agenda might include a review of your experience in the previous session, your homework (the work being done in between sessions), one or two current problems, checking in on your current mood, and homework for the next week. The goal is to solve problems, not just complain about them. This type of therapy is predictable and action-oriented. The therapist will consistently check in to see if you’re still getting what you need from therapy. 

Self-Help Homework 

What you learn in therapy is what you practice outside of therapy on your own. Research demonstrates that clients who carry out homework assignments see a reduction in problematic symptoms faster and feel an improvement in negative symptoms longer. 

Your self-help homework may include: 

keeping track of your moods, thoughts, and behaviors; scheduling activities; developing goals; challenging your negative thoughts; relaxation exercises such as deep breathing; changing the way you communicate with others; mindfulness/meditation; behavioral experiments; journaling, role-playing; use of social support, attention to self-care such as proper sleeping nutrition or improving your health. 

CBT encourages you to try out new skills and practice healthier ways of thinking and acting.

There are Typically 5 Steps To CBT

1. Identify situations or problems. These may be the result of a medical condition, a mental illness, or a thinking or behavioral disorder.
2. The aim is to build awareness of thoughts, emotions, and beliefs about those situations or conditions. In other words, to start “thinking about your thinking.”
3. Clients will identify their negative or distorted thinking. To do this, the CBT therapist may ask the client to pay close attention to their physical, emotional, and behavioral responses to a troubling event and record them so they can discuss this in the session.
4. Challenge negative or distorted thinking. The therapist will ask the client to question whether their thoughts are based on facts or a distortion of the situation.
5. *Change thoughts and beliefs. This is the most important part. The ultimate goal is to replace negative, distorted thoughts with positive, accurate ones that are more realistic.

A distorted view can cause someone to:

• Predict the future negatively and stop you from trying new things. “I could never get that job, I’m not going to apply.”
• Assume that you know what people are thinking about you without having actual evidence to support this. “That guy hates me.”
• Focus on the negatives and ignore the positives (even if there are more positives). “I made the Dean’s List, but I got a 75 on a test, who cares about the Dean’s List.”
• Label yourself and others because you don’t feel good about yourself, “I’m a loser,” “She is so full of herself.” 

Consider this example of how CBT may look for someone going to therapy for anxiety and depression. 

Jade believes she is “too timid” and “will never amount to anything” in all areas of her life. Over the years, she assumed life would be difficult and no good could come from any of her efforts personally and professionally to improve herself. This led her to give up on things quickly and believe that there was “no point in trying.” She believed “if I try to do something good for myself it won’t work out.” Jade’s therapist helped her identify these beliefs and look at the evidence for and against them.

She was able to learn that she constantly predicted a negative outcome. She began to challenge herself to see how her beliefs towards herself had little evidence to support her hurtful assumptions. Jade began working with her therapist to learn how to be more assertive and to trust her thoughts and actions, instead of second-guessing or criticizing herself. She began to consider the actual odds of a positive outcome based on her actual efforts and capability.

The therapist and client work together to challenge negative attitudes the client holds about themselves, the world, and the people around them. These beliefs may contribute to their feelings of helplessness, worry, and hopelessness.

Why Is CBT Great For Millennials?

Millennials are more likely to expect immediate results. This is because they have grown up in the internet era where we can get information and needs to be met faster than ever. Want your groceries in two hours? How about ordering a car online?! Anything is possible. It’s no surprise that millennials don’t intend to spend their time in years of therapy, looking to determine if their mother is the source of their problems.

Therefore, CBT is the perfect therapy for millennials because it is the ultimate DIY therapy. This type of therapy can be done with self-help books and/or internet programs. There is a caveat here.

I only recommend doing CBT on your own if you’ve received CBT with a therapist first. This way, you understand the process and the roadmap for how to accomplish getting relief from negative symptoms. CBT therapists will lead by example. They will teach you healthier ways to analyze problems and come up with healthy solutions.

Above all, CBT is time-limited, solution-focused and collaborative. If you want to get the most out of CBT, you need to do all the recommended assignments and “buy in” to the therapy. This will help you become a better version of yourself. 

Many people call millennials the burnout generation because of the many demands we have on our time. We often believe that we should always be working hard and moving up the ladder. This is a good work ethic, but only to a point. When you’re always working and don’t take time to rest, you can become burned out.

Have you questioned seeing a therapist, but assumed it would be too expensive? Do you worry it will take too long or they will force you to discuss things against your will?

What are your thoughts on CBT? Do you have experience with this type of therapy? How was your experience? 

Reference: Beck, J. S. (1964) Cognitive Therapy: Basics and Beyond, New York: Guildford Press