Cognitive Behavior Therapy in Clinical Practice


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Introduction of Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) was given by Dr. Aaron T. Beck in 1960 when he was a psychiatrist at the University of Pennsylvania. It is a psychotherapeutic approach that addresses dysfunctional maladaptive behaviour, emotions, contents and cognitive processes through several explicit, objective slanting systematic procedures. Dr. refined the models of the experience of emotion to Emotional Disorders. To test the psychological concepts of depression he carried out several experiments in which he identified several other ways to conceptualise depression.

This therapy focuses on the treatment of several kinds of behavioural, emotional and psychiatric problems. It is important to recognize unhelpful behaviour and thoughts and to enhance healthier habits and abilities. Many therapists deal with the anxiety and depression of patients with the use of blended CBT (Akin, 2010). This technique acknowledges that there may be several behaviours that cannot be controlled through rational thoughts. CBT is action action-oriented and problem-focused approach.

Aaron T. Beck found that depressed patients experienced a stream of negative thoughts that seemed to arise spontaneously. He identified these cognitions as automatic thoughts. Dr. Beck assists people in recognizing and evaluating these automatic thoughts and he found that this evaluation helps patients to think more practically (Wong, 2008). This therapy helps people to behave more functionally and results in long-lasting changes. Clients change their values and beliefs about other people and themselves. This model is used by therapists to change the thinking, emotional responses and behaviour of patients to overcome their difficulties.

It was effective in treating a wide variety of disorders in people (Welfel and Patterson, 2004). It has been found to be effective in many studies. This model has also been verified to be useful as an adjunctive treatment to medication for serious psychological disarray such as schizophrenia and bipolar disorder. This theory has been studied for families, children, adolescents and couples (Australian Association for Cognitive and Behaviour Therapy, n.d). It is proven to be effective in many types of mental disorders. Many current researchers have expanded the work of Dr. Beck and various forms of cognitive therapy have evolved.

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Use of Micro-Counseling skills

These counselling skills consider the core communication abilities of counselling and other fundamental expertise that can help the client to access their deepest thoughts or clarify their future dreams. The micro counselling skills includes the analysis of attending skills, basic questioning skills, confrontation, focusing, and reflection of meaning and influencing skills.

1. Attending behaviour: It is the behaviour that encourages patients to talk and show that the counsellor is interested in what's being said by her. In the entire process of the interview, it is important to report at the initial stages.

2. Questioning: Effective communication can help the counsellor in the interview and may assist in gaining more data about the client. It is a useful technique in the collection of information about the client in the stage of the interview. There are different techniques of questioning that can be used by counsellors to achieve the expected result. Closed questions are those that can be answered in minimum words such as ‘yes' or ‘no', whereas open questions are those responses that cannot be answered in little words.

3. Responding: It allows the counsellor to convince the client that they are being heard correctly. Throughout the interview, it is important to use accurate responses as it helps the counsellor to encourage and clarify the story of the client.

4. Client observation: Observation is utilized in the entire interview of counselling. It is used to recognize incongruities or discrepancies in the communication of counsellors or clients.

5. Confrontation: It is the skills which help the counsellor to enhance their self-awareness. This ability can be used to show up the discrepancies that patients have previously been unaware of. It is used by counsellors to observe mixed messages in the behaviour, feelings and words of clients. In the process of confrontation, three steps are involved i.e. recognition of mixed messages that are expressed through nonverbal and verbal communication, carrying the awareness of the incongruities messages and helping the client to work through them and in the end analysis of change brought by the client through counselling session.

6. Focusing: It enables the counsellor to direct the flow of the client's conversation into specific areas. This skill is relevant to all stages of a counselling interview. Focusing enables counsellors to focus on the whole secession and to bring about potential solutions and broader perspectives. The first aspect of focus is the individual focus in which counsellor focus on the personal characteristics of the client.

7. Influencing: These skills take a more direct approach to change in the behaviour of the client with specific alternatives for actions that can encourage change faster and in some situations more permanent. It is the part of counselling the counsellor used to hear the problems of the client actively.


From the above report, it can be articulated that CBT is used to address dysfunctional maladaptive behaviour, emotions, contents and cognitive processes through several explicit, objective-slanting systematic procedures. In the above report, the initial interview of CBT has been presented. In the entire counselling session, several micro-counselling skills are used.


  • Akin, A., 2010. Self-Compassion and Interpersonal Cognitive Distortions. ERIC database.
  • Cameron, H., 2008. The counselling interview: A guide for the helping professions. Basingstoke: Palgrave Macmillan.
  • Cognitive Behaviour Therapy. 2011. Mental Health Practice.
  • Geldard, D. and Geldard, K., 2009. Basic personal counselling: A training manual for counsellors. Frenchs Forest, N.S.W: Pearson Education Australia.
  • Ivey, A.E., 1968. Micro-Counseling and Attending Behaviour: An Approach to Pre-Pacticum Counselor Training. ERIC Database.
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