Cognitive Behavior Therapy in Clinical Practice

Answer :

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 behavior, 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 conceptualizing depression.

This therapy focused to the treatment of several kinds of behavioral, emotional and psychiatric problems. It is important to recognize the unhelpful behavior and thoughts and to enhance healthier habits and abilities. Many therapists dealing with anxiety and depression of patients with the use of blend CBT (Akin, 2010). This technique acknowledges that there may be several behaviors that cannot be controlled through rational thoughts. CBT is action oriented and problem focused approach.

Aaron T. Beck found that depressed patients experienced stream of negative thoughts that seemed to arise spontaneously. He identified these cognitions as automatic thoughts. Dr. Beck assists people to recognize and evaluate 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 result in long lasting changes. Clients change their values and beliefs about other people and themselves. This model is used by therapists to change their thinking, emotional responses and behavior of patients to overcome their difficulties.

It was effective in treating wide variety of disorders in people (Welfel and Pattersonm, 2004). It is 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’s, 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.

Use of Micro-Counseling skills

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

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

2.Questioning: Effective communication can help the counselor in interview and may assist to gain more data about client. It is the useful technique in collection of information about client in the stage of interview. There are different techniques of questioning can be used by counselor to achieve the expected result. Close 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 counselor to conform the client that they are being heard correctly. Throughout the interview it is important to use accurate responding as it helps counselor to encourage and clarify the story of client.

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

5.Confrontation: It is the skills which help counselor 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 counselor to observe mixed message in behavior, feeling and words of clients. In the process of confrontation three steps are involved i.e. recognition of mixed message that is expressed through non verbal and verbal communication, carry the awareness of thee incongruities message and help client to work through them and in the end analysis of change bring by client through counseling session.

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

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


From the above report it can be articulated that CBT is used to addresses dysfunctional maladaptive behavior, 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 counseling secession several micro counseling 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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