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How do you treat someone who thinks or acts in a negative way? In this lesson, we’ll look at what cognitive behavioral therapy is and the six phases in CBT.


Jenny is a compulsive eater. Whenever she’s upset or tired or bored, she eats large quantities of food. Cake, candy, pasta, pizza – if it’s available, Jenny will eat it! It makes her feel better and fills her up with positive emotions.Georgie, meanwhile, has a different problem.

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She loves her boyfriend very much, and they are generally happy. But Georgie worries that he might one day decide to leave her. She thinks about this all the time, and it’s starting to take over her life. Last month, she stopped taking her birth control because she knows that if she gets pregnant, he’ll marry her. She knows it’s wrong, but she can’t seem to make herself do the right thing.Both Jenny and Georgie have psychological problems.

Abnormal psychology is the study of abnormal thoughts, behaviors, or feelings. There are many ways to look at abnormal psychology, and not all psychologists agree on the best way to treat psychological patients. While one psychologist might believe that problems spring from biological processes and should be treated with medication, another might claim that trauma in childhood is the issue and encourage patients to talk about their childhood problems. Let’s look closer at one type of psychological treatment: cognitive behavioral therapy.

Cognitive Behavioral Therapy

Georgie is not taking her birth control.

She hopes that she’ll get pregnant and that her boyfriend will marry her. A large part of Georgie’s problem is her irrational fear that her boyfriend will leave her. Thoughts about that happening haunt Georgie day in and day out.

Cognition is just a fancy word for thought processes. When someone like Georgie has maladaptive thoughts, it can affect their feelings and behaviors. Despite not having any evidence that he will, Georgie thinks that her boyfriend will one day leave her.

This makes her feel scared, and in turn, it makes her try to trap him with pregnancy.One way to deal with faulty thinking is through Cognitive Behavioral Therapy, or CBT for short. CBT focuses on changing the thoughts and behaviors of the patients. Unlike some other approaches to psychology, CBT isn’t very interested in the situation that caused the thoughts. Instead, it is interested in how to change a person’s reaction to the situation.For example, Georgie’s boyfriend hasn’t given any indication that he’s going to leave her, but that’s what she believes will happen.

A cognitive behavioral therapist will work with Georgie to see that her thoughts are irrational and that she has no proof that her boyfriend will ever leave her.Remember Jenny? She overeats. She’s tried diet pills and drinking lots of water and has even seen a hypnotist, but nothing works. She’s obsessed with food and can’t stop thinking about it. And when she does break her diet and eats something bad for her, she thinks, ‘Well, I blew my diet on that burger.

I might as well get the fries and milkshake, too.’ Jenny’s thoughts about food are making her overeat. If her therapist can get her to change the way she thinks about food, then she might be able to change her eating habits as well.

Six Stages of CBT

Let’s say that you’re a psychologist treating Georgie and Jenny. You need each of them to change the way they think and, therefore, the way they feel and act.

But how do you change someone’s thought patterns? It’s not easy to change how people think, but it can be done. Most psychologists use a six-step approach to CBT. The six stages are:1. AssessmentFirst, you must find out what’s wrong and what the patient’s cognitive process is.

When Georgie walks into your office, you don’t know what her problem is. She might be there because she has lost her job or because she’s just made a million dollars. And when you do find out that she’s worried about her boyfriend, you still don’t know what is causing her to act the way she does. You won’t know how to approach Georgie until you assess her.2. ReconceptualizationThis is the main part of CBT.

During this phase, you encourage patients to look at their world differently. For example, you might begin by having Jenny realize that just because she ate a burger that was against her diet, it doesn’t mean she has to blow her diet even more with fries and a milkshake. Eventually, you’ll get Jenny to think about food in healthier, more productive ways.3.

Skills acquisitionDuring this phase, you give the patient skills to deal with issues. For example, you might have Georgie examine some of her thoughts and explain to you which are logical and which are fear-based.4.

Skills consolidationOnce a patient has started to learn new skills, they have to apply those skills to their real life. For example, perhaps during skills acquisition, you had Jenny write down her thoughts and feelings. During consolidation, you might have her write them down before she eats. This way, she’s aware of her thoughts and feelings and is making food choices based on hunger, not emotion.5. MaintenanceDuring this phase, the patient will look to the future and what challenges might lie ahead.

For example, you and Georgie might talk about what will happen if she and her boyfriend break up or how she might react if they move in together.6. Follow-upThis final phase involves checking in on the patient to see how they are doing as time passes. Jenny and Georgie might come in for follow-up appointments several months after their treatment is finished. This allows you to fine-tune any problems that have come up and to evaluate how well they are continuing to do.

Lesson Summary

Cognitive behavioral therapy focuses on changing a person’s thoughts and actions. In turn, this changes their feelings and behaviors. There are generally six phases in cognitive behavioral therapy:

  1. Assessment
  2. Reconceptualization
  3. Skills acquisition
  4. Skills consolidation
  5. Maintenance
  6. Follow-up

Learning Outcomes

When the lesson is over, you should be able to:

  • Define abnormal psychology
  • Explain what cognitive behavioral therapy is
  • Identify the six stages of cognitive behavioral therapy

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