Posted: October 16th, 2023

CBT is a psychological therapy that emphasizes both cognitive and behavioral aspects

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CBT is a psychological therapy that emphasizes both cognitive and behavioral aspects. Why do both physiological variables and physical interventions need to be considered?

Cognitive behavioral therapy (CBT) is a psycho-social intervention that is often used to treat mental health issues such as depression, anxiety, alcohol and drug use, marital problems, sleep disorders, and clinical issues. CBT focuses on challenging and changing cognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems (Beck, 2011).
Both physiological variables and physical interventions need to be considered in CBT because thoughts and behaviors interact in a bidirectional relationship with biological and physical factors. CBT views psychological issues as involving complex interactions among thoughts, feelings, physiology, and behaviors (Hofmann et al., 2012). As such, addressing only cognitive and behavioral components may not fully address the problem. Physiological arousal and physical symptoms can maintain maladaptive thoughts and behaviors, and vice versa.
For example, in clinical depression both cognitive distortions (e.g. negative thoughts about oneself) and biological/physiological factors (e.g. abnormal neurotransmitter levels, inflammation, sleep disturbances) interact to cause and maintain depressive symptoms. CBT aims to modify thoughts and behaviors, but may also target physiological variables through lifestyle modifications (e.g. exercise, diet, sleep hygiene), stress management techniques, and in severe cases, medication. Addressing the physiological component can help change thought patterns and behaviors.
Similarly, in conditions like chronic pain, maladaptive thoughts and avoidance behaviors can exacerbate physical symptoms and vice versa. CBT for pain management aims to change thoughts about pain, address maladaptive behaviors, improve coping, and incorporate physical interventions like exercise or relaxation to manage physiological arousal and directly target the pain (Williams & Garland, 2002). The cognitive and behavioral changes complement the physical interventions to more comprehensively treat the problem.
In summary, CBT is a biopsychosocial model that recognizes the interplay between thoughts, behaviors, physiology, and the physical body. To be most effective, CBT interventions need to consider both cognitive-behavioral and physiological-physical components (Hofmann et al., 2012). A holistic approach that addresses thoughts, actions, biology, and the body is ideal for treating mental and physical health issues.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36(5), 427-440.
Williams, A. C., & Garland, A. (2002). A cognitive-behavioral therapy assessment model for use in everyday clinical practice. Advances in Psychiatric Treatment, 8(3), 172-179.

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