The Difference Between Cognitive And Behavioral Therapy

Group therapy in session sitting in a circle with therapistSince there is significant overlap between cognitive therapy and behavioral therapy, it is most often combined as cognitive and behavioral therapy (CBT). When it is approached separately there are some notable difference.

Cognitive therapy and behavioral therapy focus on different aspects of underlying behavior, which dictates the therapist’s approach. Cognitive therapy is rooted in thought processes and perception of situations. Essentially, negative thought processes (some of which may be automatic) are what is influencing negative feelings. The goal of cognitive therapy is to actively change negative thought processes and possibly alter feelings of depression and/or anxiety.

Behavioral therapy focus on how behaviors are mediated by rewards, even unconsciously. Although some behaviors do not seem rewarding, they are rewarded by avoidance of an adverse feeling, such as anxiety, fear, or panic. Desensitization therapy is a common approach in behavioral therapy. The goal is small doses of exposure to an anxiety-provoking stimulus will slowly decrease the fear response. Desensitization is used for mental health conditions involving fear, panic, and traumatic experiences.

Since cognition and behavior are often deeply intertwined, many therapists approach both simultaneously. Often there is a feedback system between thought and behavior. For example, negative thinking, such as believing one is unacceptable, will affect behavior. A person who is insecure or believes no one will accept them will alter their behavior to actively avoid people and social situations. The behavior of active avoidance “rewards” the person by reducing anxiety and the possibility of rejection.

The therapist’s goal from a cognitive standpoint is to help the patient realize their negativistic thinking and find ways of changing their thought processes. The patient may be instructed to replace negative internal dialogue with affirmations. From a behavioral standpoint, they may be encouraged to enjoy a social function they would otherwise avoid.