Cognitive Behavioral Therapies

 

Cognitive behavioral therapy (CBT) is a therapy that was developed during the 1950s and 1960s in Anglo-Saxon countries. It is exercised by psychologists, psychiatrists or psychotherapists and includes a set of treatments. Its main purpose is to help patients suffering from psychiatric disorders. This therapy must follow relatively standardized protocols. It consists of exercises centered on the observable symptoms linked to the difficulties encountered by the patient at the time of therapy.

This type of therapy comes from behavioral and cognitive trends. It is a question during these CBTs of intervening on a behavior as well as on the cognitive processes (representations, beliefs, construction processes) linked to this behavior. The accompaniment of the patient by the therapist is therefore an important aspect which takes place throughout the sessions to intervene on the cognitive processes, conscious or not, which are played out during the therapy.

CBTs are based on theories of learning with classical (or Pavlovian) conditioning and operant (or Skinnerian) conditioning. These two types of conditioning are involved in maintaining anxiety disorder and addiction. And this is what will be worked on during therapy.

 

The goal of CBT is to reduce anxiety or addiction and encourage confrontational behavior. To do so, the principle used during this therapy is exposure to anxiety-provoking situations or triggering an irresistible urge to consume, otherwise known as craving. This exhibition is at the heart of CBT and can draw on different theories including that of Beck. According to Beck's cognitive theory of information processing (Beck, Emery & Greenberg, 1985), experience on the organism gives rise to cognitive patterns stored in long-term memory. It is these patterns that would be responsible for selecting and processing information unconsciously and then managing the action. Anxiety disorders and addictions are therefore composed of patterns unsuitable for everyday life. CBT will target and promote controlled cognitive patterns (conscious, slow) over the automatic information processing processes that are carried out by inappropriate patterns of anxiety disorders and addictions. There are different types of exposure explained by Cottraux (1994) which take into account the level of relaxation of the patient (to counter anxiety) or craving (to counter addiction), the nature of the presentation (imaginary or real ) as well as the intensity of the exposure (gradual, maximum etc.). One of the best known and practiced exposures is in vivo exposure. However, these exposures encounter some obstacles, in particular a strong aversion to the patient, difficult control and a situation that is complex or even impossible. For imaginary exhibitions we find the same type of obstacles with in addition difficulties for some patients to imagine the scene (anxiety or triggering craving) and for the therapist to know precisely and control what the patient imagines. This is what virtual reality techniques can bring to CBT.