Cognitive Behavioral Therapy (CBT) vs. Psychotherapy: What's the Difference?

Anxiety is a little bit tricky to treat. Although anxiety is a factor in everyone’s life, debilitating anxiety requires treatment. Medications may be advised. But some kind of “talk therapy” is usually the first step in treatment and is recommended in addition to medication as well.

Some research has shown talk therapy as the best type of therapy for anxiety. Helping people identify their underlying issues and dealing with them through more constructive thoughts and behaviors can create permanent results.

Various Types of Therapy

Cognitive Behavioral Therapy (CBT): CBT looks at the connection between thoughts and behaviors and operates on the assumption that our thoughts structure the way we respond to the world, that if we can change our thoughts, then it will change our responses to and perceptions of the world. In cognitive behavioral therapy the client is asked to identify their negative thoughts, then the therapist will challenge them in various ways to see if they are valid or useful. Finally these thoughts are replaced with true and useful ways of thinking.

Exposure Therapy: This therapy was designed to treat phobias and obsessive compulsive disorder. It works by exposing the client to the feared stimulus over and over in a gradual and supportive way until the fear is extinguished. It is a type of CBT.

Acceptance and Commitment Therapy (ACT): ACT teaches the patient to live with their own life and live in the moment they are in. It is a type of cognitive behavioral therapy, in which judgment is suspended and the goal is just to “notice.”

Dialectical Behavioral Therapy (DBT): This counseling technique uses CBT, but adds in some Eastern meditation and concepts of acceptance and mindfulness. It was designed to treat people with borderline personality disorder.

Interpersonal Therapy (IPT): This therapy looks at the stress the client is under, the resources the client brings to the problem and the social context of the problem. IPT focuses a lot on the interpersonal relationships of the client. It is usually time-limited, taking three or four months.

Eye Movement Desensitization and Reprocessing (EMDR): This therapy is especially useful for people suffering from the effects of trauma. The client is asked to revisit the traumatic memories in a supportive environment, using specific physical stimulus with the idea of neurological reprogramming.

Psychotherapy Then and Now

“Psychotherapy” is the umbrella term for all the above therapies and others. The term implies the main method of care is through verbal interaction with the therapist. While talking is the most prevalent type of psychotherapy, other, more tactical therapies might also be included under this term, including things like equine therapy, art therapy, wilderness therapy, etc. For all these therapies, benefits are not seen immediately, changes happen slowly and can take months to be noticeable and maybe even years to become permanent.

All psychotherapy has the goal of changing thought patterns and thus behavior to increase happiness. The negative thought patterns that exist are called “distortions” by psychotherapists.

Types of distortions:

  • Awfulizing - thinking only of the possible negative affects of an event
  • Drawing conclusions – predicting what another might say or do
  • Exaggerating – also called “catastrophizing”
  • Black and white thinking – seeing things as either perfect or perfectly awful
  • Over generalization – applying the results of one situation to all situations
  • Dismissing the positive – believing that positive experiences are an anomaly, or were not as positive as they were.

Psychotherapy and Cognitive Behavioral Therapy

Sigmund Freud was the “father of psychotherapy.” Freud initiated talk therapy, where the inner world of the client is explored. Freud was focused almost entirely on the client’s past and how relationships and experiences affected the person’s feelings and perceptions. “Psychoanalysis” was the term used to indicate how this type of discovery was iniitally used. Psychotherapy has branched out considerably from that point.

Psychotherapy relies heavily on the relationship between the client and the practitioner. The difference between psychotherapy and “counseling” in the vernacular is that “psychotherapy” implies treatment of a clinical problem where “counseling” may be discussions with someone with no diagnosable problems. Counselors also may be qualified specific to a discipline, such as school counselors or alcohol recovery counselors.

Cognitive behavioral therapy can be done individually or in a group, similarly to other types of psychotherapy. Sessions will explore how the individual feels about others, their life and the world. Actions affect thoughts and feelings, so they will be analyzed, too. Unlike some other forms of psychotherapy, and in contrast to Freud’s vision, CBT does not put much emphasis on the past, but looks at the immediate beliefs and behaviors of the client.

Cognitive behavioral therapy is the dominant therapy used today and influences the other major techniques. Since CBT is a subset of psychotherapy, if someone says, “Are you going to have cognitive behavioral therapy or psychotherapy?” they are likely ignorant of the nomenclature in the field of counseling psychology, or they might really be asking, “Are you going to have cognitive behavioral therapy or traditional psychoanalysis?”

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