Communication in Cognitive-behavioral therapy

Actively Listening in Cognitive-Behavioral Therapy

Sammy Krebsbach

University of Oklahoma

            Communication lies at the center of every aspect of life. Between verbal and nonverbal communication, every person is constantly communicating with the world around them and the fact of the matter is that some people are better at it than others are. Cognitive-behavioral (CBT) therapy is a type of therapy that incorporates many different communication techniques to improve a client’s life. In order to be an effective therapist, one must be able to listen actively, create interpersonal relationships, and effectively communicate therapy goals. In this paper the focus will be on the active listening component of cognitive-behavioral therapy because it is at the root of the effective therapy. In order to understand what the desired changes are, one must listen carefully to the patient and caregivers to find a starting place.

            “Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events” (National Association of Cognitive-Behavioral Therapists, 2008). With this understanding that thoughts are the root of behavior, CBT aims to change thought processes and make them less maladaptive. One means of doing this is through “cognitive restructuring” which teaches a client not to treat automatic thoughts as “truths” but rather to question them in a more rational manner (Ledley, Marx, & Heimberg, 2010, p. 13). For example, for an extremely paranoid client who walks into a room and sees people talking the client may assume it is about them and that the room is out to get them in some way. The therapist works to correct the thought process by asking the person questions like “do you know they were talking about you?” and “Why do you think they were out to get you?” the more sessions a client attends, they learn to question their paranoid automatic thoughts on their own and become a healthier individual. CBT is a very structured form of therapy that is effective on a much shorter time line than other types of therapy such as psychoanalysis due to its use of “homework” assignments (National Association of Cognitive-Behavioral Therapists, 2008). The structure involved along with the ease of using parents and educators as enforcers makes this type of therapy is particularly helpful with Autism spectrum disorders, ADHD, and anxiety disorders (Wood, Drahota, Sze, Har, Chiu, & Langer, 2009).

            Effective communication is the key to success in cognitive-behavioral therapy. Many different aspects are of vast importance as earlier discussed. However, first and foremost, before any therapy can take place both the therapist and the client must practice active listening. This paper will examine the role of active listening in several “major techniques” as provided by Gelder in his 1997 journal article The Future of Behavioral Therapy. It should be noted that although this article focuses on the behavioral aspect not the cognitive, the end result of changing behavior is the same. Also, the basic concepts of the importance of active listening can be rather easily applied to any other technique after reading this section. The first technique that is highly used although with limited applications is exposure treatment. This involves exposing a client to something they have consistently avoided. The cognitive implications are that therapist may deal with the thoughts during such exposure. The therapist must listen carefully to the client to find different things that a client has avoided so that they can decide which things to expose them to and also the source of their anxiety so that they can offer good cognitive reshaping. If the therapist did not listen actively the exposure may address the wrong root cognitive and or behavioral issues thus making it a much less effective treatment. If the issue being addressed is for example agoraphobia, an anxiety disorder, it is important that the therapist understand both the roots of the anxiety and its mutations. Therefore, they must actively listen to find out when the subject started feeling the anxiety and the things they see as keeping them from being safe. The next therapy to examine is response prevention. This therapy predominantly treats obsessive-compulsive disorder clients. This strives to stop behaviors that the client feels compelled to which are maladaptive. The cognitive implications are similar for this situation. However, the active listening takes a different role. Sometimes this listening must be to nonverbal cues as well. One must see which compulsions are causing the most problems and take information from the client as well as family and friends. Without this listening the most important and subtle compulsions may be ignored and therefore very little improvement in quality of life for the client. Self control and problem solving techniques are also addressed but go hand in hand with response prevention and exposure therapy respectively. Therefore, the active listening techniques apply in the same way and to explain further would be redundant and pointless.

            In conclusion, for effective therapy many forms of communication must be successfully utilized, however active listening sits as the foundation for all the rest of these issues. In order to give a client the help and outcomes that they desire, a therapist must listen carefully to verbal and nonverbal cues from the client and others in their life. Active listening is key in all relationships though when one examines it. People talk so that they can be heard, they rarely talk to hear their own voice. Listening and being engaged in the conversation encourages people to communicate with you and enjoy the communications. This is positive, humans are not solitary creatures, they thrive on community. Communication is the foundation of community and therefore the foundation of what it means to be human.

References

Gelder, M. (1997). The Future of Behavior Therapy. The Journal of Psychotherapy Practice and Research , 285-293.

Ledley, D. R., Marx, B. P., & Heimberg, R. G. (2010). Making Cognitive-Behavioral Therapy Work: Clinical Process for New Practitioners. New York: The Guilford Press.

National Association of Cognitive-Behavioral Therapists. (2008, April). What is Cognitive-Behavioral Thearapy? Retrieved February 2011, from NACBT Online Headquarters: http://www.nacbt.org/whatiscbt.htm

Wood, J. J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. A. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. Journal of Child Psychology and Psychiatry , 224–234.