COGNITIVE-BEHAVIOUR THERAPY IN TORONTO  
Cognitive-behaviour therapy is based on the concept that changing negative thinking patterns and self-defeating behaviours can have a powerful effect on a person's emotions. CBT is a structured therapy that serves to examine all elements that maintain a problem.  Such elements include one’s thoughts, feelings, and behaviours.  It requires a collaborative partnership between the client and the therapist.  

TREATMENT PROCESS
In order to establish an effective treatment plan, the client will be asked to provide a detailed account of their symptoms and any events that may be associated with their symptoms.  The client will also be asked to complete a series of forms that will help the therapist assess the current state that the client is in.  The therapist and client will discuss mutual expectations of the therapy process, as well as identify the desired outcome.  In order for the treatment to be effective and sustainable, it is imperative that the client play an active role in this process.  For this reason, clients are often asked to practice specific techniques between sessions.  Progress toward achieving goals will be monitored throughout the course of treatment.
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IT WORKS, IT WORKS QUICKLY, AND IT LASTS.

THE ROLE OF A CBT THERAPIST
CBT therapists help clients develop coping skills that enable them to be more in control of their thoughts and their actions. It is a common tendency for those suffering from anxiety to amplify the frightening aspects of situations. Depression often distorts a person’s view of themselves, the world around them, and their future. A CBT therapist can help clients gain a more balanced perspective that will reduce their emotional distress.  CBT therapists can also help clients overcome avoidance by creating a safe environment for them to gradually overcome obstacles and live a more fulfilling life. 

THE EVIDENCE

IT WORKS.  Clinical research has demonstrated time and time again that it is the most effective psychotherapy for symptoms of anxiety and depression.  In a review of 332 studies with 10,000 individuals, those individuals receiving CBT had a superior outcome to those not receiving CBT*. 

IT WORKS QUICKLY.  There is convincing evidence that much of the benefits people achieve in CBT occurs early in treatment for common life problems, such as anxiety and depression.  For example, in one research study, 90% of the symptoms of depression decreased in the first six weeks of treatment*.  Although there is no exact formula, a general rule of thumb is that significant benefits should be achieved after approximately ten sessions of CBT.  

IT LASTS.  The benefits of CBT can last for several years.  Reviews of 141 research studies have shown that clients can maintain the gains they have achieved from CBT for at least 6-24 months*.  In a long-term study with generalized anxiety disorder, the improvements in symptoms were maintained for up to 10 years after therapy*.  A review of 48 studies for approximately 3000 people diagnosed with major depression demonstrated that the relapse rate for those treated with CBT was only 30% compared to 60% for those who received medication alone*.  


*References

DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., et al. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry62, 409-416.

Tolin, D. F. (2010). Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review. Clinical Psychology Review30, 710-720. 

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review26, 17-31. 

Hollon, S. D., Stewart, M. O., & Strunk, D. 2006. Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology57, 285-315. 

Hollon, S. D., DeRubeis, R. J., Evans, M. D., Wiemer, M. J., Garvey, M. J., Grove, W. M., et al. (1992). Cognitive therapy and pharmacotherapy for depression: Singly and in combination. Archives of General Psychiatry49, 774-781. 

Haby, M. M., Donnelly, M., Corry, J.,&  Vos T. (2006). Cognitive behavioural therapy for depression, panic disorder and generalized anxiety disorder: A meta-regression of factors that may predict outcome. Australian and New Zealand Journal of Psychology40, 9-19.

Norton, P. J., & Price, E. C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. Journal of Nervous and Mental Disease195, 521-531. 

Durham, R. C., Chambers, J. A., MacDonald, R. R., Power, K. G., & Major, K. (2003). Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8-14 year follow-up of two clinical trials. Psychological Medicine33, 499– 509. 

Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I. (1998). A meta-analysis of the effects of cognitive therapy in depressed patients. Journal of Affective Disorders49, 59– 72.
Richard T. Bloch, M.A., C.C.C.
Cognitive Behaviour Therapist Toronto