Cognitive Emotional Behavioral Therapy
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Cognitive emotional behavioral therapy (CEBT) is an extended version of
cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
(CBT) aimed at helping individuals to evaluate the basis of their emotional distress and thus reduce the need for associated dysfunctional
coping Coping refers to conscious strategies used to reduce unpleasant emotions. Coping strategies can be cognitions or behaviours and can be individual or social. Theories of coping Hundreds of coping strategies have been proposed in an attempt to ...
behaviors (e.g., eating behaviors including binging, purging, restriction of food intake, and substance misuse). This psychotherapeutic intervention draws on a range of models and techniques including dialectical behavior therapy (DBT),
mindfulness meditation Mindfulness is the practice of purposely bringing one's attention to the present-moment experience without evaluation, a skill one develops through meditation or other training. Mindfulness derives from ''sati'', a significant element of Hind ...
,
acceptance and commitment therapy Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically based psychological intervention that uses acceptance and mindfu ...
(ACT), and experiential exercises. CEBT has been used primarily for individuals with eating disorders, as it offers an alternative when standard CBT is unsuccessful in relieving symptoms. Research indicates that CEBT may help reduce emotional eating, depression, and anxiety and also improve
self-esteem Self-esteem is confidence in one's own worth or abilities. Self-esteem encompasses beliefs about oneself (for example, "I am loved", "I am worthy") as well as emotional states, such as triumph, despair, pride, and shame. Smith and Mackie (2007) d ...
. CEBT was developed in 2006 by British psychologist Emma Gray (née Corstorphine). Its key components include psychological education; techniques to enhance awareness of emotions and motivation to change; and strategies to restructure beliefs about the experience and expression of emotions. Although (CEBT) was initially developed to help individuals with
eating disorders An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating ...
, its effectiveness in helping people to better understand and manage their emotions has meant that it is increasingly being used by psychologists as a 'pretreatment' to prepare patients for the process of therapy for a range of problems including
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, depression,
obsessive compulsive disorder Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Fixation (psychology), a persistent attachment to an object or idea * Idée fixe (psychology), a preo ...
(OCD), and
post traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a ...
(PTSD), which can often be emotionally challenging.


Techniques

Dialectical behavior therapy (DBT) - DBT is a type of psychotherapy used to treat various disorders. The purpose of this therapy is to help create positive changes in a person's behavior. DBT focuses mainly on treating individuals who have bulimia, drug-dependence, borderline personality disorder, depression, or other psychological disorders.
Mindfulness meditation Mindfulness is the practice of purposely bringing one's attention to the present-moment experience without evaluation, a skill one develops through meditation or other training. Mindfulness derives from ''sati'', a significant element of Hind ...
- Mindfulness meditation is a technique that increases and improves awareness. This technique aims to lower stress and improve our attention. It is a form of focusing on what is presently happening. Mindfulness meditation aims at improving mental health through helping those with disorders be able to manage their emotions.
Acceptance and commitment therapy Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically based psychological intervention that uses acceptance and mindfu ...
(ACT) - Acceptance and commitment therapy is a treatment aimed at helping people to accept the feelings and experiences they go through. Oftentimes people must deal with unpleasant feelings, thoughts or experiences and in response they avoid those emotions as a way of coping. In regards to the way we react, ACT helps with acceptance, making a decision to make changes, and going through with that commitment. Experiential exercises - Experiential exercises play an important part in CEBT because it allows individuals to become actively involved in the learning process. Experiencing what is being taught can have a positive impact on those individuals who experience emotional and behavioral difficulties. These exercises are often used in different types of therapy in order to help individuals learn about diversity, acceptance, injustice, and so forth. Experiential exercises can be incorporated in the treatment of individuals dealing with disorders. These exercises help people to know how to react or cope in certain situations.


Background

In 2006, Dr. Emma Gray (née Corstorphine) started the idea of Cognitive emotional behavioral therapy (CEBT). CEBT uses techniques from other types of treatment such as Cognitive behavior therapy and Dialectical behavioral therapy. The main goal of CEBT is to help individuals learn to cope with their emotions, reduce stress and anxiety, and make changes to their behavior. Gray noted that emotion plays a crucial part in disorders, therefore it needs to be further addressed in terms of treatment. Cognitive behavioral therapy aims to treat where a patient needs the most help, whether that is emotional, behavioral, cognitive, etc. CBT has been practiced since the 1960s. There is a greater focus on cognitive psychology and its impact on behavior. In 2003 there began to be suggestions that CBT needed to be expanded to meet the needs of even more specific vulnerabilities such as emotion, social environments, relationships, etc. Gray saw the need for an approach that has a greater focus on the emotional components. Gray's research specifically analyzes cognitive emotional behavioral therapy (CBT) for eating disorders. She found that CBT and related techniques for bulimia were not effective. CBT mainly uses treatments aimed at discovering cognitive or behavioral issues to be the source. Gray's findings show that therapy focused on emotion helped individuals manage their emotions and difficulties. Research has shown that emotional distress is a major cause of bulimia. Additional studies show that what triggers bulimia is oftentimes one's emotional state and their relationships. CEBT helps these individuals with disorders to cope with their emotions and develop the skills necessary to positively handle their situation.


Case

Gray (née Corstorphine) analyzes a case to determine whether cognitive emotional behavior therapy for eating disorders (CEBT-ED) is effective. In this case, a 22-year-old woman named Anna, who has bulimia and anorexia, goes through CBT and is able to regulate some of her eating patterns and lower the number of times she purges. It was acknowledged that Anna had emotional trauma due to the environment she grew up in. Her self esteem and expression of emotion were repressed because of her family. CEBT-ED allowed her to feel encouraged to show her emotions and discover the source of her difficulties. CEBT is an effective way of easing the symptoms of cognitive and emotional disorders when the typical CBT does not provide sufficient exercises and training.Slyter, M. (2012). Treating eating disorders with the Buddhist tradition of mindfulness. ''Ideas and Research You Can Use: VISTAS'', ''32''(1), 1-12. Emotion is the primary issue of eating disorders. In Anna's case CBT would have been helpful but would have focused mainly on changing negative or unreasonable thoughts. At the center of Anna's problem was her emotional trauma as a child and her difficulty in expressing how she felt. To address Anna's specific needs, CBT was not enough, but CEBT allowed room for self-reflection to find the root of her issues. CEBT helped her to identify and understand her emotions, allowing her to learn skills that would help her cope with these emotions and relieve the symptoms of her issues.


References

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Further reading

* Corstorphine, E. (2006) Cognitive-emotional-behavioural therapy for the eating disorders: Working with beliefs about emotions. European Eating Disorders Research, 14, 448–461. * Corstorphine (2008). Modifying cognitive behavioural therapy for the treatment of eating disorders – using schema modes to work with emotions. In J. Buckroyd (Ed.) Psychological responses to treatment in eating disorders and obesity. Wiley Cognitive behavioral therapy Mindfulness (psychology)