CBT operates on the theory that an individual will have a thought, which leads to a feeling, which then leads to a behavior; if the thought is a healthy or logical one, this poses no problem to the individual. However, when the individual begins to present with some kind of cognitive dysfunction or mood disorder, an unhealthy, dysfunctional, or illogical thought can quickly lead to maladaptive behavior (Martins, 2007). When an individual has the same thought and emotional reaction over and over again, he or she is essentially wearing a groove in his or her psyche, causing the thought, feeling, and behavioral response to become automatic. CBT seeks to cause a disconnect between the automatic response and the initial thought (Martins, 2007). CBT is commonly used for individual suffering from mood disorders, anxiety disorders, or even chronic sleep or pain issues (Peters, 2008).
When used in family therapy, cognitive behavioral therapy can be quite effective. According to Peters, “The goal is to help the family see how the maladaptive behavior originates with thoughts, then feelings Then to help them change the thoughts, which will then address the feelings and ultimately the behavior” (Peters, 2008). Because CBT believes that maladaptive behaviors are the result of operant conditioning, it utilizes personal awareness and introspection to change the behavior.
The intimate relationships within families are often the result of well-worn, repetitive struggles between individuals. Cognitive behavioral therapy can be very effective in this regard, because it can address the different ways that individuals within a family unit are reacting to each other (Peters, 2008). Most experts in cognitive behavioral family therapy agree, however, that certain conditions must be met for the therapy to be effective.
Peters (2008) suggests that for cognitive behavioral family therapy to be successfully administered for a family unit, the individuals within the unit must have gone through certain processes prior to or in conjunction with beginning family CBT. He suggests that all the individuals who will participate in the therapy must have gone through what he terms “motivational interviewing” and be ready to accept change in their lives (Peters, 2008). The individuals will also ideally continue working on their personal issues individually; the problems that will be focused on in cognitive behavioral family therapy will relate to the family unit and the intimate relationships between the family members.
This may seem like a small corollary, but in many situations, having even one individual within a family unit that is unwilling to participate in therapy and put in the work necessary to make changes can derail the entire process. In this type of situation, cognitive behavioral family therapy would need to be set aside until all members of the family unit that are participating in the dysfunctional relationships are willing to participate in therapy, and are ready for change (Peters, 2008). In addition, CBT requires honest and openness, which can be difficult to elicit from individuals if they fear reprisals from their family members after sessions (Martin, 2007). Creating a healthy, open environment for family CBT can be problematic, but if it is done, CBT can be effective as a form of family therapy.
References
Foa EB, Rothbaum BO, Furr JM (Jan 2003). "Augmenting exposure therapy with other CBT procedures". Psychiatric Annals 33 (1): 47–53.
Foroushani, P. et al. (2011). Meta-review of the effectiveness of computerised CBT in treating depression. BMC Psychiatry, 11 (131), Retrieved from: http://www.biomedcentral.com/content/pdf/1471-244x-11-131.pdf [Accessed: 15th Feb 2013].
Martin, B. (2007). In-Depth: Cognitive Behavioral Therapy. Psych Central. Retrieved on February 17, 2013, from http://psychcentral.com/lib/2007/in-depth-cognitive-behavioral-therapy/
Peters, S. (2008). Cognitive Behavioral Family Therapy. [online] Retrieved from: http://www.slideshare.net/guestdbc5d7/cognitive-behavioral-family-therapy-377828 [Accessed: 16 Feb 2013].
