Cognitive-behavioral therapy (CBT) is a combination of two therapy techniques: cognitive and behavioral. Therapists that subscribe to this approach apply theories of social learning (children learn by observing and imitating), and those of behavior modeling and reinforcement. CBT practitioners look at personalities as forming from these experiences in childhood and adolescence.
From this theoretical perspective, disorders or dysfunction can be linked back to childhood experiences. Although the root is in childhood, treatment focuses on the resultant thoughts and behaviors.
Over time, a child who feels that she is not being validated in thoughts and feelings, or receives unhealthy responses, may learn poor coping skills. It can also be true that someone important in her development reinforced (perhaps unknowingly) irrational or unhealthy thoughts or behaviors.
The child grows into an adult without a strong ability to cope with stressors in a healthy and effective manner. She may not be aware that some of her thoughts or behaviors are problematic, nor might she have the coping skills to respond to the resulting crisis.
Cognitive therapy refers to an approach that focuses on a person's cognitions: their thoughts, assumptions, and beliefs. With this therapy approach, a person learns to recognize and change faulty or maladaptive thought patterns. The focus is on restructuring the dysfunctional cognitions through a process of identifying, challenging, and reshaping them.
Behavioral therapy focuses on changing a person's unhealthy and problematic behaviors, actions, and responses. The focus is not on "why" something happens, but changing the process to prevent, alter, or replace it with a healthier more effective behavior.
Peter is depressed; nights are the worst. Once darkness falls and everything is quiet, he finds himself replaying disappointments in life and is engulfed with feelings of hopelessness. To avoid these feelings, Peter does not go to bed, instead he stays up, watching television until he falls asleep on the couch.
Cognitive processes would focus on helping Peter confront his fears and feelings of disappointment, while the behavioral component would focus on stopping the avoidant nightly routine.
Dialectical Behavioral Therapy (DBT) is a modified form of CBT specifically designed to work with those who have recurrent suicidal thoughts and behaviors, self-injury, and difficulty managing emotional reactions.
Schema Therapy (also called Schema Focused Therapy) uses traditional cognitive-behavioral and other therapeutic interventions, to address the symptoms of BPD, while also affecting profound change in the deeper schemas, or patterns, of the individual.
STEPPS is a structured psycho-educational group program, specifically for BPD, that is provided in conjunction with individual psychotherapy and medication.
