Cognitive-Behavior Therapy (CBT): Is It Psychotherapy or Not?

Somehow the assumption is being perpetuated lately in society that CBT and psychotherapy are two different things. Let us look at this. IF the aim of psychotherapy is ultimately for individuals to become less “neurotic” if you will, and more adapted to life and more content, then the two are definitely not different processes.

There are many types of psychotherapy. The first one, initiated by Sigmund Freud, was Psychoanalytic psychotherapy. The idea of this treatment was to help clients gain insight into their unconscious complexes and problems, and this would lead to positive changes in their lives. The process took often months or years. In the last 40 years or so short-term Dynamic psychotherapies and other Insight-oriented psychotherapies have been developed.

The traditional Psychoanalytic psychotherapy has fallen out of grace with many practitioners and clients. For one, the treatment is time-consuming and costly. It also had limitations (as all treatments have) when it became clear for instance that phobias usually do not go away by just talking about them. Insurance companies seldom if ever pay for long-term Psychoanalytic treatment.

Over the decades other treatments came along. Phobias were treated with imaginal or in vivo Exposure (first-generation CBT, which was essentially Behavior therapy). The following is a partial list of psychotherapies: Client-centered psychotherapy, Reality therapy, Gestalt therapy, Family therapy, Humanistic psychotherapy, Control Mastery therapy, Interpersonal psychotherapy, Redecision therapy, Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavior therapy (DBT), CBT (second generation, which includes Cognitive work), Acceptance and Commitment therapy (ACT) and Third-generation CBT, which includes ACT components.

CBT is one of the therapies that has been best studied and shows often very good results, though it is not perfect, hence, the changes it has gone through over time. What is exciting is that recent studies show how beneficial good psychotherapy is (of whichever type), both on behavior as well as showing positive changes in the brain.

In conclusion, CBT is psychotherapy. While different types of therapy lend themselves particularly well for different problems and disorders, a positive relationship established between client and therapist is one of the best predictors of successful outcome.

By Elke Zuercher-White, Ph.D., ABPP