Cognitive Behavioral Therapy (CBT)
What is CBT?
Cognitive Behavioural Therapy (CBT) highlights the link between thoughts, feelings & behaviours. It is a talking therapy which can be an effective treatment for common mental health problems such as anxiety, depression and panic. It is a structured form of talking therapy which has been shown to be as effective as medicine for treating specific mental health problems. It can also be used to treat physical health problems by helping patients manage to cope better with their symptoms. Overall, it's popular because it tackles the problem directly by changing the way a client thinks and feels about themselves & others.
How might CBT help?
For Janice, this would typically involve a treatment of approximately 12-16 sessions over 3-4 months of weekly appointments. In the assessment, I would establish a 'formulation' which means I would make sense of how her body image, anxiety & perfectionism were linked. I would identify how specific situations (e.g. being turned down for a job) triggered underlying core beliefs (i.e "I am not worthy, I am useless") which led to a cycle of negative thoughts, feelings & behaviours:
TRIGGER: REJECTED FOR JOB
Negative thoughts: "No one really values me", "I have to be perfect otherwise no one will like me"
Negative feelings: Sad, depressed, anxious, lonely,
Maladaptive behaviours: Avoiding going out, avoiding phone calls from parents, spending excessive amounts of time on appearance
Physiological Reactions: Nausea, sickness, heart pounding, breathing fast
I would identify how her current coping strategies may be adding to the problem by not allowing her to disconfirm (or prove wrong) her negative beliefs. In order to address her goal of feeling positive and confident in herself, the treatment would involve challenging some of Janice's beliefs about herself and others' appraisal of her, and developing alternative balanced perspectives. It may also include 'behavioural experiments' which involve actively trying out things that she may have previously avoided and keeping an account of her predicted responses and her actual responses.