The search for different ways to help people manage and cope with different psychological and behavioural problems is a constant in psychology. Throughout the relatively short history of this discipline, different people and schools of thought have managed to develop more or less effective techniques to treat such problems and disorders.

Some of the contributions that have shown the greatest scientific evidence in the successful treatment of such problems come from the cognitive-behavioral paradigm, the predominant one at present. In the present article we will see ten cognitive-behavioral techniques of proven efficacy .

The cognitive-behavioral paradigm

Born from the fusion between behavioral techniques and procedures that seek scientific knowledge based on the observable and the knowledge that behind behavior there are diverse psychological processes that explain why we act, think and feel how we do it, the model or cognitive-behavioral approach is based on the work on cognitive aspects in order to produce a significant and deep modification of behavior.

Work is done on the inheritance left by behaviorism, applying and adapting numerous techniques typical of this current so that the behavior modification is not something mechanical and temporary, but rather that it causes a change in the way of perceiving reality and the existence of problems in patients. Aspects such as information processing, coping mechanisms, self-concept and self-esteem or other variables such as skills, beliefs and attitudes towards the world are taken into account.

Through the methods derived from this approach , a wide range of mental problems are treated from a scientifically validated point of view and centred on current problems, working from the symptoms present to obtain an improvement in the patient’s quality of life and relief from their discomfort.

A dozen cognitive-behavioral techniques

Within the cognitive-behavioral paradigm there are multiple treatments, therapies and techniques that can be used to produce an improvement in the patient. Many of them are techniques arising from behaviourism to which cognitive elements have been added . Some of the techniques used are briefly explained below.

1. Exposure techniques

This type of technique is especially used in cases of phobias and anxiety disorders and impulse control . They are based on confronting the patient with the feared or anxiety generating stimulus until it is reduced, so that the patient can learn to manage his behaviour in front of it while at a cognitive level he restructures the thought processes that make him feel uneasy in front of this stimulus or situation.

In general, a hierarchy of feared stimuli is made between patient and therapist, so that the latter can gradually approach and be exposed to them. The speed of approach can vary greatly depending on whether the patient feels more or less able to cope with the feared.

The exhibition techniques can be applied in many different ways, both live and in imagination and it is even possible to take advantage of the technological possibilities to apply exposure through virtual reality.

2. Systematic desensitization

Although the procedure applied in systematic desensitization is similar to that of exposure, since it also establishes a hierarchy of anxiety-inducing stimuli to which the patient is to be exposed, it differs from previous techniques in that the patient has previously been trained to make responses that are incompatible with anxiety.

Thus, seeks to reduce anxiety and avoidance of situations and stimuli by carrying out behaviours that prevent it from appearing, and over time cause a counter-conditioning that ends up being generalised.

Different variants of this technique are emotional staging (applied especially with children and using a pleasant context in which stimuli are gradually introduced), emotional imagination (in which positive mental images are used to avoid anxiety as much as possible) or contact desensitization (in which the therapist would act as a model to teach how to act).

3. Cognitive restructuring

This technique is basic in the treatment of most psychic disorders, forming part of almost all cognitive-behavioral techniques. It is based on the modification of the patient’s thought patterns through various methods, identifying the patient’s own thought patterns and their influence on the patient’s life and generating together with the patient more adaptive and functional cognitive alternatives.

Thus, beliefs, attitudes and points of view are changed, all with the aim of making the person interpret things differently, on the one hand, and set different goals and expectations, on the other.

These modifications have the power to make new habits appear and make those routines that are not very useful or that generate discomfort disappear. In this way, it is the person him/herself who is encouraged to become involved in contexts, initiatives, tasks with therapeutic potential, and to which he/she would not have been exposed if the old system of beliefs had been preserved.

4. Modeling techniques

Modelling is a type of technique in which an individual performs a behaviour or interacts in a situation with the aim that the patient observes and learns a specific way of acting so that he or she is able to imitate it . The aim is for the observer to modify his/her behaviour and/or thinking and provide him/her with tools to face certain situations.

There are different variants depending on whether the observer must replicate the behaviour, whether the model dominates from the beginning of the desired behaviour or has similar resources to the patient so that an approach is made to the objective, the number of people acting as a model or whether the modelling is done live or through other means such as imagination or technology.

5. Stress inoculation

This technique is based on preparing the subject to face possible stress situations. It aims firstly to help the patient to understand how stress can affect him/her and how he/she can cope with it , and then to teach him/her different cognitive and behavioural techniques like the others reflected here, and finally to make him/her practice them in controlled situations that allow their generalization to everyday life.

The aim is for the person to get used to dealing with stressful situations in a rational way, without being blocked by their emotions.

Thus, stress inoculation is a kind of psychological training that modifies our predispositions to react to stressful situations, allowing us to adopt a more appropriate pattern of behavior and that does not make us fall into self-fulfilling prophecy (in this case, stress by stress anticipation).

6. Training in self-instruction

Created by Meichenbaum, self-instructional training is based on the role of the instructor on behavior. It is about the instructions with which we guide our own behaviour by indicating what and how we are going to do something , which are tinged by the expectations towards the results to be obtained or towards one’s own effectiveness.

Certain problems such as low self-esteem or perceived self-efficacy may result in the behaviour being impaired and cannot be successfully performed or even avoided. This technique is intended to help the individual to be able to generate correct and realistic internal self-talk that will allow him/her to carry out the actions he/she wishes to perform.

The process happens because first the therapist makes a model of the action to be performed indicating the steps out loud. Then the patient will carry out this action based on the instructions that the therapist will recite . The patient will then proceed to instruct himself or herself aloud, and then repeat the process in a low voice and finally through subvocal speech, internalized.

This technique can be used by itself, although it is often incorporated as part of other therapies dedicated to the treatment of different disorders such as depression or anxiety.

7. Training in problem solving

Training in problem solving is a type of cognitive-behavioral treatment through which it is intended to help subjects deal with certain situations that they are unable to solve on their own.

In this type of technique, aspects such as the orientation towards the problem in question, the formulation of the problem, the generation of possible alternatives to solve it, the making of a decision regarding the most appropriate one and the verification of its results are worked on. In short, it is about knowing how to approach complicated situations in the most constructive way possible, without being carried away by fears and anxiety.

8. Operating techniques for behaviour modification

Although of behavioural origin, this type of technique is also part of the cognitive-behavioural repertoire. Through this type of techniques, the aim is basically to provoke a modification in behaviour through stimulation.

They allow both motivating and contributing to learn new behaviors as well as reducing or modifying them by applying reinforcements or punishments . Within the operating techniques we can find shaping and chaining to promote adaptive behaviours, differential reinforcement to reduce behaviours or change them for others and satiation, time out or overcorrection as a way of modifying or extinguishing behaviours.

9. Self-control techniques

The ability to self-manage is a fundamental element that allows us to be autonomous and adapt to the environment around us, to keep our behavior and thoughts stable in spite of the circumstances and/or be able to modify them when necessary. However, many people have difficulties in adapting their behaviour, expectations or way of thinking to reality in an adaptive way, which can lead to different disorders.

Thus, self-control techniques are used to facilitate the learning of behaviour patterns in which impulsivity is appeased by consideration of the future consequences that certain actions may bring.

Training that strengthens self-control skills , as achieved with Rehm’s self-control therapy, can be used to control problems of various kinds such as those produced by depressive and anxious processes.

10. Relaxation and breathing techniques

Physical and psychological activation is a very important element in explaining problems such as anxiety and stress. The suffering caused by the presence of problems and difficulties can be partly reduced by relaxation techniques, learning from them to manage body sensations so that one can also help to manage the mind.

Within this group we find Jacobson’s progressive relaxation, Schultz’s autogenous training or breathing techniques.

Advantages of cognitive-behavioral techniques

Cognitive-behavioral techniques have shown a very high level of effectiveness in the treatment of various psychological problems and disorders. Through them it is possible to modify the patient’s behaviour and contribute to the acquisition of more adaptive life and behaviour habits, working and modifying also the cognitive base that induces the original behaviours.

With this type of technique the mind and behavior are stimulated, producing a clear improvement in a large number of cases. Its level of effectiveness is such that it is now considered the therapy of choice for most mental disorders .

Another great advantage of this type of technique is its attachment to the scientific method, being the therapies, techniques and cognitive-behavioral treatments contrasted at an experimental level.

Disadvantages and limitations

Despite the great effectiveness of these techniques in the treatment of the symptoms of mental disorders and problems, the techniques of the cognitive-behavioural type have a series of limitations that make them not always effective.

Firstly, it is important to note that although they take the past into account when collecting information to understand current problems, cognitive-behavioral techniques focus on the here and now, not placing too much emphasis on what has already happened that may have caused the maladaptive behavior.

While these techniques are very useful for treating the current symptom, mostly behind a mental disorder is a deep suffering produced by blockages or events experienced for a long time and that can end up generating the disorder. If the source of the suffering is not treated and the patient is not able to cope with it, the disorder may recur.

It also highlights the fact that these techniques generally aim to eradicate what generates discomfort, but in the process it is not uncommon for rigid behaviour to be generated which in turn can lead to other adaptation problems.

In addition, some studies have shown that many patients feel that this type of therapy does not take into account their condition, feeling misunderstood and having cases of poor adherence to and abandonment of treatment. For these reasons, other therapies have emerged, such as third generation therapies and others from other paradigms.

Bibliographic references:

  • Almond tree, M.T. (2012). Psychotherapies. Manual CEDE de Preparación PIR, 06.
  • Kahn, J.S.; Kehle, T.J.; Jenson, W.R. and Clark, E. (1990). Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychology Review, 19, 196-211.
  • McNamee, S. and Gergen, K.J. (1996). Therapy as a social construction. Barcelona: Paidós.
  • Olivares, J. Y Mendez, F. X. (2008). Behavior modification techniques. Madrid: Biblioteca nueva.
  • Vila, J. & Fernández, M.C. (2004). Psychological treatments. The experimental perspective. Madrid: Pirámide.