Cognitive Behavior Therapy
Encino Psychiatrists Karen L. Vause and Ramzi Kiriakos
Encino Psychiatrists
16550 Ventura Blvd.
Suite 212
Encino, CA 91436
Direct Contact Information
Karen Vause, MD (818) 995-0640
Ramzi Kiriakos, MD (818) 881-8208
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Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) is a treatment applied to: anxiety disorders, panic attacks, social phobias, stage fright, obsessive compulsive disorder, depression, eating disorders, substance use disorders, and addictions. In Cognitive Behavior Therapy, the therapist teaches and coaches the patient in the use of various techniques and exercises to overcome their problems. Specific personalized goals are set and specific expectations are rehearsed to overcome the disabling symptoms. The patient is asked to complete tasks each week (homework) with clear expectations to establish recovery. Improvement usually occurs within 10 to 16 weeks. 

Among the techniques used in Cognitive Behavior Therapy are:

Relaxation Training

One form of Cognitive Behavior Therapy is relaxation training. The patient is taught techniques that are practiced 15 to 20 minutes per day or when their symptoms occur. 

Guided Imagery

The patient is taught to close their eyes and visualize visiting a scene that is pleasant and calming to them. (a beach or another beautiful location).

Specialized breathing techniques

Slow and deep breathing using the abdominal muscles is another frequently used technique.

Muscle Relaxation

Progressive contraction and relaxation of the muscle groups throughout the body can also be helpful.

Assertiveness Training

Another form of Cognitive Behavior Therapy is assertiveness training. This technique helps individuals define their emotions and desires in interpersonal relationships and learn how to effectively communicate them to others. It teaches how to communicate tactfully and confidently communicate disagreement and to set interpersonal limits as needed. Another form of assertiveness training is to help the patient approach strangers and engage them into a 5 minute social exchange.

Gradual Desensitization

A common form of Cognitive Behavior Therapy is gradual desensitization is when the patient is exposed to an anxiety provoking situations in small steps. As the exposure increases gradually, the individual becomes more accustomed and able to tolerate the situations that were intolerable before treatment. This is a very effective technique for social anxiety, stage fright, performance anxiety and obsessive compulsive disorder.

Thought Restructuring

Many times in Cognitive Behavior Therapy we use thought restructuring. When someone is depressed or very anxious they start to have negative thoughts about themselves.  In thought restructuring, the patient is taught to write a list of the negative thoughts they have about themselves. They then have to refute those thoughts and identify the errors in their conclusions about themselves. This exercise may be repeated once or twice daily for up to a month.  This teaches the individual to respond to internal negative thoughts with more positive thinking. After practicing this technique, most people are able to use thought restructuring to stop negative thinking and decrease their anxiety and depression.

Implosion or Flooding

Implosion or flooding is a faster application of CBT. When someone has severe anxiety with panic or phobias is exposed to the source of their anxiety and survive the experience, they eventually are able to face their fears.  In the example of fears of close spaces, the patient is accompanied by the therapist into a small room until the fear subsides. Eventually the patient may be able to enter a small space alone. This exercise may be preceded with relaxation therapy. It is an effective technique for agoraphobia (fear of open spaces), xenophobia (fear of strangers), height phobia, elevator phobia, and car phobia.

Behavioral Activation

Another practical application of Cognitive Behavior Therapy is behavioral activation. Depressed individuals often feel less energetic and may withdraw socially and become less active. The reduced activity levels diminish the quality of life and increases the feeling of emptiness and depression. The patient using this technique lists in detail what they used to do when they felt healthy. These activities are added one by one on a daily basis. As the number of previous activities is added, the individual feels a sense of empowerment and an improvement in the quality of life. These changes eventually reduce depressive symptoms.

Thought Stopping

This is a specific form of Cognitive Behavior Therapy used in Obsessive Compulsive Disorder (OCD). The person may suffer from repeated intrusive thoughts. This can also occur with phobias and panic disorder and depression. One way to overcome this form of thinking is to order oneself to stop thinking that way. With repeated practice of “thought stopping”, the intrusive dysfunctional thoughts will disappear.

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