Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
Most people have back pain at some time in their lives. According to the Nuprin
Pain Report, over half of the U.S. adult population suffers from backaches each
year. For 15% of adults, back pain is a major health problem in which pain is
experienced for more than 100 days in a given year. Back pain has also been
ranked as one of the primary causes of days lost from work, and as one of the primary
reasons for seeing physicians.
Women tend to report low back pain more often than men. The occurrence of
low back pain increases with age and decreases with educational level. The prevalence
of low back pain appears to be highest among the separated, divorced, and
widowed; it is lower among married people and people who have never married.
People who do heavy physical work are more likely to experience low back pain.
However, low back pain can occur regardless of occupation or employment status.
For the many people who experience mild back pain, the pain episode usually
ends on its own without the need for special medical intervention. Even among
those who seek medical attention, most back pain episodes improve within a few
months regardless of the treatment. Nevertheless, a significant number of people
experience recurrent episodes of back pain, and a significant number develop
persistent, chronic pain that endures beyond six months. Their problem interferes
with work, with sleep, and with usual daily routines.
Frequently, a specific cause of low back pain in an individual person cannot be
pinpointed. A variety of diseases and disorders can cause low back pain. Trauma
to the lower back associated with a falling, lifting, or twisting injury is one of the
most common causes of low back pain. These injuries from trauma can cause
muscle strains or compression fractures of the vertebrae (bones making up the
spinal column) of the back.
Mechanical causes of low back pain include poor muscle tone, chronic strain
from poor posture, and curvature of the spine. Degenerative disorders such as a
herniated or "gslipped" disc and osteoarthritis are also common causes of low back
Osteoporosis is sometimes a cause of low back pain in older women. In osteoporosis,
the hormonal changes of menopause result in a decrease in bone density
or a "gthinning" of the bones of the lumbar spine (low back). Other less common
causes of low back pain are tumors of the lumbar spine, congenital disorders such
as misalignment of the vertebrae, and infections. Since low back pain is a complex
phenomenon, the exact cause is not always clear. Although surgery and/or
conservative treatments such as bed rest, physical therapy, and medications
sometimes help, these treatments do not always result in a cure for pain. Many
patients continue to experience persistent low back pain despite repeated medical
When pain persists beyond several months, it is referred to as "gchronic"
pain. Chronic pain often has a significant impact on many areas of a person"fs
life. Activity is usually affected. Some individuals become unable to work and
spend significant amounts of time reclining on the bed or the couch.
may decrease their involvement in social and recreational activities. Changes
in mood are also common. Some people report feeling "gdown" or depressed,
anxious, irritable, frustrated, and angry. Bodily responses that may occur as a
result of pain include disrupted sleep patterns, reduced energy level, and
decreased muscle tone and strength. Because the impact of low back pain on
the affected individual can be extreme, his or her family members can also
experience lifestyle changes.
Behavior Therapy Treatment
There are several goals in the treatment of chronic low back pain through
behavior therapy methods. The first goal is to help the person understand the
factors that may increase pain, suffering, and disability. These factors can
include muscle tension, overactivity or underactivity, and psychological
stress. The second goal is to teach the person new skills to control muscle tension,
change activity patterns, and reduce psychological problems and stress.
Relaxation and Biofeedback Training. In order to learn to relax certain
muscle groups such as the muscles of the low back, both relaxation exercises
and biofeedback strategies are used. In progressive muscle relaxation, the
individual is taught how to relax major muscle groups. In biofeedback, sensors
are attached to the skin over muscle groups such as those of the low
back, and feedback, in the form of a tone or light, is provided to the individual
about his or her muscle activity. For example, a person with higher than normal
muscle tension in low back muscles might hear a pulsating tone of
increasing pitch until he or she is able to relax and thereby lower the pitch.
Because learning to relax through biofeedback and relaxation training is like
learning any new skill (e.g., learning to play a musical instrument), several
sessions are usually necessary, and practice at home with relaxation training
is beneficial for many people with chronic low back pain.
Changing Activity Patterns Through Goal Setting. People with low back
pain commonly overextend themselves and overdo activity. This results in
increased pain, which in turn causes the person to rest and avoid activity for
several days. Over time, some people with low back pain become extremely
inactive and avoid other people and activities that used to be pleasurable. A
common goal for behavior therapy is to help the person change maladaptive
activity patterns. A first step is often to help the person learn to pace activity.
The person is taught to gradually increase activity and become involved again
in recreational and social activities. This is usually done by having the person
set reasonable goals for pleasant activities that can be accomplished if broken
down into small steps. Physical therapy is very often part of the treatment
program, and the behavior therapist and physical therapist work closely in
the treatment program.
Cognitive Coping Skills. Individuals with chronic low back pain often
have a number of negative thoughts. Typical thoughts may include: "gI will
never get better" "gNobody understands my pain" "gI can"ft do anything anymore
and therefore am useless" The person may or may not be aware of these
thoughts. Negative thoughts can lead to anxiety, depression, and increased
pain. The aim of cognitive coping. skills training is to help the person recognize
these thoughts, examine them objectively, and replace negative thoughts
with more positive and realistic coping thoughts, such as, "gThere are still
many things I can do" and "gI have coped with pain before, so I can do it
again." Other cognitive strategies include imagery (mentally focusing on a
pleasant, relaxing scene) and distraction.
Inpatient Pain Programs. Many behavior therapy techniques can be
implemented on an outpatient basis. For some people with chronic low back
pain, however, an inpatient pain program is useful. Inpatient pain programs
take a comprehensive approach to the assessment and treatment of an individual"fs
pain problem. The person is usually seen by a number of medical specialists
as well as by clinical psychologists. The goal is to provide several types
of treatment to the person in an environment that is designed to help the individual
change behavior. Inpatient programs may involve medication adjustment
(when appropriate), physical therapy, biofeedback, pain management
groups, and individual therapy. Nursing staff are usually specially trained to
help the patients apply the new skills they learn in day-to-day activities.
Members of the treatment team meet regularly to review each patient"fs
progress and coordinate treatment goals. Family members are often included
in various parts of the program. Research studies have shown that inpatient
pain programs can help patients reduce pain, increase activity levels, decrease
medication use, and improve their emotional adjustment to the pain problem.
For more information or to find a therapist:
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