CBT (Cognitive Behavior Therapy)

Cognitive Behavior Therapy began as Rational Emotive Behavioral Therapy (REBT) in the early 1950's as a brainstorm of Albert Ellis. Aaron T. Beck in the 1960's modified the therapy renaming the approach CBT where its major use was for clinical depression. Other uses for CBT developed using the same or modified principles to treat mental illnesses that range from OCD (Obsessive Compulsive Disorder), Generalized Anxiety Disorder, Panic Disorder, Social Phobia, and in recent years used to treat symptoms of Schizophrenia. Other types of CBT that evolved are Dialectical Behavior Therapy, Self-Instructional Training, and Schema Focused Therapy. Treatment using CBT focuses on:

1. Self-Evaluation - We evaluate managing life s tasks; are we doing, saying, and acting like we should.

2. Identify Skill Deficits - Irrational perception of skill deficits believing we cannot change.

3. Evaluation of Life Experience - Unrealistic expectations of life

4. Self-Talk - Identify and challenge negative self-talk

5. Automatic Thoughts - Challenge negative thoughts related to situations

6. Irrational Beliefs - Identify and change irrational thoughts to reflect reality

7. Overgeneralizing - Identify and change catastrophizing thoughts

8. Cognitive Distortions - Identify distorted reality and objectively change the way we perceive

9. Pessimistic Thinking - Identifying cognitive distortions of the world changing to perceive realistically

 

Cognitive Behavior Therapy for Internet Addiction

In 2006, Internet use by Americans increased 6 percentage points to 73% use from 2005 figures with an estimated 147 million people using the internet in homes, business, and schools (Young, 2007). The prevalence for usage tends to be higher in affluent neighborhoods, which are predominantly white. Surveys of users indicate approximately six percent of Internet users are addicted where addicted users average between 10 and 40 hours per week on the internet. Some of the prevailing symptoms of Internet addiction include:

1. Inability to control use / Preoccupation with Internet

2. Hiding or lying about behavior / Environmental Distress (Family, school, work, and friends)

3. Psychological withdrawal

4. Continued use despite consequences of behavior

5. Time management issues

6. Need for longer amounts of time online

7. Repeated attempts to reduce Internet use

8. Mood modification through internet use

Internet net addiction becomes problematic when the individual increases their time online with Internet activities such as playing online games, chatting with online friends, or gambling on the Internet. Time consumed online gradually increases while time spent with family and friends decreases and the individual becomes more solitary. True addicts substitute sexual intimacy with a partner with online sex chats and pornography. Internet addicts seek the mental pleasure or the dopamine rush and typically uses the Internet as an escape into a virtual world from everyday problems (Young, 2007).

Cognitive Behavior Therapy has effectively treated Impulse Control Disorders on Axis I of the DSM and has successfully been used to treat Obsessive Control Disorder, Intermittent Explosive Disorder, Pathological Gambling, and Trichotillomania (Compulsion to pull out hair). CBT is a three month (12 week) treatment program where patients are taught to monitor thoughts and identify those that trigger addictive feelings and actions. The early stage focuses on specific behaviors and situations in which the impulse control disorder (addiction) causes the greatest difficulty. Therapy then focuses on cognitive thoughts and distortions that have developed and the effects of these on behavior. Overall, the treatment involves assessment of distortion, problem-solving skills, coping strategies training, modeling of therapy, support groups, and keeping thought journals (Young, 2007).

Behavioral intervention involves using an Internet log to establish a baseline for clinical treatment. The goal is to reduce and control Internet usage to a moderate level rather than achieve abstinence immediately. Techniques used to help manage behavior include assertion training, behavioral rehearsal, coaching, cognitive restructuring, desensitization, modeling, reinforcement, relaxation methods, self-management, and new social skills.