CBT, or Cognitive Behavioural Therapy, is a common form of psychotherapy that’s used to treat many problems and is the basis of many more complex forms of therapy. Dr. med. Konrad Hitz, Operational Medical Director at The Kusnacht Practice, discusses how CBT works, what it can be used to treat and more. Dr. med. Konrad Hitz has worked at the Psychiatric University Hospital of Zurich as well as a private Psychiatric Clinic in Graubünden, Switzerland. These roles helped further his skills using CBT to assist patients with a variety of problems, from PTSD to eating disorders. His learnings were used to form the basis of many treatments at The Kusnacht Practice.
How does Cognitive Therapy work? What does a meeting look like?
Konrad Hitz: CBT is an effective form of psychotherapy that aims to change dysfunctional cognitions and behaviour that one suffers from, and replace it with healthier alternatives. CBT sessions are usually held in a one-on-one setting. Depending on the content, sessions can also take place outside of a therapy room. For example, to treat anxiety relating to a fear of heights, you might explore this in real-life surroundings or virtual reality.
What can CBT be used to treat? Depression, anxiety, PTSD? What has Cognitive Therapy been especially useful in treating?
KH: CBT is very well researched and can be used in numerous psychological diseases. It works exceptionally well in depression, anxiety and there are different CBT approaches to treat PTSD with outstanding results like Prolonged Exposure and EMDR. CBT is also useful in treating eating disorders.
Are there any cases when Cognitive Therapy is non-effective?
KH: The psychotherapeutic method a therapist applies in the treatment of a particular client always has to be known to be effective in treating the disease the client suffers from. It needs to be suitable for and accepted by the client. The therapist has the best treatment outcome when they are convinced of the treatment method and well trained in applying it. Any form of psychotherapy can fail.
What is the difference between psychotherapy and Cognitive Therapy?
KH: CBT is a specific form of psychotherapy, where the cognition and behaviour of an individual are paid particular interest and attention in treating a psychological disease.
Why does Cognitive Behavioural Therapy work best in the short term?
KH: I do not necessarily agree that it works best in the short term only. For example, in the treatment of anxiety, a big part of the suffering of an individual might not be the anxiety as such. However, the avoidance strategies applied by the client in order not to become anxious may create more significant suffering and social consequences than the anxiety itself. CBT tackles the avoidance of cognitive and behavioural strategies and has the potential to get the individual back to their prior state, enjoying life.
At what point should a person go and see a therapist?
KH: It does not hurt to go out and seek support if one comes across a change in one’s joy, level of activity, quality of sleep or increase of anxiety. Seeing a therapist does not mean you enter the realm of therapy – it can be a reassuring experience to get feedback from a specialist and discuss the actual situation and treatment options.
Why is the first step always so hard? How can we get motivated to start going to therapy?
KH: Change, even for the better, needs effort and commitment that can be hard to bring up, especially when you are already low in mood or anxious. Part of a mental health issue can be the lack of self-esteem or seeing one’s future in a negative, pessimistic light. Also, there may be the shame of admitting that something has changed. And don’t forget, very often with psychological diseases, it feels like it’s our fault and we instead tend to hide rather than seek out help.
During a session, do you set goals for the future? Does a person learn problem-solving techniques?
KH: Of course – the individual is supported in defining goals, shaping those goals and putting them into practice. Problem-solving techniques are rediscovered as a part of resource activation and more.
Thank you very much Dr. med. Konrad Hitz
KH: Thank you, and please send in any other questions you may have