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What is cognitive therapy? Is it different from cognitive behavioral therapy? Why should you consider it if you are suffering from depression? Lots of questions — now, let's go get some answers.

If you have been diagnosed with depression or believe you're depressed and have been searching the internet for answers, we're sure you know that antidepressants or talk therapy are the initial treatments of choice, with a combination of the two often being recommended as well. "Talk therapy" comes in numerous different forms, though. Indeed, quite a few kinds of talk therapy can be the right path on the road towards not being depressed anymore.

Of all these, cognitive therapy is an important option to consider. Why? What are the reasons for which you should look into cognitive therapy? 

First things first: What is cognitive therapy?

With so many different forms of therapy out there, things can get a little confusing. You'll likely have heard of "cognitive behavioral therapy" (also sometimes called "cognitive behavior therapy", and shortened to CBT), and may even have assumed that we omitted a word in the headline. CBT is, after all, considered the gold standard in talk therapy! So, what is cognitive therapy, minus the "behavioral"? Is that a distinct entity? The answer to that is complex as well — but in short, it depends on where you live. Let us elaborate a bit. 

"Cognitive therapy", or CT for short, was developed by Aaron T Beck in the 1960s. At its core, the Beck Institute says, lies the by now well-tested idea that how we see situations "influences the way we think, feel and behave". Or, as one research paper put it, "The fundamental assumption is that a thought precedes a mood", meaning that changing the way we think changes everything else, too. 

Cognitive behavioral therapy (CBT) is, in the US, more of an umbrella term that covers different modes of therapy that touch on the cognitive model. This includes therapies such as problem-solving therapy and self-instructional therapy. These focus on techniques, but according to practitioners of CT, but integrates all areas of a person's life and psyche (like cognitive, behavioral, emotional; physical, and interpersonal) to create a unique treatment plan tailored to each person individually

Perhaps unexpectedly, cognitive therapy isn't a form of CBT, but rather, CBT is a form of cognitive therapy — which was developed by a whole different group of psychologists. However, and this is where it gets complicated, if you're living in Europe and are planning to attend something labeled "cognitive behavioral therapy" (or "cognitive behavioural therapy" with a U, of course!), you're almost certainly going to participate in exactly what people in the US, from the Beck Institute, would call cognitive therapy. The two terms are near-interchangeable in Europe, but not so much in the US. Though to make it even more confusing, even the Beck Institute and the (US) Academy of Cognitive Therapy now refer to "CBT" on their web pages. 

OK, whatever it's called, is this the right kind of therapy for depression?

Cognitive therapy has been established to have the potential to treat depression, yes, and it may be right for you because:

  1. Together with antidepressants, cognitive therapy was found to be effective in treating severe or chronic depression. 
  2. Cognitive therapy can help patients who were initially prescribed only antidepressants as a treatment — but who didn't benefit sufficiently and are still depressed — overcome depression. 
  3. Cognitive therapy has also been shown to be a viable alternative to antidepressants for mild and also sometimes more severe forms of depression. This is good news for people who want to avoid antidepressants, for instance because of side effects or because they are pregnant. 
  4. Depressed people who participate in cognitive therapy have lower odds of relapsing (becoming depressed again) than patients who only take antidepressants. 
  5. Cognitive therapy doesn't merely give you a "contingency" or "disaster management" plan in the form of a set of psychological tools, but it can help you fundamentally change your perceptions of the world in a way you will benefit from far beyond the duration of your depression. 

If you are planning to try cognitive therapy

To get ready to start therapy, you can think about what you are hoping to get out of it. Go deeper than "I don't want to be depressed anymore", if possible — consider what problems you have in your life at the moment, what plagues you most, and what kinds of changes you'd like to see. You can write your thoughts down to bring to the initial session if you like. 

At your first session, you will discuss your mood and the goals you have. Your therapist will probably give you some questionnaires to participate in, to determine whether you meet the diagnostic criteria for depression and how severe that depression is. After this, you will start the real work.

Your therapist will encourage you to implement the things you learn in therapy in your daily life and to report back about how you are doing each week. You'll often notice positive changes within three or four sessions.

The actual duration of therapy is up to you and your therapist. In cognitive therapy, your therapist will encourage you to come back for review sessions at increasing intervals — you may come back three and six months after you stop attending weekly therapy, and then see your therapist a final time after a year. 

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