Chronic Disease Treatment, Alternative Medicine Treatment,
Phone Mobile 091 98791 58791
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Chronic Disease Treatment, Alternative Medicine Treatment, Alternative Medicine
Chronic Disease Treatment Specialist, Alternative Medicine Treatment Specialist, Alternative Medicine Specialist
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Dr Prakash Shah

Senior Practioner interested in management of health
tele physician

Phone – mobile 091 98791 58791

Land line – 091 79 26672700

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Cognitive therapy

Cognitive therapy (CT) states that thoughts, feelings and behavior are all connected with each other. These individuals can overcome difficulties by identifying and changing these unhelpful or inaccurate thinking, problematic behavior, and distressing emotional responses by Cognitive therapy. The therapist helps to develop skills for modifying beliefs, identifying distorted thinking, in different ways, and then changing behaviors. Now the individual understand’s internal reality, select appropriate interventions and identify areas of distress.

We change targeting thoughts (to change emotion and behavior), behavior (to change feelings and thoughts), or the individual's goals (by identifying thoughts, feelings or behavior that conflict with the goals)

As an example of how CT works:- Having made a mistake at work, a man may believe, "I'm useless and can't do anything right at work." He may then focus on the mistake (which he takes as evidence that his belief is true), and his thoughts about being "useless" are likely to lead to negative emotion (frustration, sadness, hopelessness). Given these thoughts and feelings, he may then begin to avoid challenges at work, which is behavior that could provide even more evidence for him that his belief is true.

Depressed people acquire a negativity of the world in childhood and adolescence;. Depressed people acquire such negativity through a loss of a parent, rejection by peers, bullying, criticism from teachers or parents, the depressive attitude of a parent and other negative events. The negativity of the person are activated in life. Depressed people have negative thoughts about themselves, their experiences in the world, and the future.

As a result he may focus even more on any mistakes he may make, which serve to reinforce the original belief of being "useless." In therapy, this example could be identified as a self-fulfilling prophecy or "problem cycle". We in therapy work together to explore and shift this cycle. Now the thoughts that do not meet his description may then be shifted to something more accurate or helpful, leading to more positive emotion, more desirable behavior, and movement toward the person's goals. Cognitive therapy takes a skill-building approach, where I help the person to learn and practice these skills independently, eventually "becoming his or her own therapist."

Application of Cognitive therapy

Cognitive therapy has been applied to a very wide range of behavioral problems

• Learning in school and college
• Addiction
• Anxiety disorders
• depression
• Bipolar disorder
• Phobia
• Schizophrenia
• Substance abuse
• Suicidal ideas
• Weight loss

Uses of Cognitive Behavior Therapy

Cognitive behavior therapy has been used to treat people suffering from a wide range of disorders, including anxiety, phobias, depression, and addiction. CBT is one of the most researched types of therapy because treatment is focused on highly specific goals and results can be measured relatively easily.

Cognitive behavior therapy is often best-suited for clients who are comfortable with introspection. In order for CBT to be effective, the individual must be ready and willing to spend time and effort analyzing his or her thoughts and feelings. Such self-analysis is a great way to learn more about how internal states impact outward behavior.

Cognitive behavior therapy can replace medication. One of the greatest benefits of cognitive-behavior therapy is that it helps clients develop coping skills that can be useful both now and in the future of his/her life.

In cognitive therapy thoughts, feelings and behavior are mutually influenced by each other. Shifting cognition is seen as the main mechanism by which lasting emotional and behavioral changes take place. Treatment is very collaborative, absolutely personal, skill-focused, and based on a case conceptualization. CBT is transparent to the individual receiving therapy. At the end of the therapy, an individual will often have learned the cognitive therapy skills well enough to "be their own therapist," decreasing dependence on a therapist to provide the answers.

During regular cognitive therapy sessions, I teache the tools of cognitive therapy. Then between sessions, the patient does homework. That homework helps the person learn how to apply the tools to solve specific life problems. "They make small changes in their thinking and behavior every day". "Then over time, these small changes lead to lasting improvement in mood and outlook."

Benefits of Cognitive Behavior Therapy

Cognitive therapy has become the standard "counseling therapy" to treat any psychological conditions. In addition to its high rate of success, it is also cost-effective. The benefits from cognitive therapy often come in weeks rather than months or years, as not in the case with other treatments.

Can cognitive therapy replace antipsychotic medications? Robert DeRubeis, PhD, professor of psychology and associate dean for the social sciences at the University of Pennsylvania - answer is yes. Medications have all kinds of side effects and can actually add to depression," With cognitive therapy, patients learn coping skills and how to apply them. When they do, there is less need for medications.

But it doesn't have to be an "either-or" decision. In some studies, cognitive therapy for depression worked even better when combined with NLP.

Because everyone's situation is unique, the decision about how to use cognitive therapy should always be made by the patient and the doctor together



Cognitive Behavioral Therapy (CBT)


Cognitive restructuring is a core part of Cognitive Behavioral Therapy (CBT). CBT is one of the most effective psychological treatments for common problems like depression, anxiety disorders, and binge eating. to reduce problems with mood, anxiety, and stress.

Choose one type of cognitive distortion to focus on at a time. Example: you recognize that you're prone to "negative predictions." For a week, just notice any times you find yourself making a negative prediction—for example, you might notice yourself expecting not to enjoy a party, expecting to feel too tired to exercise, expecting that your boss won't like an idea, etc.

When you find yourself having the cognitive distortion, ask yourself: what other ways you could think? For the negative predictions example, you might ask yourself what other outcomes are possible. Try these three questions: What's the worst possible thing that could happen? The best possible thing that could happen? The most realistic?

At the end of the week, determine what percentage of the times you ruminated it led to useful problem solving? CBT can help us make changes in the way we think ("Cognitive") and the way we act ("Behaviour)". Making changes in what we think will affect what you do and feel, and changing what we do, affects the way we think and feel. Making these changes then can help us feel better. CBT focuses on looking for ways to improve your mental wellbeing now. CBT says that it's not the event which causes our emotions, but how we interpret that event - what we think or what meaning we give that event or situation.
For instance, someone who's depressed might wake up in the morning and think: "This is going to be another awful day", "I'm going to mess up again", or "What's the point of anything?", which will make them feel even more depressed (feelings), and may prompt them to pull the covers over their head and stay in bed (behaviours). It's very likely that this will increase their negative thoughts, which in turn will increase the feelings of depression, and make them even less likely to get out of bed. A vicious cycle is the result - continuing to think and act the same way will help maintain our depression (diagram below), or anxiety.
CBT can help you to break these vicious cycles of negative thinking, feelings and behaviour. When you see the parts of the vicious cycle clearly, you can change them - and therefore change the way you feel.  It can also be helpful to look at the way our thoughts and feelings affect our bodies, and the physical sensations we can experience.

“I guarantee you that what you’re going to see are a lot of distorted, inaccurate, black-and-white, catastrophic thoughts," "We ask you to underline those and challenge them.” The idea here is to recognize themes that come up again and again, to challenge the thoughts and words you use to describe stress-inducing situations, and to calibrate your emotional reactions to them.

Cognitive-Behavioral Therapy, Step By Step

The first step in cognitive-behavioral therapy for depression is to help patients identify distortions in thinking. Patients are typically instructed to keep a written log of any negative thoughts or bouts of intense unhappiness as well as when and where they take place throughout the day. This written record is a valuable tool. It not only helps patients to understand how common their negative thoughts and behaviors are and what situations trigger them but also is useful for monitoring improvements in their occurrence.

Next, patients learn to replace irrational thoughts with reasonable ones. This does not mean they are taught to “always think happy thoughts;” instead, patients learn to ask themselves questions to test the validity of their thinking. Thus, patients learn to analyze their distorted thoughts objectively until they eventually gain control over them. Although this process is primarily an intellectual one at first, over the course of therapy, it gains emotional resonance.

In addition, cognitive-behavioral therapy for depression usually begins with simple behavioral exercises, because it’s generally easier to change abnormal behaviors than to alter long-held thought patterns. Together, patient and therapist establish concrete goals and structure exercises to meet these goals. In common behavioral technique, activities that overwhelm the patient are broken down into smaller, more manageable steps to be accomplished one at a time.

Another common approach is positive reinforcement, in which patients reward themselves for making healthy changes. This method often helps to alter negative habits associated with depression, such as overeating, staying in bed, or becoming socially isolated. In mild depression, cognitive-behavioral therapy is often effective on its own. In moderate to severe depression, it should be combined with medication for more effective treatment. Severely depressed patients may be unable to do the work required for cognitive-behavioral therapy; once they begin improving, however, cognitive-behavioral therapy may be a useful adjunct therapy.


Self-compassion involves talking to yourself kindly whenever you have a sense of suffering.

Example: you've done something silly and normally you'd call yourself a "stupid idiot." Instead you take a self-compassion approach. You acknowledge you've made a mistake, that you feel embarrassed, and that this is part of the universal human experience. Over time, if you replace self-criticism with self-compassion, your thoughts will change. As you do this, you might notice your thoughts about other people becoming kinder and more accepting too.

After identifying our thoughts, we need to challenge them when they are irrational – make dispute them with evidence and facts and alternative healthy thinking

Reminder – identifying your unhealthy thinking and deliberately disputing the thoughts with healthy rational thinking will bring healthy emotional responses.


Engage Clients in Therapy Homework

  • Psychotherapists that successfully incorporate homework in the therapeutic process manage a variety of factors. Homework is closely related to what patient most want to change and to the general goals of therapy.
  • It is important to frame homework as a practice that will improve coping skills and help them achieve their goals.
  • Something important to consider is that the patient's active symptoms could interfere with homework (e.g. low motivation, high anxiety levels). Therapists need to adjust the homework load and complexity to the patient's symptoms and avoid making him/her feel overwhelmed. Another piece of good news, however, is that it has been found that the severity of depression does not influence clients' compliance with homework. even very severe depression patient do home.
  • Encouraging the patient's participation when planning homework assignments: It has been shown that therapists that involve the patient in planning the homework have better completion rates.
  • start with simple tasks, and then periodically assess the readiness of the patient to move to higher levels of complexity. One example is to start with the recording of stressful situations, related emotions and automatic negative thoughts only, and at a later time take the next step to challenge those thoughts.


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Roshni Poly Clinic
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Near Prabudas Thakkar College,
Opp. Vitrag Flats, Narayan Nagar Road,
Paldi, Ahmedabad-380007 INDIA.

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