​​What Medications are Prescribed in Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT) is a type of psychotherapy used to treat a range of mental health conditions. Please continue reading to understand what it involves, how it works, and when and how medications are prescribed in CBT.

What is cognitive behavior therapy?

Cognitive behavioral therapy (CBT) is a scientifically validated and widely used form of psychotherapy (talk therapy). It involves working with a mental health professional (therapist, psychotherapist, or counselor) in a structured environment over several therapy sessions. 

Cognitive behavior therapy helps you become aware of irrational or negative thought patterns and emotions. You learn how your distorted thinking affects your behavior. The goal is to help you restructure your thoughts to healthier thinking patterns. Ultimately, CBT aims to help you develop coping skills to deal with challenging situations more effectively in your daily life. 

Can anxiety disorders and eating disorders benefit from cognitive therapy?

Cognitive behavioral therapy is a very useful tool for treating a wide range of mental health disorders and mood disorders such as anxiety, major depressive disorder (MDD), bipolar disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). People with other mental health issues such as phobias, eating disorders, sexual disorders, personality disorders, and schizophrenia are also greatly benefited from CBT. It is not common knowledge but CBT plays a significant role in treating sleep disorders, chronic pain, and relapse prevention in people with substance use disorders.

Does CBT include prescription medications?

Cognitive behavioral therapy is a form of psychotherapy. Medications and other pharmacological interventions are not typically prescribed to patients. However, CBT is most effective for some people in treating mental health conditions when combined with medications like antidepressants. Therefore, CBT therapists may offer cognitive behavior therapy alone or adjunct with other therapies and medications. 

Your therapist will decide whether you will benefit from CBT alone versus CBT plus exposure therapy and medication such as antidepressants. The therapeutic approaches and treatment guidelines will depend on the type and severity of the mental illness you are dealing with.

Can CBT work without medication?

Many people can benefit from cognitive behavioral therapy alone in overcoming mental health disorders like anxiety, depression, post-traumatic stress disorder, and obsessive-compulsive disorder. One of the advantages of cognitive behavioral therapy is that, unlike medication, its effects can last long after the treatment has stopped. With that said, some people can benefit from antidepressant medication alone. Experts say that a combination of medication and CBT is usually the most effective in helping a person overcome mental disorders.

What is needed for cognitive behavioral therapy?

Cognitive behavior therapy is offered over a limited number of sessions in a question and answer format. How many sessions you will need depends on the severity of your mental illness and other factors. In general, most people need 5-15 sessions.

Regarding what to expect during the therapy sessions, cognitive behavioral therapy work involves learning about your mental health disorders. Your psychologist will help you take a close look at your emotions, thoughts, and how they affect your behavior and actions. 

During the CBT treatment process, you will also practice coping mechanisms and techniques for relaxation, assertiveness, along with stress management. Your therapist will help you unlearn negative thoughts and behaviors while adopting healthier thinking patterns to replace negative feelings. 

CBT aims to help you gain a different perspective and build resilience. This approach, in turn, can aid you in dealing effectively with negative emotions in the face of challenging situations. 

Can you do CBT online?

Yes, studies have shown that cognitive behavioral therapy can be efficiently delivered online and that treatment efficacy is as good as face-to-face therapy sessions. Therefore, online CBT is a good option for people who cannot attend office meetings with their therapists. 

Medications vs. CBT: What is right for me?

According to the American Psychological Association and the American Psychiatric Association, medications, psychotherapy, or a combination of the two can help people with mental health disorders. Emotional and behavioral problems present differently in people, so there can be different responses to the same treatment modalities. Therefore, there is no “one-size-fits-all” treatment. You should work with your mental health professional to choose a treatment based on scientific evidence and personal preference. It is also a good idea to take into consideration your ability and willingness to participate and stay with the treatment for the recommended duration. The following is scientific evidence for treating mental disorders. 

Evidence-Based Treatment for Mental Disorders

• Depression: Cognitive behavioral therapy, interpersonal psychotherapy, and antidepressant medications are beneficial. The evidence says that a combination of psychotherapy and medications is usually more effective than either modality alone. 
• Anxiety: Cognitive behavioral therapy, antidepressants, and anti-anxiety medications are helpful. Research, however, says that psychotherapy may be more effective than medications.
• Eating disorders: Cognitive behavioral therapy, other types of psychotherapy, and antidepressants are helpful. The evidence suggests that a combination of psychotherapy and medications can be more effective than either of these treatments alone.
• Substance use disorders: People who are struggling with alcohol and drug addiction can benefit from cognitive behavior therapy, and 12-step support programs. Severe substance use disorders may require medication-assisted treatment for relapse prevention.
• Bipolar disorder and schizophrenia: Most people require treatment with mood-stabilizing and antipsychotic medications. The addition of cognitive behavioral therapy can improve outcomes. 

Personalizing Your Treatment

When trying to figure out whether you need cognitive therapy, medications, or both, keep in mind that different people respond differently to these treatments. Therefore, what works for your friend or family member may not work for you. If one treatment is not helpful, you should work with your mental health professional and try a different approach. Research shows that  psychotherapy, like cognitive behavioral therapy (CBT), can be effective even in those individuals who do not benefit from medications.

Another thing to remember is that CBT and medications require you to stick with the treatment. Do not expect results overnight, especially with medication therapy like antidepressants, there is a possibility that you may feel worse before you start to feel better. Start medication treatment for your mental illness only when you are willing and able to do it long enough to be helpful. 
 

References

1. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610
2. https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt
3. https://www.apa.org/ptsd-guideline/patients-and-families/medication-or-therapy
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464866/