The cognitive component emphasizes how we think. It is not the event that leads to the consequences but instead, it is the interpretation of the event that drives subsequent behavior.
Below is an example using the ABC approach:
Activating Event: Friend ignoring you on a sidewalk
Belief: My friend is upset with me
Consequences (emotional, behavioral, physiological): Upset, hurt, proceed to ignore friend
In contrast, if the belief doesn't personalize the event, such as instead thinking the friend didn't see you or is distracted by something, the consequences are very different. This is suddenly something you may not think about much at all. You may reach out to your friend that very evening to check in on them.
Often, we engage in patterns of thinking (cognitive errors) that lead to problematic behaviors. The sad part is that our behaviors cause a chain of reaction that frequently reinforces the original interpretation. For example, if you proceed to ignore your friend because you are hurt, that friendship may in fact fade away.
In any situation, there are gaps in data. We fill in those gaps to fit our interpretation. Sometimes the negative interpretation is accurate and therapy focuses on skill building and acceptance.
Cognitive errors include:
All or nothing thinking: Experiences fall into one of two categories. For example, people are good or bad. Projects are perfect or failures.
Personalization: Taking blame for something that isn't your responsibility. Even other peoples' opinions are none of your business.
Magnification/minimization: We distort the experience's importance, making it into something bigger or smaller than it is.
Over-generalization: We see a single instance being repeated. For example, we receive a bad review at work and assume we will be fired, often then acting accordingly.
Discounting the positive: The focus is on negative data.
Jumping to conclusions: Often before waiting until we have sufficient information, we make the decision.
Mind reading: We assume we can read other peoples' minds (which then often hold what we project onto them) and we assume people can read our minds.
Fortune telling: We launch ourselves into the future without yet knowing all the facts.
Emotional reasoning: We assume something is true because we feel it.
Should thinking: We are driven by "should" statements often leading to resentment and resistant. As I describe it: don't should on yourself.
Specific to anxiety, cognitive errors often involve increase the of the likelihood of a negative outcome and/or increase in the consequence of the outcome.
Specific to eating disorders, errors often involve a misperception of importance of body shape and size as well as a misperception of how one actually looks.
The behavioral component is influenced by the type of condition you are treating. With depression, when people experience anhedonia which is lack of interest in things usually enjoyed, the focus is behavioral activation. You identify activities you used to enjoy and roll into those activities even when you may not think you want to. With anxiety, therapy frequently involves a guided, gradual approach to things avoided to provide evidence that the world won't fall apart. Any type of needed behavioral change looks at setting up reinforcement strategies and identifying alternative behaviors.
A standard piece of CBT also includes relapse prevention. You identify how you know you are at risk of a full blown episode or relapse and develop concrete tools to nip the cycle in the bud sooner rather than later such as increased social support or removing yourself from the situation.
Schema therapy is a branch of CBT that goes beyond work with acute symptoms. As we grow up, we internalize messages about ourselves. Some of these messages are accurate; some of these messages are not accurate. Unintentionally, we engage in behavior that makes these expectations happen. For example, if we often see ourselves as victims, we may place ourselves in at-risk situations where we at first feel comfortable, thus reinforcing the victim role. These internalized messages, schemas, that drive particular behaviors, can take time to identify and sift through.