Cognitive Behavioural Therapy for Parkinson’s – At Home!

Cognitive behavioural therapy (CBT) is a common mental health strategy that helps people find new ways of responding to situations by changing their thought patterns. CBT can help individuals reduce stress, deal with grief and loss, and cope with significant life changes.

Imagine your pattern of thought as glasses through which you view the world – thoughts can determine how you interpret, react, and behave in various situations (Davis, 2018). Thus, if you change these thought patterns, you can change your perspective and the way you respond to different life events. CBT can be used to interrupt negative thought patterns that lead to stress, anxiety, and depression, and instead teach people more beneficial ways of thinking to promote better mental health.

Mindfulness

Another common mental health strategy that deals with thought patterns is called mindfulness. There is an important distinction to be made between mindfulness and CBT. Mindfulness encourages individuals to simply acknowledge present thoughts and feelings with awareness and kindness, not engaging or judging the thoughts but simply noting their presence. On the other hand, CBT emphasizes the practice of identifying negative thoughts and reframing these thought patterns. It is a goaloriented style of therapy that requires active involvement from the individual (Davis, 2018).

CBT for Parkinson's

Maintaining your mental health is an extremely important component of managing Parkinson’s disease (PD). Studies suggest that up to 50% of people with PD will experience anxiety or depression, and these challenges often have a significant impact on quality of life (Spears, 2021).

Cognitive behaviour therapy has been found to help improve mood, reduce anxiety, and help individuals establish a more balanced outlook on life. In one study from 2019, 56% of people with Parkinson’s reported improvements in core mood, anxiety, sleep, self-image, and physical symptoms when CBT was used alongside medical intervention – versus medical intervention alone, where only 8% of study participants reported improvements (Dobkin et al., 2019).

For carepartners, CBT strategies can provide skills to process and adjust to new emotions that come along with caregiving, reducing psychological stress and promoting better care for themselves and their loved one.

Overall, CBT may be a key part of a treatment plan addressing mental health concerns among the Parkinson’s community.

How can I implement CBT into my daily life?

CBT can help you learn how to identify problems and harmful thought patterns more clearly, challenge assumptions and irrational thoughts, become more self-aware, and develop attainable goals. Here are some simple ways to practice CBT in your daily life:

• Become aware of unhelpful and negative thought patterns. Some of these patterns include ‘all or nothing’ thinking, over-generalizing, jumping to conclusions, and assigning inaccurate labels to yourself or others. Learning to identify and interrupt these patterns will allow you to move towards more beneficial ways of thinking.
• Try different exercises to examine your thoughts. You may try putting your thoughts ‘on trial’, by gathering evidence in support of, and against, a certain thought, and then determining if that thought is accurate and fair. Alternatively, maintain a thought record sheet or journal where you keep track of unhelpful or inaccurate responses you may have to situations, and identify alternative, or more realistic ways to interpret these events.
• Set SMART goals to make behavioural changes. SMART stands for specific, measurable, achievable, relevant, and timely. Creating SMART goals helps you identify a realistic and clear path forward towards a new behaviour or way of thinking.
• Practice mindfulness. CBT can be used in conjunction with a mindfulness practice. Mindfulness meditation can teach you how to relax more easily and stay present and grounded, leading to more mental clarity and realistic thinking which can reduce anxiety and boost your mood.
• Start a daily gratitude journal. One way to shift focus onto the positive aspects of your life is to start a gratitude journal. You may try making a list of everything you are grateful for, sending letters to people you appreciate, or writing down things that you are looking forward to.

SMART Goal Setting

S – Specific

Goals should be clear and precise, including who, what, when, where, and why.

“I will go on a walk to the park with my friend three times this week to ensure I stay active and healthy.”

M – Measurable

The ability to track goals will help you stay on track and disciplined.

“I will increase my weight-lifting by two pounds.”

A – Achievable

Goals should be realistic and attainable, while pushing your abilities.

“I will learn to use a new program on the computer.”

R – Relevant

Ensure your goals are aligned with where you are in life, and with other goals.

“I will eat the recommended daily serving of vegetables to support my health.”

T – Timely

Establish a target completion date, and set time aside to work on goals.

“I will walk three times a week, and be able to walk 5km at a steady pace by the end of the month.”

Parkinson Society BC also offers free short-term, and non-crisis counselling services for people touched by Parkinson’s disease. Counselling can provide you with a safe and structured environment to discuss and process emotions, learn new coping strategies, and provide you with the extra support you and your loved one(s) may need. To learn more, visit www.parkinson.bc.ca/counselling.

Sources

Davis, K. (2018). How does cognitive behavioral therapy work? Medical News Today. https://www.medicalnewstoday.com/articles/296579#howdoes-it-work 

Dobkin, R. et al. (2019). Cognitive behavioral therapy improves diverse profiles of depressive symptoms in Parkinson's disease. International Journal of Geriatric Psychiatry, 34(5), 722–729. https://doi.org/10.1002/gps.5077 

Spears, C. (2021). Depression. Parkinson's Foundation. https://www.parkinson.org/Understanding-Parkinsons/Symptoms/Non-Movement-Symptoms/Depression

This content was published in the Fall 2021 edition of our quarterly magazine, Viewpoints. The content was accurate as of this publication date.