THE BASICS

Cognitive behavioural therapy (more commonly referred to as CBT) is an evidence based talking therapy. You may have heard of CBT as it is the most commonly used therapy by the NHS for treating anxiety and depression, however, it can be useful for various other difficulties.

 

CBT uses a structured approach that aims to understand the relationship between a person’s thoughts, feelings, and behaviours. In other words, what we think influences how we feel and results in what we do/how we respond. An example of this may be: if someone thinks they can’t cope in a particular situation, they may feel anxious and may respond to this by avoiding these situations. With this understanding, a CBT therapist would support their client to make changes to both their thoughts and behaviours to promote emotional change. 

 

IN MORE DETAIL

CBT is based on the concept that your thoughts, feelings, physical sensations and behaviours/responses are all connected, and that negative thoughts and feelings can cause us to get stuck in a negative cycle. The more we respond in a particular way, the more we reinforce the negative thoughts and feelings. 

 

CBT seeks to help you deal with your problems in a more positive and adaptive way by breaking down the problem and making small manageable changes over time. We explain it to clients by getting them to think about running up the stairs, if we try and jump 5 steps at a time to get to the top we’re more likely to fall or have an accident, making the idea of getting back up to try and again that much harder. We take it a step at a time, so you get to look back at the end and see how far you have come. 

Whilst we may consider past experiences and even explore these in more detail, CBT adopts a more “here and now approach”, by focusing on your current problem. Try and think of the current problem as a fire, CBT aims to put out the fire, not necessarily look for what started it. That being said, as highly intensive trained therapists, we adopt what we call a formulative approach to the problem. This basically means that we create a blueprint that outlines the problems, potential triggers or factors that increased our vulnerability to these problems and reasons why this has not resolved on its own. This then acts as a foundation for treatment and enables us to target individual areas of need. 

 

USES FOR CBT

CBT has been proven to be an effective form of treatment for a number of different problems. In addition to depression or anxiety disorders, CBT can also help people with:

• Obsessive Compulsive Disorder (OCD) 

• Panic Attacks/Disorder

• Phobias (Emetophobia for example) 

• Post-Traumatic Stress Disorder (PTSD) 

• Sleep Disturbance

 

CBT can also be used to help those with long term health conditions including Irritable Bowel Syndrome and Chronic Fatigue Syndrome (CFS). Whilst CBT cannot cure the symptoms, it can help people learn to better cope with them. 

 

WHAT TO EXPECT FROM A CBT SESSION 

CBT sessions are often weekly or fortnightly, with the frequency of sessions being discussed and agreed between you and your therapist. There are some occasions where a person may have more than one session per week, which would be discussed and agreed with your therapist.

 

CBT is a short-term therapy and typically ranges between 6-20 sessions, with sessions lasting up to 60 minutes. There are occasions where a person may be offered a session lasting up to 90 minutes, which would be based on work being completed and only suggested if required.

 

CBT is based on a collaborative relationship between you and your therapist. Each session you would agree how you want to use the session to make sure you’re getting the most out of it and that you have a clear direction to focus on. Your initial sessions will be assessment focused so would be more led by your therapist to begin with. 

 

You and your therapist will explore the different areas identified in your assessment and formulation and work out what is realistic and achievable for you as an individual. Your therapist is not there to pass judgement or give advice, they are simply concerned with what you deem to be right or wrong, helpful, or unhelpful, and apply various interventions and techniques to make positive changes in line with your goals. 

 

You and your therapist will agree what you will practice between sessions, often referred to as “homework” (if you can come up with a better word, let us know and we promise never to use the word homework again). Then, you would share the outcomes of your practice in your next session. Over the course of therapy, your practice results in skill development and changes to both your thoughts and behaviours. Effectively, providing you with a toolbox filled with tools you can go on to use independently in life, without your therapist. 

 

PROS AND CONS OF CBT 

No therapy offers a “magic pill” nor can any therapist wave a “magic wand”. CBT requires commitment from both the person seeking therapy and the therapist facilitating sessions. The research tells us that the relationship you have with your therapist is VITAL for success, so make sure you choose the right one for you. 

 

Advantages of CBT include:

• CBT is short term, and a piece of work can be completed in a shorter period of time compared with other therapies. This also reduces the financial burden in the long term as accessing private therapies can be expensive. 

• CBT leaves you with a toolbox of skills to continue to meet your goals and overcome potential obstacles or stressors you may face in the future. 

• CBT helps you to realise your full potential and focuses on an individual’s strengths and capacity to change themselves. 

• It can be as effective as medications in treating problems that medication alone has not helped with. 

• CBT is accessible and easy to introduce into your daily life. Our problems are already difficult, CBT helps to work through a problem without over complicating things. 

• CBT is evidence based and is proven to be helpful for problems listed above as documented clearly in research. 

 

Disadvantages of CBT include: 

• Like any therapy, CBT requires commitment from the person seeking it – a therapist acts as a facilitator of change, the actual change often takes place between sessions.

• CBT is only as effective as you practice what you learn as agreed in sessions. Life can get busy and carrying out extra work between sessions can take time. 

• CBT involves talking about and confronting difficult thoughts and feelings – you would need to consider if you are ready to do this.