Congnitive Behavioural Therapy (CBT) and how it could help you
What is CBT?
CBT stands for Cognitive Behavioural Therapy. The 'cognitive' part is to do with how you think and the 'behaviour' part is to do with how you act. It is a way of looking at your problems or difficulties. It aims to help you examine your thoughts and feelings, specifically in how you see yourself, others and the world around you.
Rather than looking at the past as a counsellor or psychotherapist might CBT instead is focused on the present and how changes in the present could positively affect the future. This is done by looking for patterns in thoughts and behaviours and finding better alternatives to the things that aren't delivering results.
As a talking therapy, CBT is a short term approach where the therapist, counsellor or psychotherapist helps the client to develop a problem solving attitude. The working relationship between the CBT practitioner and client is usually an equal one where the two work together in partnership.
CBT therapists available
How many sessions will I need?
Everyone is an individual so there is no categorical answer to this question. Some people will see a CBT practitioner for 6 sessions because that is how many the NHS have allocated for that person. It is possible to see improvement within this time scale but some people may need more sessions than this. Each session usually lasts just under an hour. Sessions are usually held at weekly or fortnightly intervals.
Part of CBT is practise which is done in the time between face to face sessions. This homework may involve diary keeping or practising thought or breathing techniques.
What issues can it help with?
There is a growing evidence base that CBT can help with a wide variety of issues. The most common applications of CBT is for anxiety, depression and post traumatic stress disorder.
Other issues CBT can be used for include:
Chronic fatigue syndrome
What does the process involve?
CBT often happens one on one but it is possible for there to be group sessions and there are also online programmes that are CBT based. Two notable examples of online treatments are called Fear Fighter which as the name suggests has a focus on fears and phobias. The other online course is called Beating the Blues and is designed to address depression.
If you are working one on one with a cognitive behavioural therapist the two of you will work in partnership to identify the scale and scope of the issue you would like help with.
As a part of this process the two of you will identify the different elements or chunks of the problem. Through working together you will be able to examine what is working for you and what is not. This will lead to ideas and approaches that could help you to change the unhelpful aspects.
In the beginning of the process the practitioner will be more likely to be an active participant in the structuring of the sessions and homework but later on, the client is more likely to be the one taking responsibility for what happens in the sessions. The plan is that by the end of the process the client will be able to be independent and successful in tackling the situations that were previously difficult.
How does it work?
CBT uses the idea that actions, sensations, feelings and thoughts are related and connected. It claims that negative thoughts can lead to a vicious cycle. CBT focuses on the meaning that people attach to things. For example it may be that in a conversation with someone the other person looks bored. It could be that when this is noticed by the other person they think
“Oh, they look bored. That must mean that they hate me and think I am boring”
This assumption may not be true but if it is believed to be true it can have a negative impact. CBT helps a person to identify what it is they are doing in their thoughts that could be impacting on their life and to change these thoughts.
CBT has borrowed from other disciplines such as Neuro Linguistic Programming (NLP) and adopted the concept of “chunking down” or taking a big problem and dividing it into it’s components and then looking at tools and techniques that can address each chunk.
This page from Psych Central is a great if you want to read in more depth about CBT and how it works.
What are the chances of success?
Cognitive behaviour therapy can be very effective for some people but is not a magic bullet and will not work for everyone. It can be very effective in tackling depression and anxiety issues as well. CBT has even been shown to help the way some people deal with the consequences of tinnitus. It can be as effective as medication for depression.
What homework will I be given?
Doing work outside of the sessions is an essential element of the process. To begin with, some of the homework assignments may be to do with identifying situations when certain thoughts, feelings or behaviour occur. Later in the process, the focus might be on approaches or techniques that would be better alternatives for past behaviour.
The pros and cons of CBT
- You remain in control of the process and what you tackle and if it suits you.
- It is a great medication free option which means it can be a plausible option for many
compared to talking therapies like counselling and psychotherapy CBT can be completed in a much shorter time scale.
- CBT is available in a variety of different styles including one to one, groups and virtually which makes it very flexible.
- The tools and techniques developed within the sessions can still be relevant and useful long after treatment has finished.
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What if the symptoms come back?
There is no guarantee with any technique that the problem won’t come back. That being said the techniques developed during CBT sessions can be used in future if symptoms return. Familiarity with the techniques and with being symptom-free will increase the chances of remaining so in the future.
How can I see a cognitive behavioural therapist?
The best starting point would be to see your GP. It is possible that they would be able to refer you for CBT on the NHS. However, it is likely that there would be a considerable waiting list for availability and there would a limited number of sessions available which would possibly be insufficient to fully tackle the issue.
It would be worth checking the British Association for Behavioural and Cognitive Psychotherapies and National Association of Cognitive Behavioral Therapists websites as they have a database of therapists who they have accredited. A third option would be to take a look at The British Psychological Society (BPS) website as they have a list of psychologists who specialise in CBT.
An alternative that costs significantly less would be to combine self-help with CBT. There are many books available and videos online that use CBT techniques to help people to bring about their own changes. This can be less effective as there is no therapist to guide and facilitate the process.