Cognitive Behavioural Therapy (CBT)

What is CBT?

CBT stands for Cognitive Behavioural Therapy.

It has been found that a lot of the times it’s not the events in our lives that affect us but the WAY WE INTERPRET them. The way we think affects the way we feel and the way we behave.

CBT can help you to change how you think (‘Cognitive’) and what you do (‘Behaviour’). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the ‘here and now’ problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

When does CBT help?

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.

How does it work?

CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:A Situation – a problem, event or difficult situation. From this can follow:

A Situation – a problem, event or difficult situation. From this can follow:

  • Thoughts
  • Emotions
  • Physical feelings
  • Actions

What does CBT involve?

If you have individual therapy:

  • You will usually meet with the herapist for between 6 and 20, weekly, or fortnightly sessions. Each session lasts 50min.
  • In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.
  • The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.
  • You decide what you want to deal with in the short, medium and long term.
  • You and the therapist will usually start by agreeing on what to discuss that day.

The work

  • With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.
  • Together you will look at your thoughts, feelings and behaviours to work out:
  • if they are unrealistic or unhelpful
  • how they affect each other, and you.
  • The therapist will then help you to work out how to change unhelpful thoughts and behaviours.
  • It’s easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend ‘homework’ – you practise these changes in your everyday life. Depending on the situation, you might start to:
  • question a self-critical or upsetting thought and replace it with a more helpful (and more realistic) one that you have developed in CBT
  • recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.
  • At each meeting you discuss how you’ve got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don’t seem to be helping.
  • They will not ask you to do things you don’t want to do – you decide the pace of the treatment and what you will and won’t try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

How effective is CBT?

  • It is one of the most effective treatments for conditions where anxiety or depression is the main problem.
  • It is the most effective psychological treatment for moderate and severe depression.
  • It is as effective as antidepressants for many types of depression.
  • CBT isn’t for everyone. Another type of talking treatment may work better for you.
  • CBT works as well as antidepressants for many forms of depression. It may be slightly better than antidepressants in helping anxiety.
  • For severe depression, CBT should be used with antidepressant medication. When you are very low, you may find it hard to change the way you think until the antidepressants have started to make you feel better.

Problems with CBT

  • CBT is not a quick fix. A therapist is like a personal trainer that advises and encourages – but cannot ‘do’ it for you.
  • If you are feeling low, it can be difficult to concentrate and get motivated.
  • To overcome anxiety, you need to confront it. This may lead you to feel more anxious for a short time.
  • A good therapist will pace your sessions. You decide what you do together, so you stay in control.

How long will it last?

A course may be from 6 weeks to 6 months. It will depend on the type of problem and how it is working for you.

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