About CBT

What is Cognitive Behaviour Therapy?

Cognitive Behaviour Therapy, or CBT, is a way of helping individuals and couples cope with stress and emotional problems. It is a psychological approach that was developed in the United States in the early 1970’s, by Aaron T Beck and more recently has made a significant impact on the choice of therapeutic interventions.

The early pre-Socratic thinker Epicectus second century B.C. said,

“It is not what people experience, but how they interpret it, that determines how they are.”

CBT is a relatively short term, and active, form of psychotherapy with a strong psycho-educational bias. It helps us to look at the connections between how we think, how we feel and how we behave. It particularly concentrates on ideas that are unrealistic, which often undermine self-confidence and make people feel depressed or anxious.

The goal of therapy is to help people uncover dysfunctional and irrational beliefs, test the reality of their thinking and build more adaptive and functional coping mechanisms in order to tackle problems.

By teaching people to step back into the position of an observer, and to hypothesis test their automatic thoughts and feelings using the CBT model, they can develop alternatives in reasoning, enhance their problem solving skills and increase their self/social/interpersonal awareness.

Through the re-attribution of meaning and insight into, and understanding of their core beliefs, deep and lasting changes in the way people see themselves, their world, and the future can be facilitated.

More than just focussing on current difficulties, CBT can also facilitate the development of new skills, and teaches a model for future problem solving, so people can become, in effect, their own therapist with a repertoire of strategies to better cope with future problems as they arise.

How can CBT therapy help me?

CBT techniques can be useful for treating a full range of problems, from more clearly specifying and achieving life-goals, through to helping people with debilitating, chronic problems. The research on the efficacy of CBT is extensive and shows it to be an effective form of counselling, in treating many problems including:

  • Anger Management
  • Behavioural Problems
  • Depression
  • Drug / Alcohol Problems
  • Eating Problems
  • Health Issues
  • Generalised Anxiety
  • Low Self Esteem
  • Obsessive Compulsive Disorder
  • Pain Management
  • Panic Attacks
  • Performance Anxiety
  • Phobias
  • Post Traumatic Stress Disorder
  • Relationship and Family Issues
  • Sexual Abuse
  • Self Harm
  • Sleep Problems / Insomnia
  • Social Anxiety
  • Work Related Stress

More about CBT

  • The main focus of CBT is on the “here and now”.  Your problems are affecting your life now, so the therapy concentrates more on the present.
  • CBT is a time-limited therapy.  The therapist and client agree in advance to work together for a fixed number of sessions and review progress regularly.
  • CBT is collaborative.  The therapist and client work together to attain change.  The therapist shares knowledge with the client, so that s/he can become their own therapist.
  • CBT is practical and problem-focused.  It involves doing therapy tasks between sessions (referred to as “homework”).
  • As the name suggests, CBT works on developing more helpful thoughts and behaviours as a means of achieving valued change.

Although it is not a dominant part of CBT, it is sometimes useful to look at how or why a problem has developed.  It is initially unimportant to understand how problems have developed to help come up with solutions.  For example, if you broke your leg and went to hospital you might expect the doctor to fix your leg and stop the pain rather than ask you questions about how you broke it.  CBT is similar with the focus on the solution of the current problem or difficulties. However, further into the therapy, it might be important to find out how you broke your leg to prevent you from doing it again.

In CBT we try to understand how the problems are maintained.  This could be because of:

  • Unhelpful ways of coping or behaving e.g. being dependent on substances to cope etc
  • Thinking distortions e.g. always predicting that the worst will happen or only focusing on the negative aspects of an event
  • Negative emotional states e.g. sadness, anger, guilt, shame
  • Physical symptoms e.g. breathlessness or a racing heart
  • Traumatic or difficult life events

CBT offers specific interventions or techniques to help overcome difficulties in all these areas.

What happens during a course of CBT?

Generally the duration of therapy is 6-20 sessions.  Both the therapist and the client work together in a collaborative manner and have a transparent relationship, with the aim of the client taking more control over time in order to ‘becoming their own therapist’.  CBT sessions typically last 50minutes and follow a specific structure that helps ensure that session time is used to maximum efficacy.

Typical CBT Session structure

As a way of determining how you’ve been feeling over the last week, compared to other weeks, at the beginning of each session you will be asked to rate your mood.  The therapist will ask you about your previous week and together you will draw up an agenda for the session and this will feature any significant problem(s) or issue(s) that you would like to discuss as well as looking at ways that you have changed or reflected on your thinking or behaviour following your previous session.

As you follow this agenda you will adopt a combination of problem-solving techniques that enable you to distance yourself from the problem situation in order to assess the accuracy of your thoughts and beliefs.  You will also learn new skills and explore ways to implement these into your coming week.  As you will learn, both therapist and client are quite active in this form of treatment.

Why CBT is the psychological treatment of choice in the UK

What makes CBT stand out from other forms of therapy or counselling is that emphasis is placed on evidence-based practice. A wide range of different trials and extensive research investigating the efficacy of CBT has repeatedly shown CBT to be an effective and cost-efficient means of helping people with their occupational, family or emotional problems. Further, the help which people receive through CBT has been shown to persist, reducing the recurrence of problems. In the UK, CBT is currently being suggested as a frontline treatment of choice for an increasing variety of mental health problems (NICE, The National Institute of Clinical Excellence, UK). All of this may sound technical; but it does demonstrate is that by embarking on CBT, you are receiving up-to-date professional therapy based on the latest research.