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What is CBT?

Cognitive Behavioural Therapy, or CBT as it is usually known, is a special form of psychotherapy or counselling.

It is a way of talking about:

How you think about yourself, the world and other people

How what you do affects your thoughts and feelings

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.

How does it work?
Why CBT?
The Therapeutic Relationship
Out of session work
Recommenations for CBT
Problems with CBT

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:

Thoughts

Emotions

Physical feelings

Actions

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it. When you see the parts of the sequence clearly, you can change them - and so change the way you feel. CBT aims to get you to a point where you can "do it yourself", and work out your own ways of tackling these problems.

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Why CBT?

Research shows CBT to be as effective as medication in the short term and more effective in the longer term in preventing relapse.

Strategies and skills learned can be reapplied at any time.

It is a relatively short psychological intervention (usually between 6 and 20 sessions).

It is problem and solution focused.

Changes unhelpful thoughts-feelings-behaviour patterns by experimenting with alternative patterns of behaviour and thinking.

It is a structured intervention

It looks at current problems

It is educative - with a focus on prevention of relapse

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The Therapeutic Relationship
Cognitive behavioural therapists work in partnership with patients to help identify thoughts, feelings and behaviour which cause difficulties in the patient's life. Cognitive behavioural therapists aim to gain a very good understanding of their clients' concerns or goals and then help them achieve those goals. The therapist's role is to ask questions, listen, facilitate and support, while the patient's role is to express concerns, learn, and put into practice some of the techniques and strategies discussed. Cognitive behavioural therapists do not tell the patients what to do - rather, they teach skills to increase well-being and the ability to identify more helpful ways of coping with difficulties. The success of CBT depends on the active participation of the patient in the whole process. It is about working together.

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Out of Session Work
Out of session work is a central feature of CBT and people who are willing to do assignments at home seem to get the most benefit from CBT. Out of session assignments will be agreed between the therapist and the patient and might include the patient keeping a thought record, practicing new skills or engaging in relaxation exercises. The out of session work should always be on the agenda for discussion in the next therapy session.

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Recommendations for CBT
During the past two years, CBT has become the first choice of therapy, encouraged and recommended by the Government, doctors and the psycho-medical fraternity. It is now the therapy of choice and most general practitioners will encourage their patients to seek help from a Cognitive Behavioural Therapist.

The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. NICE advocate that CBT is the treatment of choice for a number of mental health difficulties including depression, anxiety, obsessive compulsive disorder and post traumatic stress disorder.

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Problems with CBT
If you are feeling low and are having difficulty concentrating, it can be hard, at first, to get the hang of CBT - or, indeed, any psychotherapy. This may make you feel disappointed or overwhelmed. A good therapist will pace your sessions so you can cope with the work you are trying to do.