Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy that helps people manage problems by encouraging them to recognise how their thoughts affect their feelings and behaviour. It combines a behavioural approach with a cognitive approach to break overwhelming problems down into smaller parts, making them easier to manage.
Mental health conditions can be difficult. While the topic of mental health and the importance of speaking up is becoming normalised, the stigma will still exist, and this can make it difficult to know where to turn for support.
What is CBT?
CBT combines two approaches for practical and solution-focused therapy.
The idea behind CBT is that our thoughts and behaviours influence each other. The premise is that challenging how we think or behave can change how we feel about life. The therapy examines learnt behaviours, habits, and negative thought patterns, aiming to adapt them and turn them into positive ones.
Unlike other therapies, CBT is rooted in the present and looks to the future. While past events and experiences are considered during the sessions, the focus is on current concerns. During a CBT session, the therapist helps the client understand any negative thought patterns; they learn how they affect them and, most importantly, what can be changed.
This type of therapy is beneficial for those with specific issues. It is efficient (rather than insight-based) and focuses on solving the problem.
Some of the people that may benefit from CBT include:
Those with depression and anxiety
People with post-traumatic stress disorder (PTSD)
Those with an eating disorder
People who have an addiction
People who are experiencing sleeping problems, such as insomnia
People who have a fear or phobia
Those with obsessive-compulsive disorder
Those who want to change their behaviour
CBT has become one of the most popular forms of talk therapy and is the most recommended modality by the National Institute for Health and Care Excellence (NICE) for common mental health conditions such as depression and anxiety. During treatment, the therapist works with the client to help them focus on the "here and now." They allow the client to recognise how past events may have shaped their thinking and behaviours, providing the skills to adapt and manage these thoughts and behaviours.
What to expect from CBT
CBT can be one-on-one or part of group therapy. Whichever format is chosen, the relationship with the therapist should be collaborative. The client will actively participate in the treatment and have a voice regarding future progression. The issues discussed with the therapist will be in confidence and without judgment to help the client gain a new perspective.
CBT can last anywhere from six weeks to six months, depending on the circumstances. Usually, there is one session per week, each lasting under an hour. At the start of treatment, the client meets the therapist and discusses why they seek CBT.
Work with the therapist on the content and structure of sessions. After the sessions, the therapist may also assign specific tasks for you to complete at home.
As the therapy progresses, the client will become more prominent in the sessions and start to decide on the session's content and structure without the therapist's help. Once the treatment is over, the client should feel confident and comfortable enough to continue working on themselves independently.
How does CBT work?
Cognitive behavioural therapy aims to help understand what can feel like an overwhelming problem by breaking it into more manageable parts. These smaller parts are thoughts, feelings, actions and even physical sensations. These elements are interconnected and can often feel trapped in a negative spiral. For example, if a marriage or a relationship has ended, they feel like a failure and believe they cannot be in a functional relationship. These thoughts can result in feeling lonely and lacking energy when feelings like these occur, making one unlikely to want to socialise or go out and meet new people. This negative spiral can trap a person into feeling isolated and unhappy.
Rather than accepting negative thought patterns, CBT aims to show clients other ways of reacting so they can break out of negative cycles instead of thinking about failure when a relationship ends, learning from mistakes, and moving. This new way of thinking may make feeling more energised and confident, helping the individual meet people and, one day, start a new relationship.
While this is a simplified example, it illustrates how easy it is to get trapped in negative cycles and how changing your thinking and behaviour can significantly affect you. In CBT, you will learn to recognise your thoughts, behaviours, and feelings while learning other, potentially more helpful ways of thinking and behaving.
CBT can identify negative thought patterns and teach new skills for dealing with different problems. Once I have developed these coping skills, I can use them whenever needed.
Is CBT the right fit?
Now that one understands the therapy, one can decide whether CBT is right. The treatment will benefit those who relate to its ideas, which include the solution-focused approach, ideas about behaviour and thinking patterns, and the importance of completing at-home tasks.
Being committed and doing the assignments set is an integral part of CBT. While the sessions offer support and space to explore concerns, the work done outside the sessions will likely have the most impact. Staying focused and completing assignments will help the client progress quickly and fulfil the joy of developing stronger self-confidence and self-belief.
Akhtar, (SAC Dip), Lead Counselling Psychologist.
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