What is CBT?

What is CBT?

Cognitive Behaviour Therapy

Psychological therapy such as cognitive behaviour therapy (CBT) helps make sense of a persons’ emotional difficulties by breaking it down and looking at the problem/experience within a CBT framework.

CBT focuses on the individuals thinking, emotions, behaviours and physiology, also taking into account what has and is going on around them at the time of therapy. It helps to identify connections between your thoughts feelings and behaviour and enables you to develop practical skills that will act as coping mechanisms.

It is an evidence based psychological intervention which is pragmatic and easy to work with. It can be completed in a relatively short period of time compared to other talking therapies, which involves attending regular CBT sessions (usually weekly or fortnightly) and carrying out extra work between sessions. Depending on the problem, the therapy may take place in a clinic, outside or in your own home.

It aids understanding and guides management of unwanted distressful symptoms. The skills you learn in CBT are useful, practical and helpful strategies that can be incorporated into everyday life to help you cope better with future stresses and difficulties even after the treatment has finished. CBT can help you get to a point where you can tackle problems without the help of a therapist – to become your own therapist.

To benefit from CBT, you need to commit yourself to the process and you need to be able to think in psychological terms. More generally, successful treatment depends on the people receiving it being prepared to try to make their lives better, using the advice and support which is offered.

It is useful if you can be clear about how you hope to benefit from the talking treatment. It will help you to make the best use of your sessions and also to decide if it is proving to be useful for you. If you go along determined to make the most of every session and be completely honest about yourself, it’s more likely to work.

What happens during CBT sessions?

The first session will be spent making sure CBT is the right therapy for you and that you are comfortable with the process. The therapist will ask questions about your life and background. If you are anxious or depressed, the therapist will ask about your experiences, whether it interferes with your family, work and social life. They will also ask about events that may be related to your problems, treatments you have had and what you would like to achieve through therapy. If CBT seems appropriate, the therapist will let you know what to expect from a course of treatment and may indicate how many sessions would be required. If it is not appropriate, or you do not feel comfortable with it, they can recommend alternative treatments.

During your CBT sessions you will work collaboratively with your therapist to break down your problems.

Problems are broken down into five main areas:

  • Situations
  • Thoughts
  • Emotions
  • Physical feelings
  • Actions

CBT is based on the concept of these five areas being interconnected and affecting each other. For example, your thoughts about a certain situation can often affect how you feel both physically and emotionally, as well as how you act in response.

You and your therapist will analyse these areas to work out if they are unrealistic or unhelpful and determine the effect they have on each other and on you. To help you with this, your therapist may ask you to keep a diary or write down your thought and behaviour patterns. You and your therapist will analyse your thoughts, feelings and behaviours and will then be able to help you work out how to question and change inaccurate/unhelpful thoughts and behaviours. After working out what you can change, your therapist will ask you to practise these changes in your daily life and you will discuss how you got on during the next session. Your therapist will be able to make other suggestions to help you. Confronting fears and anxieties can be very difficult. Your therapist will not ask you to do things you do not want to do and will only work at a pace you are comfortable with. CBT is a collaborative process, your therapist will not tell you what to do; they will work with you to find solutions to your current difficulties. During your sessions, your therapist will check you are comfortable with the progress you are making.

What kind of relationship will it be?

The relationship with a psychotherapist is very different from the one you make with a friend. It’s a therapeutic relationship or a working relationship. You will find out very little about their personal life and their own difficulties and struggles, but you will reveal a lot about yourself.

Finding a CBT Therapist

If you are considering having CBT privately, ask your GP if they can suggest a local therapist. The British Association for Behavioural & Cognitive Psychotherapies (BABCP) keeps a register of all accredited therapists in the UK and the British Psychological Society (BPS) has a directory of chartered psychologists, some of whom specialise in CBT.