March 14th, 2019
What is CBT? An Introduction
Cognitive Behavioural Therapy or CBT is an evidenced based, structured, time limited, talking treatment looking at the relationship between how we think (‘Cognitive’) and what we do (‘Behaviour’). It was originally conceptualised by Professor Emeritus Aaron Beck, a psychiatrist, and his colleagues from the University of Pennsylvania who discovered the importance and key role negative cognitions played in depression. Current therapies had tended to focus on previous experiences rather than on everyday beliefs and experiences which Beck and colleagues now realised were crucial to treating depression.
CBT is based on the idea that our thoughts, feelings, physiological sensations and behaviours are interlinked and connected and influence one another. For example, negative thoughts and unhelpful behaviours can keep us trapped in viscous cycles and affect our feelings. The aim of CBT is to help someone become more aware of difficult and unhelpful thinking styles and behaviours and make changes to improve how they are feeling. CBT is collaborative and there is a real emphasis on the client and therapist working together towards shared goals. The focus of therapy is in the here and now but commonly there are discussions about the past to see how these experiences influence the way somebody sees themselves, the world and others. CBT can be delivered individually or in a group format. At the start, weekly or fortnightly sessions are recommended. The number of sessions depends on someone’s difficulties but can range from six to 20 and each meeting usually lasts 50 minutes to an hour.
The aim of CBT is for the therapist and client to develop a shared understanding of the development of the client’s difficulties and what is maintaining the problem and causing distress. Subsequently, the therapist can share crucial skills and techniques and support the client to implement new ways of approaching their difficulties to alleviate distress. A key aim of the therapist is to enable a person to become their own therapist. There is an expectation that clients will practice strategies outside of sessions to gain most long-term benefit. Therefore, CBT is a commitment; it can feel like hard work at times and can feel uncomfortable as you start developing different behaviours and confront your emotions. But the hard work is worth it as CBT has been shown to be effective, as effective as antidepressants when treating depression. The National Institute for Health and Clinical Excellence (NICE) recommends CBT for a number of conditions such as depression, anxiety, panic, phobias, post-traumatic stress, eating disorders, obsessive compulsive disorder, psychosis and bipolar affective disorder. CBT can also help with anger, sleep difficulties, and physical health problems such as pain and fatigue. CBT can be accessed alongside taking medication and for more severe difficulties a combination approach is recommended.
It’s important to remember that CBT is not for everyone and there are other talking therapies available. Don’t be disheartened if you have tried CBT before and it hasn’t worked. It doesn’t mean that next time it won’t be effective.
For more information about CBT check out this helpful video developed by Mind: https://www.youtube.com/watch?v=9cBvFBE-c&feature=youtu.be