Cognitive behavioural therapy (CBT)
What is CBT?
Cognitive behavioural therapy (CBT) is a psychological therapy that focuses on the person’s problem as it is experienced in the here-and-now. Your therapist will explore with you your cognitions (your thoughts and beliefs), your behaviours (your actions, activities, or urges), and how they affect the way you feel both emotionally and physically.
We know that our thoughts, emotions, behaviours, and bodily sensations are constantly interacting and influencing one another. If we can change one, a change in other areas of our experience will follow.
As shown above, the interaction between thoughts, feelings, and behaviours can result in a vicious cycle that maintains depression and anxiety. It can be difficult to know how to break out of that cycle.
CBT aims to identify individuals’ maintenance cycle and how to break this to improve symptoms of depression and anxiety disorders.
Research demonstrates that CBT can be an effective treatment for a wide range of common mental health problems, such as depression, generalised anxiety disorder (GAD), social anxiety disorder (SAD), health anxiety disorder, panic disorder, specific phobias, obsessive compulsive disorder, post traumatic stress disorder (PTSD), and body dysmorphic disorder (BDD).
What can I expect from CBT
CBT is a short term and time limited therapy, which is structured to support you to make the most of the sessions and overcome your difficulties in a structured and goal orientated way.
CBT is a very collaborative process meaning you are encouraged to be an active participant, jointly setting the agenda and agreeing homework assignments with the support of your therapist.
All sessions will start with setting an agenda, agreeing an aim for the session to support you to move closer towards your goals. At first this structured way of working might feel strange though experience shows it to be a useful way of supporting good outcomes by staying on track.
The effectiveness of CBT is greatly supported by clients applying what they have taken from the therapy session into the real world. Therefore, there is an expectation that you will regularly engage with activities between sessions, sometimes referred to as ‘homework’, which will be reviewed in the following session.
Format of CBT
CBT with NHS Talking Therapies consists of weekly sessions generally at the same time each week, lasting around 50-60 minutes.
Session 4 in therapy will be a review session in which your therapist will discuss your progress and consider any difficulties that you are experiencing in therapy. A full course of CBT would typically consist of 12 sessions, although some people may require fewer and some people a little more depending on their needs.
Each CBT session follows a similar structure. This includes setting an agenda, reviewing how you have been feeling and your experiences over the past week, and a review of any between session tasks. The main body of the session will be working on a CBT based intervention. The session ends with agreeing a plan for things to work on between sessions, a summary of the session and feedback.
The first few sessions may be used for assessment of problems and building up a shared understanding of the factors that contribute to those problems which can then be addressed. You and your therapist will identify the main problem that you will be working on during therapy, what you hope to achieve from therapy, and set some goals to start working towards.
The final one or two sessions are used for discharge planning, summarising what you have found helpful, how to maintain the progress you have made and deal with any setbacks you may encounter.
Your progress and safety will be regularly monitored throughout your treatment so we can ensure you’re getting the most out of it.
