I was awarded a Master of Arts Degree in Cognitive Behavioural Therapy in 2001 by the University of Wales.
Cognitive behavioural therapy has become one of the most popular forms of talk therapy, and is recommended by the National Institute for Health and Care Excellence (NICE) for common mental health issues, It's most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.
Living with a mental health issue can be difficult. While the topic of mental health and the importance of speaking up and reaching out is becoming normalised, stigma remains, making it difficult for many to know where to turn for support. But help is available. If you're not comfortable talking to friends and family, you may turn to a professional - like a doctor or a counsellor.
CBT combines two different approaches for a practical and solution-focused therapy. The therapy is very active by nature, so you may be expected to take a proactive role within your treatment. This may include completing tasks at home.
How Cognitive behavioural therapy (CBT) works
CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. It is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. One of the aims is to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You're shown how to change negative patterns to improve the way you feel. It looks for practical ways to improve your state of mind on a daily basis.
During the treatment, your therapist will work with you to help you focus on the "here and now". They will help you recognise how past events may have shaped your thinking and behaviours, teaching you how to, not only adapt your thoughts, but manage them.
CBT is also used to treat people with long-term health conditions, such as: irritable bowel syndrome (IBS) chronic fatigue syndrome (CFS) and fibromyalgia. Although CBT cannot cure the physical symptoms of these conditions, it can help people cope better with their symptoms.
What happens during CBT sessions?
If CBT is recommended, you'll usually have a session with a therapist once a week or once every 2 weeks.
The course of treatment usually lasts for between 5 and 20 sessions, with each session lasting 50 minutes. During the sessions, you'll work with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings and actions. You and your therapist will analyse these areas to work out if they're unrealistic or unhelpful, and to determine the effect they have on each other and on you. Your therapist will then be able to help you work out how to change 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'll discuss how you faired during the next session.
The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life. This should help you manage your problems and stop them having a negative impact on your life, even after your course of treatment finishes.
The relationship you have with your therapist should be a collaborative one. This means that you will take an active involvement in the therapy and have a voice when it comes to future progression. The issues you discuss with your therapist will be in confidence and without judgement to help you gain a new perspective.
At the start of your therapy, you will meet your therapist and discuss why you are seeking treatment. Here you will have the opportunity to talk with the therapist. You will be able to outline what you hope to gain from CBT and set goals for the future. Together with your therapist you will work on the content and structure of your sessions. Your therapist may also set you certain tasks to do after the sessions at home.
Cognitive behavioural therapy looks to help you make sense of what can feel like an overwhelming problem by breaking it down into more manageable parts. These smaller parts are your thoughts, feelings, actions and even physical sensations. These elements are interconnected and can often trap you in a negative spiral. For example, if your marriage or relationship has come to an end, you may think you have failed and that you are not capable of being in a functional relationship. These thoughts can result in you feeling lonely and lacking energy. When you feel like this, you are unlikely to want to socialise or go out and meet new people. This negative spiral can then trap you into feeling isolated and unhappy.
Rather than accepting the negative thought patterns, CBT aims to show you other ways of reacting so you can break out of negative cycles. Instead of thinking that you are a failure when a relationship ends, you can choose to learn from your mistakes and move on, feeling optimistic about the future. This new way of thinking may result in you feeling more energised and confident, helping you meet new people and one day, start a new relationship.
As well as identifying negative thought patterns, cognitive behavioural therapy can teach you the skills you need to help you deal with different problems. The hope is that once you are equipped with these coping skills, you will be able to use them in the future, whenever you may need them.
For example, if you have a phobia or suffer from anxiety, you may discover through therapy that avoiding certain situations can actually increase your fears. Confronting the fears in a gradual and manageable way can help you gain faith in your ability to cope. Perhaps you suffer from depression, your therapist may ask you to note down your thoughts so you can explore them in a more realistic way. This can help you gain perspective and start to break the negative cycle.
Being committed and doing the assignments set for you is an integral part of CBT. While the sessions offer support and space to explore your concerns, it is the work you do outside of your sessions that is likely to have the most impact. By staying focused and completing assignments, you will help yourself progress quicker. This way you will hopefully start to develop a stronger sense of self-confidence and self-belief.
Uses for CBT
In addition to depression or anxiety disorders, CBT can also help people with:
- Obsessive compulsive disorder (OCD)
- Panic disorder
- Phobias
- Post-traumatic stress disorder (PTSD)
- Sleep problems – such as insomnia
- Problems related to substance misuse
