What is Cognitive Behavioural Therapy?
Cognitive Behavioural Therapy is a structured, talking therapy that can be helpful for a wide range of mental health difficulties. CBT is a collaborative approach to change and requires the patient to be very active in the process.
CBT focuses on a person’s thoughts, feelings, beliefs, behaviours and the relationship between these. The goal of CBT is to help people learn how to rethink and re-evaluate how they see the world. This is done by identifying the negative core beliefs held by the patient and working together to challenge them. By learning to recognise negative thinking and behavioural patterns, we can change these negative thoughts into positive statements, which then positively affect the resulting behaviours.
CBT is a collaborative form of therapy, meaning you are an active participant. Your therapist is there alongside you to help create the conditions to bring about positive changes to your thoughts and behaviours. CBT aims to challenge your negative core beliefs using positive action, and these actions are practiced both in and outside of the therapy room. Your therapist may give you ‘homework’ to complete in order to progress positive change.
By using CBT and working with your therapist, you will learn strategies to help you navigate life using positive mechanisms and avoid falling back into your negative patterns. The changes in thoughts, feelings, beliefs and behaviours can have a lasting impact on peoples’ lives as they find they are able to manage distress better and have a toolbox of resources available to them.
We’ve made a short introductory video about CBT:
An introduction to CBT
Hello, my name is Emily and I am a senior psychological therapist on the cognitive behavioural therapy team at the Specialist Centre for Psychological Therapies.
I've been asked to talk to you briefly about what to expect from cognitive behavioural therapy, or CBT which is a bit easier to say, as a treatment.
So, CBT is an evidence-based talking therapy, which means it has been heavily researched. And it is designed to help manage problems and difficulties by changing the way that we think and behave.
So, cognitive is thinking, behaviour is doing, and therapy is change. And it's based on the premise that thoughts, emotions, behaviours, and our physical responses in our body are all connected.
And as a treatment, it is structured. It's goal orientated. So, we will discuss at the start of therapy the things that you want to work on or change and help you to work towards those things.
The sessions are structured. Each session we decide what we want to work on in that particular session so we've got a focus, and we will check in at the end of each session to see how you feel, to see how it's gone and also do larger reviews, potentially after 10 sessions or more, to ensure that you're meeting those goals.
Now, it's psychoeducational, which is a bit of a wordy way of saying we use the knowledge that we have on psychology, on the human brain, to help explain and to help you to understand some of the symptoms you're experiencing.
We draw upon skills and techniques in the same way to help you manage distressing symptoms. What we want to do through that is to build emotional safety and coping skills to allow you to address your difficulties and reach your goals.
And another way in which we do this is we build what we call a formulation. So, it's a bit like a fingerprint. It's unique to the client. It's built together by gaining a knowledge of who you are, what your experiences have been, connecting your thoughts, emotions, behaviours, looking at the physical responses that you might experience.
So, anxiety, racing heart, pain in the stomach, things like that and how we connect them. And we want to look at these past experiences because we want to establish what your core beliefs are. So, core beliefs are the beliefs that we have about the self, the world, and other people. And those core beliefs have an impact on the thoughts we experience day-to-day.
And this formulation is done collaboratively. So, with the therapist and client working together and it helps to guide treatment and determine the focus of treatment by identifying difficulties and maintaining factors.
Because it's unique it individualises therapy. So, the interventions are specific to the client's needs. It enhances teamwork and collaboration through shared understanding and it helps to promote insight. So, if we can see patterns in our experiences, our behaviours it helps towards self-awareness and change and it also allows us to monitor progress.
So, we want to understand how the past impacts the present and move towards change and that is so part of the process of sharing that understanding. And you may be thinking, what if I'm experiencing more than one difficulty?
CBT is what we call a disorder specific therapy. So, because it's so heavily researched, protocols have been developed over time to address specific difficulties. So, for example, a generalised anxiety, depression, OCD, trauma.
If you're experiencing more than one problem, this is where the formulation comes in. It allows us to establish experiences and difficulties and that is our through point in treatment and we will adapt from that point.
And what we want to do for individuals who have experienced trauma is to help them to feel stabilised, to feel grounded, to feel safe, potentially address other symptoms such as day-to-day anxiety and depression to move towards addressing the goals in treatment which may in that case be trauma.
So, what you can expect from the sessions? They are generally 60 minutes weekly sessions and we have, I don't like to call it homework, I prefer between session work that allows us to give you exercises to do.
Some might be behavioural to help manage symptoms. Some might be thought diaries and I always think as a therapist it allows me to jump into your week and gain more insight into your experiences. So, if your treatment is not with myself I wish you the best of luck and thank you very much for your time.
Who is it for
CBT can be used to treat a range of difficulties, including but not limited to:
- Anxiety disorders
- Obsessive-Compulsive disorder(OCD)
- Depression
- Post Traumatic Stress Disorder (PTSD)
When we feel distressed or low, we often develop patterns of thinking and behaving which can worsen how we feel, meaning we can end up feeling worse over time. CBT helps us notice and change these problematic habits so we can feel better. CBT seeks to empower people by focusing on what specific changes we can make to not only begin to feel better, but to be able to maintain these improvements later in life.
In the Regional Cognitive and Behavioural Therapies Service, we see people with complex difficulties. With these people, we often incorporate other CBT based treatments into our highly individualised courses of treatments when appropriate. This is carefully considered and targeted towards the person’s difficulties and agreed goals. As such, our clinicians have high levels of sophisticated knowledge and expertise in order to offer these bespoke courses of CBT.
How can I get referred?
Our service accepts referrals from GPs and other clinicians, but only when our complexity criteria are met. Normally clients referred to us have tried some psychological treatment for their difficulties before being referred to us.
Information about referrals, including the referral form, are on our main Centre for Specialist Psychological Therapies page.