Cognitive Behavioural Therapy (CBT)

With Esther McNeile Jones

Why chose cognitive behavioural therapy?

Cognitive behavioural therapy, known as CBT, is an evidence-based talking therapy.  This means that scientific evidence indicates that CBT is effective in treating a wide-range of common mental health problems.  Based on this evidence, the government-backed National Institute of Clinical Excellence (NICE) recommends one-to-one CBT therapy as a primary treatment option for many different problems, including depression, generalized anxiety, panic, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).   CBT also can be effective in treating problems such as social anxiety, anger related difficulties, low self-esteem, perfectionism and performance anxiety.

How does it work?

One in four people experience a mental health problem in the course of a year. Often this has a huge impact on how a person manages in their day-to-day life and how they feel emotionally.  CBT therapy helps in two main ways, by looking at what a person is doing (behaviour) and what they are thinking (cognitions) and developing more helpful patterns and habits because when a person is experiencing mental health difficulties it is their unhelpful thoughts and behaviours which cause distress. Below is a diagram showing how everything links up:

CBT

Making sense of each person’s unique situation

Every client has their own individual response to certain triggers and the first task of CBT is to identify what the thoughts and behaviours are which are ‘kicked-off’ because it is these thoughts and behaviours which keep the person stuck where they are.  The therapist works with the client to make sense of problems which can seem overwhelming and together we break them down into smaller less daunting parts.  From there we can begin to introduce strategies and techniques which can create more helpful ways of being.

Case example

For example, a patient Jane, had recently lost her job and was experiencing low-mood, she was spending large amounts of time in bed and was avoiding social contact.  Through therapy Jane came to realise that staying in bed and avoiding people was not very helpful to her as it made her feel worse.  CBT for Jane included creating a structure to her days using scheduling and reasons to get out of bed, increasing the pleasure she was experiencing by including activities which she had previously enjoyed, and increasing her contact with friends and family.  Each time Jane made a small change to her behaviour we looked at how this had influenced her mood for the better.  Later in therapy we worked together on unhelpful thoughts which Jane had such as “I’m a waste of space”.  We looked at how the thoughts influence mood and how we can find balanced and believable alternatives.

What strategies and techniques will I learn?

Every course of CBT will include both behavioural and cognitive strategies and techniques.  The idea is that the patient develops skills through the course of therapy which they can then apply in the future after therapy ends.  Throughout the course of therapy both therapist and client keep track of whether interventions are working and in this way we explore options and refine solutions until we have identified what works best.  Therapy then ends with one or two blueprinting sessions in which the therapist and client create a document detailing what has been learned in therapy and when and how these skills, strategies and techniques can be applied in the future.

What is different about CBT?

  • CBT is an active therapy and to be effective requires the client to be committed to developing their skills.  The client’s learning takes place in session and is continued and consolidated through homework tasks in between sessions.
  • CBT is a skill learning opportunity, clients leave therapy with skills which will be useful to them in many different situations in the future.  The skills that are learnt help clients to really live, rather than just ‘getting through the day’.
  • CBT is collaborative, therapist and patient work together to understand what is going on (going wrong) and how things can be changed for the better: we work as a team with the client as the expert on their situation and the therapist as the CBT expert with tools to share which can help.
  • CBT is short term: generally therapy will be on a weekly basis and clients will attend for between 12 and 20 sessions.
  • CBT instills hopefulness: the realization that the future can be different to how things are now is exciting.  As one client put it “I’ve got my dreams back”.

To find out more about CBT please contact Esther using the enquiry form below or call her 07774-687 872.

http://www.cbt-oxford.co.uk

For further information on CBT please see the following these weblinks:

http://www.nhs.uk/conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx

http://www.getselfhelp.co.uk

http://www.babcp.com/Public/What-is-CBT.aspx