Cognitive Behaviour Therapy (CBT) is a talking therapy with a practical approach. The client and therapist work together, applying CBT to the problem to enable helpful changes in attitudes and behaviours to come about. CBT can be applied to us all because psychological problems can happen to anyone; they are often simply exaggerated versions of normal processes.
How we think (the cognitive aspect of CBT) affects how we feel emotionally and physically and then what we go on to do or don’t do about it (the behaviour aspect of CBT). The overall consequence affects our wellbeing. CBT helps make sense of overwhelming problems by breaking these down into smaller parts and tackling them one by one.
Thoughts, feelings, behaviours and body sensations can interact together in a cycle. This can be in a positive, neutral or negative cycle and can be out of our awareness; a negative cycle can maintain problems. CBT aims to help break the negative cycle of unhelpful thoughts, feelings and behaviours by understanding the individual’s unique perspective of the problem and then incorporates practical skills and techniques to enable change for the better.
Here and now thinking and behaving is usually the main focus of CBT. However sometimes past experience can be very important, such as following a difficult or traumatic experience, and it may be necessary to talk this through in order for treatment to progress.
Treatment involves in-session work and home-practice. Continuing to use CBT techniques in our daily lives after treatment ends, can enable us to become our own therapist.
Does it really work?
CBT has a body of scientific researched evidence indicating it can alleviate symptoms of anxiety and depression. GPs often endorse CBT and it is the recommended treatment for anxiety disorders and depression by the government’s National Institute for Clinical Excellence (NICE). NICE provides independent, evidence-based guidelines to the NHS on the most effective ways to treat disease and ill health.
NICE recommends CBT in the treatment of the following conditions:
- anxiety disorders (including panic attacks and agoraphobia)
- obsessive compulsive disorder
- post-traumatic stress disorder
- social anxiety (extreme shyness)
- health anxiety (worrying about becoming seriously ill)
- generalised anxiety disorder (excessive worrying)
- specific phobias (including vomiting)
- depression (low mood)
There is also evidence that CBT is helpful in treating many other conditions, including:
- low self-esteem
- chronic fatigue
- physical symptoms without a medical diagnosis
- sleep difficulties
- anger management
How many sessions of CBT?
The number of CBT sessions required depends on the problem. Often this will be somewhere between 6 and 20 sessions, each lasting approximately 50 minutes.
Delivery of CBT
CBT is available in a wide range of settings including hospitals or clinics. It is sometimes provided in the form of written or computer-based packages (c-CBT). This may be combined with flexible telephone, Skype or face-to-face appointments to support learning and progress. This way of delivering CBT has made it more accessible to people with busy lives, and has also reduced delays in getting help.
CBT-based self-help books are available. There are also websites providing information on CBT techniques which are free to access. Evidence shows that using these works better with support from a therapist.
Third Wave CBT Therapies
CBT is a developing, broad model. Third wave CBT therapies represent new ideas such as Compassion Focused Therapy (CFT), Acceptance and Commitment Therapy (ACT) and Mindfulness. These are exciting therapies that have the potential to enrich CBT greatly.