What is cognitive behavioural therapy?
Cognitive behavioural therapy – also known as CBT – combines two different approaches for a practical and solution-focused therapy. The therapy is very active by nature and requires you to take a proactive role within the treatment, this includes carrying out homework assignments outside of your sessions.
The premise behind CBT is that our thoughts and behaviours have an effect on each other, and by changing the way we think and behave – we can ultimately change the way we feel about life. The therapy examines learnt behaviours and negative thought patterns with the view of altering them in a positive way.
Unlike some other therapies, CBT is rooted in the present and looks ahead to the future. While past events and experiences are considered during the therapy, the focus is more on current issues and dilemmas. The therapy takes its cue from two different psychological approaches:
1. Cognitive approach
Cognitive processes refer to our thoughts – including ideas, beliefs and attitudes. The cognitive element of CBT looks at the way our thoughts can trigger or fuel certain feelings and behaviours. Within CBT your therapist will help you understand any negative thought patterns you may have, how they affect you and, more importantly, what you can do to change them.
2. Behavioural approach
Behavioural therapy notes that behaviour is often learned and can therefore be unlearned. It looks at harmful or maladaptive behaviours and helps you to understand why they occur and what you can do to alter them.
CBT looks at how both cognitive and behavioural processes affect one another, and aims to help you get out of negative cycles. The emphasis on behavioural or cognitive approaches will depend on the nature of the issue you are facing – for example, if you are suffering from depression or anxiety, the emphasis may be more so on the cognitive approach, whereas if you have a condition that causes unhelpful behaviour (such as obsessive compulsive disorder), the emphasis is likely to be on the behavioural approach.
What happens in a CBT session?
Cognitive behavioural therapy can be provided on a one-to-one basis or as part of group therapy. Whichever format you choose, the relationship you’ll have with your therapist should be a collaborative one. This means that you will take an active involvement in the therapy and will have a say in the way your sessions progress. Issues will be discussed in confidence and without judgement to help you view them in a more pragmatic light.
The therapy itself tends to last somewhere between six weeks and six months, depending on the nature of the concern being explored. Usually you will attend one session a week, with each session lasting around 50 minutes to an hour. At the start of your therapy you will meet your therapist and discuss what has brought you to therapy. At this point you will have the opportunity to outline what you would like to gain from CBT and set yourself some goals.
Together with your therapist you will then work on the content and structure of your sessions. Your therapist may set you certain tasks to do as homework and you will be able to talk about how you found these tasks during your weekly session. As your therapy progresses you will take a more prominent role in the sessions in terms of content and structure. The idea is that by the end of your course of treatment, you should feel able to carry on the work alone.
Who could benefit from CBT?
This type of therapy is particularly helpful for those with specific issues as it is very practical (rather than insight-based) and looks at solutions. For this reason the therapy works well for those who:
• suffer from depression and/or anxiety
• have an eating disorder
• suffer from post-traumatic stress disorder (PTSD)
• have an addiction
• want to change their behaviour
• have anger issues
• suffer from insomnia
• have a phobia
• suffer from obsessive-compulsive behaviour.
In some cases CBT is used for those with long-standing health problems such as chronic pain or irritable bowel syndrome (IBS). While the therapy cannot cure such physical ailments, it can help people cope emotionally with their condition and lower stress levels. There is also up and coming interest in the use of CBT alongside medication to help those who suffer from hallucinations and delusions.
How does CBT work?
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 lead to you feeling lonely, depressed and low on 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 alone and unhappy.