Oxford Online defines Cognitive Behavioural Therapy as:

“a type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behaviour patterns or treat mood disorders such as depression.”

It is one of the most commonly used modalities a therapist might utilise when working with you to change dysfunctional thoughts and maladaptive behaviours in order to improve your quality of life.

CBT is a practical, active therapy that requires participation from you during therapy sessions, and involves practice between sessions for best results.

Cognitive Behaviour Therapy is not designed to address the underlying causes of unproductive thinking and behaviour, but rather to change the way you approach your own thoughts, feelings, and behaviour in the present.

 

Principles of CBT

Cognitive Behaviour Therapy was first developed in the 1960’s by Aaron Beck, based on work started by John Watson in 1913.

Beck believed psychological problems are the result of cognitive distortions, or unfounded beliefs, that prevent you from properly processing life events. Over the years a list of cognitive distortions has been developed, including:

Personalisation

Ruminating

Polarisation

Overgeneralisation

Jumping to Conclusions

Catastrophising

Blaming

Global Labelling

Should’s

 

Albert Ellis went on to create the ABC Technique of Irrational Beliefs, which underpins much of today’s CBT work.

1. Activating Event – something which leads to an emotional response or negative dysfunctional thinking
2. Beliefs – negative thoughts and misinterpretation that occur around that event
3. Consequences – negative feelings and behaviours that occur as a result of these beliefs

 

CBT aims to change the beliefs around the activating event in order to allow more productive and healthy feelings and behaviours.

 

What Can CBT Be Used For?

CBT is an evidence-based therapy that has been in use in counselling and therapy for many years, and is often used in combination with other modalities. It is effective when working with a wide range of issues, including:

Managing strong emotions – such as anger, grief and loss, fears, sadness

Conflict Resolution – including assertiveness training and improving communication skills

Mental Health Disorders – such as bipolar, depression, PTSD, OCD, anxiety, eating disorders, phobias, anger and stress management, substance abuse, gambling addictions

Physical Conditions – such as chronic pain, migraines, chronic fatigue syndrome and insomnia and other health problems.

Anti-depressant medication may sometimes be prescribed as needed and in consultation with your GP, as it is effective when targeting brain chemistry that impacts mood.

Some other modalities or techniques that may be combined with CBT include ACT, MBCT, REBT, DBT, or MI.

 

How Do CBT Sessions Work?

Cognitive Behaviour Therapy is often short-term, and goal focussed. It is a proven and effective treatment as well as a practical, interactive type of therapy, so your sessions will require some active involvement from you.

In your first session your therapist will discuss with you the behaviours which are most troubling to you, and together you will agree a course of action. This will include formulating a plan and setting specific goals, and identifying how many sessions you will likely need to attend. You and your therapist will then work collaboratively to:

1. Identify what your automatic thoughts, emotions and beliefs are related to the situation that is troubling you.
2. Identify which of these automatic thoughts, emotions, and beliefs attached to this situation are inaccurate or unhelpful.
3. Find ways to challenge these unproductive thoughts, emotions, and beliefs through a range of CBT techniques.
4. Identify what unproductive or unhealthy behaviours have resulted from these automatic pessimistic or inaccurate thoughts, emotions, and beliefs.
5. Replace the automatic unproductive thoughts and behaviours with more productive and healthy ways to think and behave.

Once you have worked through this process and learned the skills of Cognitive Behaviour Therapy you will be able to apply it to other areas of concern in your life, or in future circumstances.

 

Techniques

CBT encompasses a range of techniques which may be used, depending on the specific concerns of the person in therapy. Some techniques your therapist might use in CBT include:

• Journaling and thought records – to keep track of the automatic thoughts in order to help you identify any cognitive distortions
• Cognitive Reframing, Rescripting and Restructuring – to examine and describe the unhelpful emotions and thought patterns and determine more productive and beneficial responses
• Activity Scheduling or Behavioural Activation – planning activity scheduling can assist you in establishing healthy habits and provide the opportunity to put the strategies discussed in counselling into practice
• Exposure Therapy – involves strictly managed interaction with what it is you fear, and is used in treating OCD and phobias
• Worst/Best/Most Likely Case Scenario – used to prove or disprove thoughts and expectations and provide actionable steps to control unhelpful behaviour.
• Mindfulness – providing focus and calm, which helps you identify and alter automatic unhelpful thoughts.

 

How Long Will CBT Take?

This is entirely dependent upon the severity of your concerns and your willingness to actively participate.

The more work you do outside the therapy office on your thoughts, emotions, and beliefs between sessions, the sooner you will start to see results.

Generally, a counsellor or therapist will want to see you weekly, and sessions may last anywhere from around three to six months.

 

When Should CBT Not Be Used?

Since CBT requires active participation, it is generally not recommended for highly complex mental health disorders, or when there are learning difficulties.

It can also be confronting as it requires you to face your emotions and anxieties, which can lead to a short-term increase in depression and anxiety. In these cases CBT can be used in conjunction with supportive counselling to ensure you are not adversely affected.

Because it is based on you addressing your own thoughts, emotions, and beliefs, CBT does not address the environment. Family, friends and workplaces can have a significant impact on mental health. If the environment, or the people in it, are dysfunctional CBT can only assist in you in your response to these external factors.

 

The most important thing to remember with Cognitive Behaviour Therapy is that the more you practice the techniques your therapist shares with you, the better you will become at managing those unhelpful thinking patterns which lead to counterproductive behaviours. And once you know how, you can apply the techniques to any and all situations in the future.

 

If you feel you would like to explore Cognitive Behaviour Therapy and how it might assist you in leading a happier and more productive life, please give me a call on 0490 697 289, or contact me here.