COGNITIVE BEHAVIOURAL THERAPY
WHAT IS CBT?
CBT AND DEPRESSION
WHY IS EVERYONE TALKING ABOUT CBT?
CBT AND SELF HELP
DOES CBT WORK?
HOW DO I USE CBT?
WHAT IS CBT?
CBT is based on the idea that an individual's thoughts influence how they feel and what they do. Sometimes these thoughts can be positive and helpful, but at other times they can be unhelpful and lead to problems.In CBT therapy clients are taught skills to help them understand their thinking patterns and change them where appropriate. Homework, such as Diary Sheets and Thought Records, may be used to help you understand how your thoughts affect your mood and what you can do about it. The therapist is likely to fill in forms/charts with you in the sessions as well as the two of you talking.
CBT therapy is generally very structured, but a good therapist will tailor their approach to the client's needs. You should not feel as though you are being made to fit in with their forms, but rather that the therapist is selecting the tools that will be most helpful to you.
Some people love the idea of being taught skills and having everything explained to them. Others seem to instinctively react against such an approach, finding it too cold and de-humanising.
CBT AND DEPRESSION
CBT therapists believe that although your thoughts may not necessarily cause depression, they may help to maintain it. Therefore helping you to change your way of thinking may help you to overcome depression.WHY IS EVERYONE TALKING ABOUT CBT?
CBT has grown out of a scientific approach (cognitive therapy and behavioural therapy) and as a result of this a lot of studies have been carried out on its effectiveness. These studies have generally shown that CBT is at least as effective as anti-depressants for mild to moderate depression. The government is therefore investing in CBT as an effective and low cost way to address the rise in depression.Most other forms of therapy have not been the subject of as many scientific studies. This is largely due to historic factors, as therapists are not usually scientists. Therapists have tended to look at case studies rather than large trials in order to learn what works and what doesn't. Case studies can be very useful, but they do not fit easily into the NHS' approach to medicine. The medical world and government departments like approaches that are easy to measure both in terms of effectiveness and cost. Other therapies may be just as effective as CBT, but at the moment they lack the statistically based studies to prove this.
One recent study suggested that it is not the type of therapy (CBT, psychoanalytic, gestalt, etc.) that really matters when considering effectiveness. The most important thing is actually the relationship between the client and the therapist. A good therapist who can build rapport with their client is likely to be effective irrespective of the type of therapy they practice. Many therapists feel that the government's current emphasis on CBT is misguided and that in the longer term other approaches to therapy will be shown to be equally effective.
CBT AND SELF HELP
The CBT approach lends itself to self help in a way that other therapies do not. There are now books, manuals and computer programmes that will help you to apply CBT to your own life. This can be helpful for some people with relatively mild problems; however it cuts out the relationship with the therapist, which many see as key to healing.DOES CBT WORK?
There is evidence to show that CBT does work for many people. However, it does not work for everyone. The same can be said for other forms of therapy and for antidepressants. In fact in the area of mental health it is rare to find a 'cure' that works for all, human beings are just too varied and complex for that.It may also be that the 6 sessions generally available on the NHS will not be enough for everyone. The government's plan of providing a brief course of CBT for everyone who needs it is a noble one, but it would be naive to think that it is going to solve all our problems.
HOW DO I USE CBT?
My core training is in Gestalt therapy and not in CBT. Gestalt therapy forms the basis of how I work, but the gestalt approach encourages experiment and that allows me to make use of certain CBT tools. My use of CBT is based on reading and attending workshops. I do not use CBT tools with all my clients, but when I feel it is appropriate for the individual and the client is agreeable then I will introduce CBT ideas and set homework.My own view is that our thoughts can indeed have an impact on our feelings and actions, but that the interaction between thoughts and feelings can be quite complex. For someone who has little knowledge of psychology quite simple ideas about challenging their own thoughts and assumptions can have a profound effect. For someone in this situation with relatively mild problems this approach can be very effective. However, there are times in our life when trying to change our thoughts is not enough and can be counterproductive. It is sometimes natural for us to feel unhappy or sad, for instance if someone close to us has died, or we have discovered that we have a severe illness. At times such as these trying to force ourselves to be happy is counterproductive, we need to go through a 'healing cycle' of emotion and this can't be rushed.
There are other times when we may be having perfectly happy thoughts and then suddenly feel overwhelmed with sadness. This sadness comes from deep inside and overrides the surface happy thoughts. It may be that subconscious thoughts have caused the sadness to emerge at that time, but for most of us the experience is of the emotions coming from nowhere. At such times we need to stop and pay attention to how we feel and allow the emotions to flow. Think of the emotion as a wave, you can't stop the wave; you have to allow it to pass.
In using CBT tools it is important not to see emotions as the enemy. Our emotions are there for a reason, they have something to tell us. At the same time by examining our thought processes and challenging our beliefs and assumptions we can help ourselves to get rid of any that may be causing us unnecessary pain and distress.
Click here to read the Department of Health's Report on psychological therapies and counselling.
