Cognitive: ‘connected with thinking or conscious mental processes’ (Cambridge Dictionary)
Behavioural: ‘relating to behaviour’ (Cambridge Dictionary)
Therapy: ‘ a treatment that helps someone feel better, grow stronger etc. Especially after an illness‘ (Cambridge Dictionary)
Cognitive Behavioural Therapy or CBT is usually classed as a ‘talking therapy’ whose aim is to help you understand that your thoughts and actions can affect your mood and how you feel. CBT then is used to change the negative or maladaptive thoughts or to change the way you react to those thoughts.
Basic stages of CBT assessment;
- Identify a behaviour,
- Does the behaviour show as an excess or deficit?
- Identify the frequency, duration and intensity of the behaviour.
- If an excess, aim to decrease the duration or intensity
- If a deficit, aim to increase frequency, duration and intensity
Using these stages it can be seen how rather than diagnosing to find an illness or disease, CBT concentrates on viewing the whole and then deciding what can be changed.
How it Works
The aim as we have seen is to identify how negative thoughts or negative reactions to a stimulus are affecting how we feel or behave. Many of these negative points have become automatic over time and seen by us as being true. For example, if crowded places make you feel anxious (social anxiety), over time your mind sees any crowded place as a stimulus to be anxious. Leading quite often to avoidance of any situation that may trigger your social anxiety.
CBT will help focus on the thought process leading to the social anxiety.
What is it about large crowds that you find stressful?
- Is it a feeling of claustrophobia?
- Not being able to escape?
- Not feeling confident in yourself?
- Feeling people are looking at and/or judging you?
- Did something happen to you in a crowd once?
- Being in proximity to others?
This can be a very difficult stage of introspection, but finding the answers to these questions often leads to self discovery. With the answers it is possible to challenge the thought processes and their outcomes.
The next stage focuses on learning new skills and goal setting that can be used in real world situations. These will be small steps and will be a gradual process. The first stage might include just imagining a crowded place or viewing pictures/videos of crowds. Next might involve being in small groups of family or friends. Breaking the stages down like this aims to ease the pressure and make goals more achievable, building confidence and reinforcing the learning. Each goal also gives an opportunity to assess the success of each stage and provides options for changing if necessary.
It is important to note that to be successful CBT requires you to be prepared to spend time self-analyzing your own thoughts and feelings. This can be difficult but is really useful in identifying how our thoughts and beliefs can affect our well being and behaviour.
What Conditions can it be Used For?
There are many conditions that respond really well to CBT, including (but not limited to);
- eating disorders
- panic attacks
- obsessive compulsive disorder
- post-traumatic stress disorder
- sleep problems
Ways it May be Delivered
In general there are four main ways in which CBT can be delivered.
- Individually – this is usually one-to-one with a therapist and can be delivered face-to-face, by phone or video link.
- Group – as above but in a small group of people in the same situation as yourself.
- Self-help book – workbook tasks to take through each stage.
- Computer – usually on line based sessions.
Please be sure if you are using a therapist that they are a trained healthcare professional.
Using CBT from a Self-Help Book
Many of the self-help books available are either based on or include some CBT techniques. This is because the process lends itself to self guided tasks and is a proven technique. The techniques are able to be carried out very effectively at home and the small steps and goal setting provides plenty of opportunity to assess your progress. The process is completely anonymous and is not pressured, you are able to fit into your day when ever best suits you.
Just arranging and attending an appointment with a therapist can be stressful, plus getting to the appointment can put you in a situation that triggers negative thoughts or behaviors. Be sure that the book is written by a professional, with good reviews and recommendations and is written in a style you find comfortable. I will be reviewing and recommending my top 5 self guided CBT books in a future blog.
- CBT has been found to be as effective as medication in treating some disorders and also in cases where medication has not been successful.
- Relatively speaking CBT can demonstrate results in a short time in comparison with some other therapies.
- Available in several ‘formats’ as described earlier
- Skills learnt during CBT are transferable to other areas of your life.
- With the different ‘formats’ it can be applied for minimal cost.
- Commitment and action is needed from you. This is the only way in which CBT will be successful.
- Sometimes the introspection stage where you face your anxieties and emotions can be a scary scenario and make you feel uncomfortable.
- The therapy focuses on changing your thoughts and behaviours but cannot change your circumstances e.g. where you live, your family situation etc.
- Relying on you to make the changes may make this unsuitable for those with complex mental health needs.
Thank you for taking the time to read my short piece on Cognitive Behavioural Therapy. Hopefully you found it useful. Please contact me with your thoughts and own experiences. If I can answer any questions I will be happy to do my best to answer them.