Cognitive Behavioural Therapy (CBT)

What is CBT? Cognitive Behavioural Therapy is a talking therapy that can help to manage your problems by changing the way you think and behave.   CBT treatment is rooted in behavioural (Lewinsohn et al, 1969) and cognitive approach (Beck, 1967). There is a significant evidence that CBT is very successful for anxiety disorders and depression. Also, it can be used for panic disorder, phobias (e.g agoraphobias and social phobia), ADHD, PTSD, conduct disorder, drug misuse, eating disorders, personality disorders, schizophrenia etc. (Eysenck, 2009; Carr, 2012)

Behavioural Component Abnormal behaviour is learned (similarly as normal behaviour) - conditioning and cognitive learning (Carr, A., 2012). It can be applied for different for different mental disorders. For example: Anxiety Psychoeducation about anxiety disorder Exposure based treatment Relaxation skills are learned. Also clients are encouraged to feel maximum anxiety. (Stampfl and Levis,1968 cite in Carr, A., 2012) Depression Behaviour activation (BA) can help clients become active and engaged in their lives to reduce depression and help to prevent future episodes BA therapists help depressed clients to increase activities that bring greater reward (reinforcement) and to solve important problems Clients are assisted in approaching important life goals and engaging with the problematic aspects of their lives Dimidjian et al. (2008)

Cognitive Component The idea of the cognitive approach is that individuals suffering from mental disorders have distorted and irrational thoughts and beliefs (this need to be changed). Depressed patients typically have negative thoughts about themselves, about the world and about the future (unrealistic). Anxious clients overestimate the threatening of certain external or internal stimuli (e.g. spider phobics). Exposure therapy is used to void safety-seeking behaviours. (Eysenck, 2009)

Schema therapy Developed to deal with the deeper psychological structures that predispose patients psychological problems. When patients manage to understand their own: schemas and schema modes their developmental origins the way they are triggered reinforced and maintained they attain the necessary psychological tools to make the necessary cognitive, interpersonal, and behavioural changes necessary to minimize further episodes. (Young et al., 2006) It has been developed to deal with the deeper psychological structures that predispose patients psychological problems.

Types of CBT CBT can be carried out in several different forms, including: individual therapy – one-to-one sessions with a therapist group therapy – with others who wish to tackle a similar problem a self-help book – where you carry out exercises from the book a computer program – known as computerised CBT (CCBT) (NHS, 2015)

Advantages of CBT Can be as effective as medication in treating some mental health disorders and may be helpful in cases where medication alone has not worked. Can be completed in a relatively short period of time compared to other talking therapies. The highly structured nature of CBT means it can be provided in different formats Skills learned in CBT are useful, practical and helpful strategies that can be incorporated into everyday life to help coping better with future stresses and difficulties, even after the treatment has finished. NHS Choice (2015)

Disadvantages of CBT To be effective, you need to commit yourself to the process on your own when the therapist is not present Could be time consuming to attend CBT sessions and carry extra work between session It may not be suitable for people with more complex mental health needs or learning difficulties. As CBT can involve confronting your emotions and anxieties Only addresses current problems and focuses on specific issues, it does not address the possible underlying causes, such as an unhappy childhood. CBT focuses on the individual’s capacity to change themselves, but does not address wider problems in systems or families that often have an impact on an individual’s health and wellbeing. NHS Choice (2015) To be effective, you need to commit yourself to the process on you own when the therapist is not present Could be time consuming to attend CBT sessions and carry extra work between session Due to the structured nature of CBT, it may not be suitable for people with more complex mental health needs or learning difficulties. As CBT can involve confronting your emotions and anxieties, you may experience initial periods where you are more anxious or emotionally uncomfortable. CBT focuses on the individual’s capacity to change themselves (their thoughts, feelings and behaviours), and does not address wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing.