Cognitive Behavioural Therapy (CBT)
There are many different strategies that counsellors and psychologists use to support their clients progress in therapy. CBT is one of many commonly used strategies.
There is lots of research around how helpful CBT is to support clients in their journey of healing and self-development. But for many clients, it is not always so well described or understood.
This blog aims to provide a clear understanding of this counselling strategy, to help you in understanding the the why, how and how long questions of CBT.
What does CBT Stand for?
CBT, or Cognitive Behavioural Therapy, is a fusion of theories around human behaviour which identify that thoughts and behaviours are interrelated to how we feel and how we approach our problems in our life.
The theory is that if we become aware of what we’re thinking in a situation, then we can become aware of how our thoughts are affecting our mood and our behaviour. The earlier forms of this theory were developed by Ellis and Beck in the 50’s and 60’s respectively.
The C part:
Cognitions, thoughts, have been found to really affect the way we perceive the world and how we interact. We can have thoughts about:
- Other people
- The world in general
This is known as the Cognitive Triad.
Thoughts can impact on a person’s belief system, identity and perception of their world. People can experience unhelpful thoughts, sometime referred to as automatic negative thoughts (ANTS), or thinking errors.
By becoming aware of what we’re thinking we can have a choice in either allowing that thought to impact on our beliefs or replacing the negative thoughts by finding a more helpful or realistic way of seeing our situation.
Some common thought distortions, or irrational beliefs that we aim to uncover in CBT therapy are:
- Personalisation – taking personal responsibility for things out of our control, or not our fault.
- Catastrophising or magnification – blowing things out of proportion, or building something up in our heads.
- Jumping to conclusions – assuming to know an outcome of a situation, before we have all the evidence.
- Mental filter – only paying attention to a certain part of a situation, eg all our flaws, rather than our successes.
- Labelling – assigning a label on ourselves or on others.
- Mind Reading – assuming we know what someone is thinking without asking them.
The B part:
The behaviour part acknowledges that our behaviour gives us clues about what’s happening in our life, the cause and affect. We act a certain way because, in theory we have learnt to do so.
How we behave is not always helpful, and this strategy provides us with understanding of what is motivating our behaviour, or hindering our behaviour. It also allows us to practice different ways of responding and learning new ways of approaching our situation.
Behavioural activation is an element of CBT which encourages a client to begin to do things that improve their mood. Examples of behavioural activation include, exercising, relaxation, working towards goals, studying, working, socialising etc.
The combination of both these parts, the C and the B, leads us to get a really clear understanding or the why of how we’re feeling. And it also helps us to improve our outcomes. Essentially this is summarised by the ABC model:
A – Activating event (what happened?)
B – Belief (our appraisals and assumptions)
C – Consequences (our emotional responses and behaviours)
What does CBT do?
CBT is a framework that your counsellor or psychologist will support you with as they take you through a journey of discovery. The first step is to identify the challenges, the issues, the things you want to change.
Then the next step is becoming aware of what thoughts and behaviours are stopping you from being able to make positive changes in your life.
Then there is an opportunity for you, with the help of your therapist, to reframe your issues and goals in CBT terms and develop strategies in how to make changes.
Research shows that CBT has been successful in improving outcomes for clients. The evidence base indicates that clients can:
- Think more clearly
- Reduce their felt level of distress
- Enhance their mood
- Improve their way of responding to circumstances
- Engage better with life, relationships and careers
- Reduce symptoms associated with low mood
- Enhanced their ability to rest
What issues can CBT treat?
Due to all the research done, CBT has been found to be helpful for several different issues including:
- Mood disorders such as depression
- Anxiety disorders including, GAD, OCD, phobias, PTSD, and panic disorders.
- Social difficulties, and relationship difficulties
- Anger management
- Some psychotic disorders depending on a person’s level of self-awareness
Alternatives to CBT
Some clients may not respond well to CBT. They may prefer different modalities of counselling. It is important to tell your counsellor or psychologist if you are not finding your treatment helpful, as they can alter their strategies, or refer you on to a more appropriate professional for you.
People are complex. The emphasis of our work is client focused. Your psychologist or counsellor will aim to truly understand your issues, and walk beside you. We may draw upon a wide range of other evidence-based approaches used in the profession:
- ACT – Acceptance and Commitment therapy
- Attachment Theory
- DBT – Dialectical behaviour therapy
- EFT – Emotionally Focused Therapy
- EFTC – Emotionally Focused Therapy for Couples
- EMDR – Eye Movement Desensitisation and Reprocessing
- Gestalt Therapy
- Gottman Family Therapy
- Internal Family Systems
- IPT – Interpersonal Psychotherapy
- Narrative Therapy
- Schema Therapy
- Somatic Therapy
- Systems Theory including Bowen Family Systems Theory
- Trauma-informed Therapy