CBT can be used on different levels of “depth” depending on who is using it and the problem for which it is being used. Essentially it is a way of understanding how a problem works and the ways in which this problem is maintained, thus enabling us to work out ways of working with the problem.
How can CBT help?
As the name suggests, cognitive behavioural therapy is about looking at the way in which our thoughts contribute to our distress and the decisions we then make in order to manage this distress. Often these decisions are helpful, but sometimes these decisions can lead us to avoid situations or overcompensate by doing too much of something, which can lead to more problems in the long run.
By understanding how your thoughts, feelings and behaviours interact with each other we are able to start to draw up a plan in order to address problems. This would usually involve understanding your thought processes and working with these. A CBT practitioner is also interested in supporting you to begin making changes in the way you do things to see whether other ways of doing things might be better for you. Sometimes this can be uncomfortable at first, as most change takes us out of our comfort zone, but the rewards can be great if it means leading a fuller and happier life again (or sometimes for the first time). The idea is that if we address the thoughts and behaviours involved in our problem, or problems, and make some sensible and constructive changes which fit in with our personal values and goals, then we will notice an improvement in our mood.
Does CBT address the past?
There is a misconception that CBT practitioners are not interested in their clients’ past, and indeed some people hope that CBT will not be concerned about the past. There may well be times when it is not necessary to talk about your past in if you are having CBT, but all good psychotherapists of all modalities will be interested in sharing with you an understanding of your past experiences in order to understand how your problems developed and to have a sense of you as a person rather than a set of problems! While we do not wish to be voyeuristic or too nosy about your privacy, sharing the relevant aspects of your history with a therapist helps to build up a therapeutic relationship and helps to avoid unpredictable issues coming up during the therapy. Also, it is helpful to understand how your past experiences may have contributed to how you are feeling, which can help us to take a kinder view of ourselves. Some people have a clear understanding of how their past experiences contribute to their problems, and others do not. People who do not would not know which of their experiences are relevant, or not. The therapist might invite you to talk about aspects of your life (e.g. family life, whether you have been through any traumas) in order to tease out with you what might be relevant.
What is the link between our past experiences and our present problems? For a CBT practitioner, a large part of the answer lies in what we call our core beliefs. These are broad statements we hold about ourselves which are like a source for our day to day thoughts. For instance, someone who believes they are fundamentally a failure might typically think that nothing they try to do is good enough. This could lead to anxiety at the prospect of someone being critical, or depression due to never having a sense of doing anything well. It could lead to anxiety and depression. The decision might then be to over-compensate, e.g. by trying to do everything perfectly which is exhausting and impossible, or avoiding doing things in order to avoid failure which leads to lack of achievement and fulfilment.
With what we might consider to be a fairly simple problem, you may not need to consider your core beliefs, and indeed they may be mostly helpful to you. However, for many people it is useful to understand the underlying core beliefs which are present, and if possible why these have developed in the first place. In doing so we can try to develop beliefs which are going to be more in your favour and plan things to do which challenge the core beliefs which are working against you.
Is Mindfulness part of CBT?
Mindfulness has been adopted by psychologists and therapists from the Buddist tradition. It can form a part of CBT, although not all CBT practitioners are trained to use it. It is particularly helpful with learning acceptance, being in the present and seeing our thoughts as being mental events rather than truths. It can be used as part of individual therapy or taught in a class.
Is CBT a short-term therapy?
CBT is often recommended by NICE guidelines (National Institute of Clinical Excellence) for the treatment of anxiety and depression, and many insurance companies and NHS services offer it as a therapy of choice. This is slowly changing in the NHS. CBT is indeed often very helpful for anxiety and depression, and has the advantage that it can be relatively short term. Having said that, some people do need to come for a longer time, and you should not see it as a failing if you come back for a few more sessions every now and then. Just as with many other challenges in our lives, we may sometimes need a little more help than we might have hoped.
CBT or another approach?
While cognitive behavioural therapy is effective for many people with anxiety and depression, we in Therapy Works aim to promote good practice in psychotherapy, rather than promoting a particular type of psychotherapy. Equally, cognitive behavioural therapy can be useful for a range of problems other than depression and anxiety. Whether the approach suits you as a person can be more important than the problem for which the problem is being used. What is most important is that your therapist can understand your problems with you, and has the knowledge and experience to work through these with you. As with all good psychotherapy, this requires a good working relationship between client and therapist.
How do I know if a CBT Practitioner is Properly Qualified?
Many therapists who are not properly qualified in CBT are saying that they offer it. This is because in recent years it has become popular with health providers. Please check the wording on websites and flyers carefully as anyone can say that they do CBT. Therapists who are accredited with the BABCP have been through a stringent vetting process which involves references from supervisors and evidence of ongoing supervision and professional development in order to ensure that best practice guidelines are adhered to. If you have any doubts about the credentials of a cognitive behavioural therapist we recommend that you cross-reference with the BABCP under the “find a therapist” link.