Cognitive behavioural therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior and emotions.
Cognitive behavioral therapy focuses on changing the automatic negative thoughts that can contribute to and worsen emotional difficulties, depression, and anxiety. These spontaneous negative thoughts have a detrimental influence on mood.
Through CBT, these thoughts are identified, challenged, and replaced with more objective, realistic thoughts. It’s most commonly used to treat anxiety and depression, but can help a broad range of both mental and physical health problems.
CBT encompasses a range of techniques and approaches that address thoughts, emotions, and behaviors. These can range from structured psychotherapies to self-help materials. There are a number of specific types of therapeutic approaches that involve CBT.
What Exactly Can CBT Be Used For
- anxiety disorders such as social phobia, obsessive-compulsive disorder or post-traumatic stress disorder
- low self-esteem
- Relationship issues
- irrational fears
- substance misuse, such as smoking, drinking or other drug use
- problem gambling
- eating disorders
- marriage or relationship problems
- certain emotional or behavioural problems in children or teenagers.
The Vicious Circle
CBT aims to break the vicious circle of self doubt, or even to the depths of self hate. CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:
- A Situation – a problem, event or difficult situation. From this can follow:
- Physical feelings
Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally.
Someone ignores you in the street
When you are feeling down and in the vicious circle of self doubt the slide downwards begins. They don’t like me, feeling sad, feeling sick, dizzy, drained, lonely and vow to never speak to them again
Changed mindset through CBT therapy. Oh I hope they are ok , I wonder if something is bothering them. I feel good but why are they sad. I need to give them a ring later to find out if they are ok.
This ‘vicious circle’ can make you feel worse. It can even create new situations that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.
Stopping Negative Thought Cycles
There are helpful and unhelpful ways of reacting to a situation. Some thoughts, feelings, physical sensations and actions can trap you in a negative cycle and even create new situations that make you feel worse about yourself. This can make you feel hopeless, lonely, depressed and tired. You may become trapped in a negative cycle, sitting at home alone and feeling bad about yourself.
CBT aims to stop negative cycles such as these by breaking down the things that make you feel bad, anxious or scared. By making your problems more manageable, CBT can help you change your negative thought patterns and improve the way you feel.
What Happens In The Treatment
The details of treatment will vary according to the person’s problem. However, CBT typically includes the following:
- assessment – this may include filling out questionnaires to help you describe your particular problem and pinpoint distressing symptoms. You will be asked to complete forms from time to time so that you and your therapist can plot your progress and identify problems or symptoms that need extra attention
- personal education – your therapist provides written materials (such as brochures or books) to help you learn more about your particular problem. The saying ‘knowledge is power’ is a cornerstone of CBT. A good understanding of your particular psychological problem will help you to dismiss unfounded fears, which will help to ease your anxiety and other negative feelings
- goal setting – your therapist helps you to draw up a list of goals you wish to achieve from therapy (for example, you may want to overcome your shyness in social settings). You and your therapist work out practical strategies to help fulfil these goals
- practise of strategies – you practise your new strategies with the therapist. For example, you may role-play difficult social situations or realistic self-talk (how you talk to yourself in your head) to replace unhealthy or negative self-talk
- homework – you will be expected to actively participate in your own therapy. You are encouraged to use the practical strategies you have practised during the course of your daily life and report the results to the therapist. For example, the therapist may ask you to keep a diary.
How Long Before The Cognitive Behavioural Therapy Will Work
Every situation and individual are unique so timescales are difficult to judge. However CBT usually lasts between 5 and 20 weeks, with one session each week. In your first few sessions, you and your therapist will likely talk about how long therapy might last.
That being said, it’ll take some time before you see results. If you don’t feel better after a few sessions, you might worry therapy isn’t working. But give it time, and keep doing your homework and practicing your skills between sessions.
Undoing deep-set patterns is major work, so go easy on yourself.
What Techniques Are Used in CBT
- SMART goals. SMART goals are specific, measurable, achievable, realistic, and time-limited.
- Guided discovery and questioning. By questioning the assumptions you have about yourself or your current situation, your therapist can help you learn to challenge these and consider different viewpoints.
- Journaling. You might be asked to jot down negative beliefs that come up during the week and the positive ones you can replace them with.
- Self-talk. Your therapist may ask what you tell yourself about a certain situation or experience and challenge you to replace negative or critical self-talk with compassionate, constructive self-talk.
- Cognitive restructuring. This involves looking at any cognitive distortions affecting your thoughts — such as black-and-white thinking, jumping to conclusions, or catastrophizing— and beginning to unravel them.
- Thought recording. In this technique, you’ll come up with unbiased evidence supporting your negative belief and evidence against it. Then, you’ll use this evidence to develop a more realistic thought.
- Positive activities. Scheduling a rewarding activity each day can help increase overall positivity and improve your mood. Some examples might be buying yourself fresh flowers or fruit, watching your favorite movie, or taking a picnic lunch to the park.
- Situation exposure. This involves listing situations or things that cause distress, in order of the level of distress they cause, and slowly exposing yourself to these things until they lead to fewer negative feelings. Systematic desensitization is a similar technique where you’ll learn relaxation techniques to help you cope with your feelings in a difficult situation.
Who provides CBT?
Counsellors, psychologists and therapists can all provide CBT, either in one-on-one therapy sessions, small groups or online. People are trained to look logically at the evidence for their negative thoughts, and to adjust the way they view the world around them. Cognitive behavioural therapy Oxford have many well trained CBT therapist.