Cognitive behavioural therapy

Our happiness is influenced by the way we think and behave. Cognitive Behavioural Therapy (CBT) improves our wellbeing by teaching us new ways to deal with everyday problems. Cognitive Behaviour Therapy aims to help people overcome a range of common mental wellbeing problems. CBT expert Antony Brown from VitalityHealth partner CBT Services explains how it works and who might benefit from it…

What is Cognitive Behavioural Therapy?

Cognitive Behaviour Therapy is a talking therapy recommended by the National Institute for Health and Care Excellence (NICE) for the treatment of a variety of mild to moderate mental wellbeing problems. Talking therapies are where the clinician has been trained to listen, attentively and sensitively, to help a person figure out what’s causing their problems and how to manage them. There are several different therapies and if you ever think you could benefit from some help, it’s important to understand which one might be right for you. NICE have an excellent set of guidelines to help people decide if CBT might be right for them.

Thinking and behaving

CBT sets out to change people’s thinking (the ‘cognitive’ part refers to the way we think) and their behaviour patterns, because both of these have such a big influence on how we feel. From the very first meeting, this will clearly be a partnership – this isn’t a one-way experience – with clinician and client working together to understand the root causes of the client’s problem, why that problem is persisting and what can be done to manage it. This collaboration allows the client to go away feeling confident that the issues they’re tackling are the ones at the heart of their troubles, and that they’re actively involved in changing their lives for the better. It’s a highly motivating approach.

Early life experiences

The first few meetings will probably focus on the client’s current anxieties, be they panic attacks, depression or other mental wellbeing issues. The therapist will suggest ways to tackle these, and the client should start to make progress. That often leads to a second phase of treatment, where together they delve into early life experiences to see how those thoughts and beliefs developed in the first place.

Time limited approach

CBT adopts a time-limited approach: it aims to complete the therapy in a fixed number of sessions. The clinician and client will agree from the outset what their goals are, then agree a timeframe within which to reach them. Skilled therapists will have a good idea, thanks to NICE guidelines and a wealth of clinical research, of what kind of timeframe is best suited to the different challenges their clients face. CBT is a practical way of treating mental wellbeing because the majority of therapy takes place between sessions, not in a room for one hour a week. At the end of the session, goals for the week ahead will be agreed and the client will go away to spend that time trying out these new ways of behaving and thinking. They’ll experiment with them, test them out, then come back and share with the therapist what they learned from their experiences.
To practise CBT, a therapist will usually have undertaken specific training and supervision over an extended period of time. The treatment pathways they’ll employ vary with the issues their client is facing: eating disorders, depression, obsessive compulsive disorder – these all have their own unique treatment methods and timeframes. People are complex and often have more than one problem to deal with, but the therapist will use their skill to work with the client to produce individual therapy plans.

Common problems

CBT is particularly useful for treating mild to moderate depression and anxiety. One in four people in the UK will experience problems with their mental wellbeing each year and these can often be brought on by common life events, such as the loss of a loved one, divorce, redundancy and so on. It’s when they start to have a significant impact on our social or occupational lives, or on our physical health – when they become persistent, not an occasional blip – that we should consider seeking help.

Effective outcomes

When we examine Cognitive Behaviour Therapy, we’re looking at a treatment that’s based on scientific evidence: more research has been carried out on CBT than on any other talking therapy, and it’s been proven to have effective outcomes with a wide variety of issues. This massive body of research, conducted over the course of many years, is one of the key reasons why NICE recommends CBT. One of the key factors in CBT’s success is that the client learns new skills and tries them out, then is helped to refine them until they work effectively. Clients will gain confidence as they watch their thought processes and feelings changing; until finally, when the sessions are done, it’s as if they became their own therapist. This gives them a good chance not just of overcoming their current problems but of becoming more resilient in the future, to prevent them needing to come back for more sessions.

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