What is CBT and will it help me?
Cognitive Behavioural Therapy (often referred to as CBT) is a style of talking therapy that helps us to understand the close links between our thoughts, feelings and behaviours.
CBT can help a variety of conditions and is recommended by the National Institute for Health and Care Excellence (NICE) for treating a range of anxiety and depressive disorders.
CBT starts with a thorough assessment to understand what your current difficulties are and what you’d like to focus on during treatment. The next stage is typically referred to as ‘formulation’ - this essentially maps out how the difficulties started and what keeps them going. We come back to the formulation throughout treatment to understand what we’re going to change and explore the impact this might have.
The next part is treatment - this part is very much dependent on what you’re presenting with and want to focus on. Each condition has a set protocol which outlines different interventions that can be used which are all evidence based - essentially meaning that they’re tried and tested and relevant to the condition that’s being treated. There are so many different interventions that are brought into treatment and this is the part that offers lots of opportunities to tailor the treatment to what you need. CBT is designed to support you to become your own therapist, so when learning the interventions, it’s important to feel confident in being able to apply them both now and in the future.
As treatment comes to an end, it’s often helpful to put together a summary of what you’ve learnt from the CBT, and any specific interventions that were particularly useful. We often refer to this stage as the ‘Therapy Blueprint’ or ‘Relapse Prevention’. This stage also involves putting together an action plan to maintain the progress you’ve made during treatment, but it also outlines what to do in the event of a setback and how to notice this as soon as possible.
CBT can feel like a daunting process to start, but please be assured that the treatment is taken at your own pace. It will naturally involve pushing yourself out of your comfort zone, but it’s always done with the intention of working towards the goals you’d like to achieve. As therapists, we would never expect you to do anything we wouldn’t be willing to do ourselves and our training involved us practising the interventions in our own lives. We appreciate how challenging (and rewarding of course) CBT treatment can be, and are happy to look at other ways we can get learning from doing something.
We do work in the sessions together, but CBT does also involve some work outside of the sessions. You can probably tell that this sounds a lot like homework - which it is to be honest. However, it’s generally done to consolidate on the techniques we’ve covered in the session and doesn’t always have to involve writing things down. And unlike homework from our school days, it’s certainly not marked and graded - although we will discuss it in the following session and reflect on any learning we can take from the work that was completed.
There’s lots of things that can influence how you find CBT. One of the biggest factors is the therapeutic relationship you have with your therapist. It’s really important you feel able to share any difficulties or challenges you’re having with the CBT itself or the symptoms you’re experiencing. There’s lots of things to look for in a therapist and it can take a little while to get into the treatment, but if you feel there are difficulties or potential issues you want to discuss, please don’t feel like you can’t discuss this with your therapist. Sometimes it can be subtle changes in how we deliver the CBT that can make the world of difference, or it might be that it’s worth exploring other styles of talking therapy or even a different therapist. Regardless of who you work with in therapy, the sessions should offer a supportive, trusting and respectful environment that’s free from judgement. People bring lots of different things to therapy and you should never be made to feel embarrassed for whatever you’re experiencing.
It can be hard to know if CBT is the right approach for you until you try it. People’s experiences of it can vary greatly depending on so many things that we don’t always have control over. My recommendations would be to be open and honest about what you’d like to get from the therapy and any concerns you have. It’s normal to feel apprehensive when you start treatment, because at the end of the day you’re opening up to a stranger about topics that might be very sensitive or difficult to discuss.
CBT sessions will offer structure but should also be set up in a way that there’s time to reflect on learning and draw your own conclusions to work out how best to manage the situation moving forward.
It’s also important to mention that CBT is available on the NHS - you can either refer through your GP or you can often refer yourself online or by calling the admin team for the talking therapies service in your area. In 2023, NHS England requested that all services offering talking therapies in a primary care setting change their name to NHS Talking Therapies for Anxiety and Depression to make it clearer to people what the service is. There might be occasions where people refer to it as it’s old name - Improving Access to Psychological Therapies (IAPT). Rest assured that this is likely just force of habit and that any online links have been updated to ensure that the referral is still directed to the right organisation.
More information, as well as a link to search for services in your area can be found here: NHS talking therapies for anxiety and depression - NHS (www.nhs.uk)
