- How you think about yourself, the world and other people
- How what you do affects your thoughts and feelings.
CBT can help you to change how you think ("Cognitive") and what you do ("Behaviour)". These changes can help you feel better. Unlike some other talking treatments, CBT focuses primarily on "here and now" problems and difficulties instead of the root causes of your distress. CBT looks for ways to improve your state of mind right now.
- Anxiety
- Addiction
- Benzodiazepine Withdrawal
- Depression
- Eating Disorders
- Family Difficulty
- Fears/Phobias
- Interpersonal Difficulties
- Loss/Bereavement
- Marital Counseling
- Pain Management
- Panic Disorder
- Post Traumatic Stress
- Self-esteem
- Sports Psychology
- Stress
- Transitions
For instance, if you have an argument with someone, you may go home feeling depressed and you'll probably brood about what they think of you.
The argument has now created a "vicious circle" - a new situation that has probably made you feel even worse. You may even 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.
Here is a simplified way of looking at what happens. The whole sequence, and parts of it, looks like this:
Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally and can also alter what you do about it. The same situation can lead to very different results, depending on how you think about the situation. How you think will affect how you feel and what you do.
CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them - and change the way you feel. CBT is a skills oriented approach where the aim is to give you the skills so that you can "do it yourself" and work out your own ways of tackling these problems.
- In the first session or two, you will work with your therapist to determine whether you can use this sort of treatment and make sure you feel comfortable with it.
- The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.
- You will work collaboratively with the therapist to decide what you want to deal with in the short-, medium- and long-term.
- You and the therapist will usually start by agreeing on what to discuss that day.
- With the therapist, you break each problem down into its separate parts. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.
- Together you will look at your thoughts, feelings and behaviour to work out: 1. if they are unrealistic or unhelpful 2. how they affect each other, and you.
- The therapist will then help you to work out how to change unhelpful thoughts and behaviours.
- It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend that you perform certain "homework" exercises between sessions so that you can practice these changes in your everyday life. Depending on the situation, you might start to: 1. Question a self-critical or upsetting thought and replace it with a positive (and more realistic) one that you have developed in CBT. 2. Recognize that you are about to do something that will make you feel worse and, instead, do something more helpful. Homework completion between sessions is a powerful predictor of therapy success.
- At each meeting you and your therapist will discuss how you've been since the previous session. Your therapist will provide suggestions if any of the tasks seem too hard or don't seem to be helping.
- Your therapist will never ask you to do things you don't want to do. You decide the pace of your treatment and what you will and won't try. The strength of CBT is that you can continue to practice and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.
- CBT is as effective as antidepressants for many forms of depression. It may be slightly more effective than medication in treating anxiety. For both anxiety and depression, CBT alone is better than medication alone at preventing relapse following discontinuation.
- For severe depression, CBT should be used with antidepressant medication. When you are very low, you may find it hard to change the way you think until antidepressants have started to make you feel better.
- Tranquillizers should not be used as a long term treatment for anxiety. CBT is a better option.
- CBT is one of the most effective treatments for conditions in which anxiety or depression is the main problem.
- CBT is the most effective psychological treatment for moderate and severe depression and for the entire spectrum of anxiety disorders.
- CBT is as effective as antidepressants for many types of depression.
- If you are feeling low and are having difficulty concentrating, it can be hard, at first, to get the hang of CBT - or, indeed, any psychotherapy.
- If you have trouble getting the hang of CBT, you may feel disappointed or overwhelmed. Your therapist will pace your sessions so you can cope with the work you are trying to do.
- It can sometimes be difficult to talk about feelings of depression, anxiety, shame or anger.
- CBT isn't for everyone. If it isn’t working, another type of talking treatment may work better for you.