cognitive behaviour therapy
by Sally Burningham
Cognitive behaviour therapy (CBT) can be a helpful treatment for many mental health problems ranging from anxiety and depression to phobias and obsessions. Despite its rather offputting name it is a straightforward and commonsense approach and one that users can help to plan and monitor themselves.
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Cognitive behaviour therapy focuses on the links between what you think about yourself or a situation (the cognitive part) and how this in turn affects the way you act (the behaviour part). It concentrates very much on what is going on at present in your life rather than delving into the past.
It may be used in conjunction with medication or on its own depending on the severity or nature of the problem.
At present, is not yet universally available so it is worth asking about its availability near where you live but be aware that there may be a long waiting list in some areas.
the aims
The aim of cognitive behaviour therapy is to help you find more realistic and appropriate ways of coping with problems in your life. If you are distressed and lacking in self esteem you are likely to see yourself in a very negative way. This in turn may lead you to misinterpret situations and other people's intentions towards you in a way that further adds to your low self-image and distress.
For example, if a friend is unable to see you for a week, you may become convinced that it is because they no longer like you, rather than believing that they are genuinely busy, or simply need some time to themselves. Your hurt or angry reaction may then actually antagonise your friend.
Cognitive behaviour therapy aims to break this cycle by encouraging you to think and behave in a more flexible and helpful way. It is a structured way of seeing yourself and allows you to explore negative beliefs. You will work with the therapist to identify those negative beliefs that are reinforcing your problems and explore and test out a range of more appropriate reactions.
For example, someone with depression might learn to challenge their self-critical thoughts. Rather than telling themselves there is no way they can cope with a situation, such as applying for a job or inviting a friend for dinner, they might say 'I may be able to manage it if I take it step by step' or 'it doesn't really matter if I make a mistake as long as I try my best'. They might then be encouraged to test out the situation in real life to see whether these new attitudes help.
Whereas someone with a phobia might work through a series of tasks, with the help of a therapist, to help them gradually overcome a specific fear. For someone with a spider phobia these might range from looking at a photo of a spider to handling a live spider.
when can it help?
Cognitive behaviour therapy has been found helpful for a range of problems. These include:
- depression. Research shows that in many cases CBT is an effective treatment for mild to moderate depression.
- anxiety disorders, including health anxiety. Studies indicate that people with anxiety disorders such as panic disorders, phobias, obsessive compulsive disorder and generalised anxiety disorders are likely to benefit from CBT.
- bulimia. There is evidence that CBT can be helpful for many people with bulimia.
- post traumatic stress. Research demonstrates that CBT is often the most appropriate form of treatment.
Therapists are beginning to use CBT for people who experience episodes of schizophrenia and manic depression. Early results seem encouraging.
finding out about CBT
If you think that this kind of treatment might be helpful for you, and it has not been suggested, ask your GP or a mental health professional whether you could be referred to an appropriate therapist. Cognitive behaviour therapy is usually provided by professionals such as clinical psychologists, psychiatrists, nurses, counsellors or social workers who have been specially trained in this kind of approach. If you decide to consult a cognitive behaviour therapist privately check with the appropriate organisation to make sure it is someone who has been properly trained (see help and info).
The first step is to meet the therapist who will assess your suitablity for this type of treatment and explain what occurs. If the therapist feels that CBT would be appropriate for you, you can then decide whether or not you wish to participate. If you do you will be expected to play an active role in your own treatment.
- Together with the therapist you will identify a number of specific goals you wish to achieve within a set period of time and strategies to help you achieve these goals.
- You will complete homework assignments between sessions such as filling in a diary or carrying out agreed tasks to test your own assumptions.
- You will constantly monitor and evaluate your own progress with the help of the therapist.
It is not a lengthy form of treatment. Each session usually lasts about an hour and you are likely to be offered 8-20 weekly sessions, although in some cases it could be more or less. CBT is generally offered on a one-to-one basis, though it is occasionally offered in groups.
help and info
Channel 4 is not responsible for the content of third party sites.
You may find it helpful to look at some of our other features such as depression, anxiety, phobias, panic attacks and obsessive-compulsive disorder in the mind room, post traumatic stress disorder: the stress of terror in the stress section, and a feature on bulimia, binge and bust in the food section.
organisations
British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Globe Centre
PO Box 9
Accrington BB5 2GD
Tel: 01254 875277 (Mon-Fri 9am-5pm)
E-mail: babcp@babcp.com
Website: www.babcp.com
The leading body for cognitive-behavioural therapy in the UK. The website has a search facility to find an accredited therapist and gives information on how the therapy works.
British Association of Counselling and Psychotherapy
35-37 Albert Street
Rugby CV21 2SG
Tel: 0870 443 5252 (Mon-Fri 8.45am-5pm)
E-mail: bacp@bacp.co.uk
Website: www.bacp.co.uk
BACP can provide you with a list of private counsellors in your area, plus information on counselling and choosing a counsellor. Please telephone or send an SAE to the above address. Alternatively, you can search for a counsellor at the website which, along with an online directory of counsellors, contains details about membership, training and an extensive publications list.
websites
Cognitive Behaviour Therapy
www.mind.org.uk/Information/Booklets/Making+sense/
MakingsenseCBT.htm
Produced by Mind, this factsheet outlines what CBT is, how it works, and how to find a therapist.
Talking Therapies
www.mentalhealth.org.uk/information/mental-health-a-z/talking-therapies/
A useful brief guide to the different sorts of talking therapies available.
What is Cognitive Therapy?
www.rcpsych.ac.uk/.../therapies/cognitivebehaviouraltherapy.aspx
A guide to CBT produced by the Royal College of Psychiatrists.
Living Life to the Full
www.livinglifetothefull.com
A self-help website using cognitive behaviour therapy to help tackle a range of problems including negative self-image, anxiety, sleep problems.
reading
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The Feeling Good Handbook by Dr David Burns (Plume, 1999) |
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Mind over Mood by Dennis Greenberger and Christine Padesky (Guilford Press, 1995) |
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Think Good, Feel Good: A Cognitive Behaviour Therapy Workbook for Children and Young People by Paul Stallard (John Wiley and Sons Ltd, 2002) |
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Making Sense of Cognitive Behaviour Therapy by Ruth Williams (Mind Publications, 2001) £3.50 (plus 44p p&p) Overcoming Depression by Paul Gilbert (Constable and Robinson 1997) |
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computer-aided packages
Beating the Blues
An eight-session, computer-aided programme that uses cognitive behaviour therapy techniques to treat anxiety and depression. Developed with Ultrasis by Dr Judy Proudfoot at the Institute of Psychiatry, King's College, London and available at some GP surgeries. For more information see www.ultrasis.com/products/product.jsp?product_id=1.
Restoring the Balance (Mental Health Foundation, 2000) £25 (single-user) or £85 (multi-user)
This self-help CD-rom is based on cognitive behaviour therapy techniques. It includes interactive exercises and is designed for people experiencing mild to moderate anxiety or depression. It is written in HTML and Javascript so should run on all Windows and Macintosh computers with a web browser. Details are available from the Mental Health Foundation by visiting www.mentalhealth.org.uk or telephoning 020 7803 1101 (office hours).
(May 2002, resources updated December 2004)
