Cognitive Behavioural Therapy

Published by Sarah Horrocks
Published on 14 February 2008

Phobias, eating disorders, addictions... Cognitive Behavioural Therapy is increasingly recommended to treat certain daily behavioural handicaps. Active participation and a development of self awareness are required by the patient.

‘Here and Now’
Cognitive Behavioural Therapy, or CBT, is defined as an active therapy because it relies on scientific work and learning theory to understand and treat certain psychological problems. Unlike psychoanalysis, which focuses on the causes of symptoms by delving deep into your past, CBT focuses on the here and now and looks for ways to improve your state now.

How does it work?
CBT is based on two complimentary approaches: behaviour (what you do) and cognition (what you think and your awareness of your environment.) The behavioural approach consists of gradual exposure to anxiety-inducing situations. The cognitive approach works principally with a patient's negative and uncontrollable thoughts that have no apparent logic. The effectiveness of CBT lies in the fact that it uses the two approaches simultaneously to control dysfunctional thinking habits that cause the problems.

CBT helps you make sense of overwhelming problems by breaking them down and learning how they affect you. You gain a concrete awareness of your problem, your negative thoughts and acts, and learn new positive habits. The therapist is a guide and role model. Among the most common techniques used are desensitisation, operational conditioning, role play techniques and family behaviour therapy.

What can be treated?
CBT has shown to be effective in the treatment of anxiety, depression, panic, agrophobia and other phobias, social phobia, bulimia, obsessive complusive disorder (OCD), post-traumatic stress disorder and even schizophrenia.

What does CBT involve?
The sessions take place individually or in a group. Individual therapy involves meeting with a therapist for between 5 to 20 hours once a week or fortnightly. Each session lasts around 45 minutes. Once the patient describes the problems, the psychologist then analyses the outline of thoughts driving their behaviour. Then the psychologist suggests another type of behaviour to replace the dysfunctional one. Group sessions involve role play and simulation, and last around 45 minutes. The length of treatment is to be discussed with the therapist.

The patient is required to imagine a situation or to confront it head on, which is hard but very effective. Gradually, the brain memorises a different way of thinking and replaces the dysfunctional thoughts. This aids the patient's ability to face certain situations that would cause anxiety before. For the sessions to be effective, any change in behaviour must be lasting and the patient must also do personal exercises outside the therapy room.

Should CBT be combined with medication?
In certain cases, it is recommended to combine CBT and medication. To treat OCD, for example, psychiatrists often prescribe anti-depressants because they are currently the only effective treatment.

Find a therapist
CBT is used by a number of different professionals including psychologists, occupational therapists, psychiatrists, nurses and counsellors. Clinical psychologists practise it within the NHS although it is not available everywhere. Many private therapists use CBT; consult the BABCP (British Association of Behavioural and Cognitive Psychotherapies) or UKCP (the UK council for Psychotherapy) to find accredited practitioners.

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