What is CBT? (Cognitive Behavioural Therapy)

CBT, or Cognitive behavioural therapy is a short-term talking therapy that focuses on the relationship between our thoughts and behaviours as they relate to our problems. CBT was developed by psychologist Aaron Beck and focuses on the way we think and how that affects our feelings and behaviour. It combines both behaviourist ideas like conditioning and ideas of cognitive therapy, creating a model of how we operate. Cognitive therapy proposes that people can become aware of their thoughts and can be responsible for changing them and that sometimes, our thoughts that surround a situation are sometimes distorted and do not always accurately represent reality. It suggests that these cognitive distortions and negative interpretations of reality are often the cause of our emotional distress. We then learn from these experiences that these interpretations are our reality and are likely to experience the same distress in the future

Cognitive behavioural therapy explores the link between our thoughts, feelings, emotions and behaviours in a given situation. If we can see how these parts interplay, we can gather a full picture, like a map, as to what is happening for us. The map looks something like this;

We find ourselves in a situation; The situation is perceived, and our perceptions will cause us to make sense of the situation with thought. The thoughts are then followed by responses to our perceived situation, through emotions, behaviours and physical sensations that result from our bodily responses. In this model it is important to distinguish between the separate categories and to help the client do the same. Emotions for example are very specific states of mind and body that will naturally result in certain thoughts, physical sensations and behaviours. Clearly identifying which things are which will give us a clear idea of the situation and how we are responding.

Once we have a model laid out, we can then challenge what is happening to make change. By changing one element, that will in turn affect the others. We can challenge the situation cognitively; by looking at alternative interpretations of the situation, identifying distorted and negative thoughts and coming up with more accurate and positive thoughts. We can also challenge the behaviours, spotting behaviours that may lead to us feeling negative emotions or thinking negative thoughts. Often behaviours will be more difficult to change than thoughts as they are reinforced by our emotions and thinking patterns, however certain behaviours may be easier to change than others i.e. our breathing patterns and posture. These can lead to reduction of negative physical sensations and encourage positive emotions.

Challenging thoughts and behaviours can take a while to take affect truly. We need to acknowledge that many of our behaviours and thoughts are learned in earlier life and have been reinforced over years of repetition. In CBT, homework is a very important part of the process. With homework, people can take notes of what is going on and attempt changes, taking note of the effects that result. In doing this, people can see what approaches and changes work for them, and those which don’t. These observations can then be brought to sessions for review or to explore different or more progressive action. The effort of doing homework can help the clients to develop the ability to self-heal and develop their own self-awareness through the framework of CBT and could reduce the time it takes for their healing to occur. Some exercises that people may do as part of their homework could involve learning relaxation techniques, practices slowing down the pace of their life so they can develop awareness, developing affirmations and positive rational statements and making them permanent.

Cognitive behavioural therapists use a method of communication called guided discovery. Guided discovery is a way of asking questions to help the client explore their problems and solutions to them consequently. This involves actively asking questions about the problem, active listening with empathy, summarising and helping to create prospective positive futures to work towards.

Cognitive behavioural therapy can be quite difficult work for people and may not appeal to some people due to the hard work involved. Unfortunately, many people who undergo cognitive behavioural therapy drop out. However, for those who undertake the therapy, there is a very strong rate of improvement and success

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