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What is Cognitive Behavioural Therapy (CBT)?
Cognitive Behavioural Therapy (CBT) is a proven approach to psychotherapy designed to help people to develop effective coping strategies that will help them to deal with a wide range of psychological issues.
CBT focuses on a problem-solving approach to help people learn how to react in a different, more positive way to the situations that can lead to problem behaviours. By learning new strategies, a person can also learn how to change their behaviour and reactions, and how to think about things in a more positive way, thereby improving quality of life.
As a treatment, Cognitive Behavioural Therapy works best when the individual has a specific sort of problem, such as anxiety, substance abuse, pain management, depression, an eating disorder, etc. It can also help to relieve the stress and social anxiety often associated with conditions such as ADHD and chronic health problems. By focusing on the problem and how you respond to it, you can engage with your CBT Therapist in creating a new set of behaviours and reactions. Over time, these new behaviours and reactions can lead to lower levels of stress and anxiety, and to an incrementally better approach to the factors that trigger them.
Depending on the person in question, and the problems that they have, CBT can be conducted together with a range of techniques, including how to change thinking patterns, eliminating negative self-talk, mindfulness, and breaking unhelpful behavioural patterns. For example, if a person has issues with substance or alcohol abuse, CBT will take place in the context of also addressing this issue in practical terms.
CBT can also help people with a range of psychiatric disorders. Used in conjunction with medication, it can help people manage any related stress and anxiety as well as contribute to a reduction in symptoms and improve a person’s quality of life. In some cases, it can lead to medication being reduced or even becoming unnecessary.
CBT for Depression
Depression is a common mental or emotional disorder that can have an extremely damaging impact on someone’s quality of life. However, with therapy, most people can experience a dramatic improvement in their symptoms. Cognitive Behavioural Therapy (CBT) is a proven approach to this potentially serious disorder.
Depression CBT works by helping patients to modify their thought patterns and behaviours in order to obtain more control over their mood and actions. Working with a therapist, a patient will explore how they feel in various situations, and examine the ways in which they react and behave in response to their depression.
Patients will work with their therapist to figure out which life circumstances are associated with their depression, and what behaviours and reactions to triggers in their environment would be more useful in terms of minimising depression and enhancing mood. Over time, they will learn how to integrate these new, more useful, behaviours into their lives and they will become enabled to create lasting change. CBT is about self-empowerment rather than developing a long-term relationship with a therapist. Therefore, patients are given the opportunity to practice and develop skills on their own, with a view to ensuring that their time in therapy is finite.
Patients are encouraged to engage with tools that they can use at home, such as keeping a journal, or noting times when circumstances make things worse for them. These tools will incrementally assist them in learning how to control and change thoughts and reactions to events associated with their depression; how to accurately understand and assess situations beyond their control and how they react to them; how to engage in self-talk that is positive and accurate, rather than self-critical; and how to use self-evaluation in order to learn how to reflect and respond in an appropriate manner. These tools, and the abilities they bring, will continue to be of use long after the therapy sessions have come to an end.
CBT for GAD (Generalised Anxiety Disorder)
Generalised Anxiety Disorder (GAD) is a condition that can be extremely distressing, and that can persist over a long period of time. People with GAD often experience such severe anxiety that they can never really relax, and the impact on both their physical and their mental health can be very severe. Untreated, GAD and its symptoms tend to get worse, as people often withdraw from social contact in an effort to minimise it. Sometimes, people attempt to manage their symptoms by resorting to alcohol or substance abuse. While this can provide them with a temporary crutch, over time this sort of maladaptive response can only make things worse.
People with GAD are often unable to identify the things that make them feel anxious. Because they are anxious most of the time, they need to find a way to manage and ameliorate their symptoms in every situation. Cognitive Behavioural Therapy (CBT) is a proven technique that can vastly improve the quality of life of people with this disruptive disorder.
CBT assumes that thoughts, feelings, and behaviours are all connected, and that by making changes in one area, problems in another can be improved. In the case of GAD, often the tendency to worry about issues rather than proactively solve problems is a destructive behavioural pattern that has developed over time, contributing to a serious problem with anxiety.
Working with their therapist, patients with GAD can gradually learn problem-solving skills and behavioural techniques that will help them to manage their anxiety. Over time, they can learn to reduce their anxiety and negative feelings and respond to triggers in their environment in a healthier way.
Depending on the specifics of their situation, patients with GAD may engage in CBT on its own, or as part of a suite of therapeutic approaches to their issues, which might include learning techniques such as mindfulness meditation to help them to control their emotions and to achieve relaxation.
CBT for OCD (Obesssive Compulsive Disorder)
People who suffer with Obsessive Compulsive Disorder (OCD) experience symptoms that include obsessive thoughts—unwelcome, unpleasant thoughts that they find themselves unable to stop thinking about—and compulsive, repetitive behaviours that they feel compelled to engage in to relieve their anxiety. OCD can have a significant negative impact on someone’s quality of life.
In some patients, medication can help in the short term, but it is not a good long-term solution to the problem. A good approach is Cognitive Behavioural Therapy (CBT) is a proven technique to help them to manage their symptoms effectively.
With CBT, the therapist and the patient may explore the origins of the condition, but the main focus is on learning new behaviours and new ways of thinking to replace behavioural and thought patterns that have been impacting negatively on the patient’s way of life.
CBT is about self-empowerment and acquiring the skills necessary to manage the condition on one’s own. Therefore, patients are given the opportunity to practice and develop skills, with a view to ensuring that their time in therapy is limited. They are taught techniques to reduce the impact of OCD on their lives and encouraged to practice them at home and to keep a record of their progress over time. Gradually, most patients become empowered by therapy and their own progress. They will find that their OCD manifests much less frequently and that they are more in control of their thoughts and behaviours.
CBT for Phobias
A phobia is specific anxiety disorder predicated around a fear of something, or of a situation, that is so intense that the afflicted person can respond to encounters with huge fear, anxiety, and negative behaviours such as hyperventilating or fainting, all of which can impact very seriously on their quality of life. For example, someone with a phobic response to air travel might organise their whole life around avoiding it, even to the extent of damaging their own work prospects and personal happiness. Cognitive Behavioural Therapy (CBT) is a proven technique to help people with phobias to manage their symptoms effectively.
CBT helps a person with a phobia to challenge any irrational thoughts and beliefs relating to their phobia and, gradually, to accept that there is no real basis to their strong negative response to their trigger. Over time, they can learn how to respond in more helpful and rational ways to the thing that they strongly dislike or fear.
The aim of CBT for phobias is for a person to become able to manage their emotional response on their own. In therapy, a person is given the opportunity to practice and develop skills and techniques to reduce the impact to the phobias on their life, and ideally to eliminate the phobia completely. A person attending CBT for phobias will usually practice the new skills and techniques at home and keep a record of progress. Gradually, most people who attend CBT for phobias will find that their phobic symptoms appear much less frequently, and that they have a greater sense of control over thier thoughts and behaviours.
CBT for PTSD (Post Traumatic Stress Disorder)
People who suffer with Post-Traumatic Stress Disorder (PTSD) have experienced a trauma in the past—abuse, rape, an accident, war, domestic violence, etc. Often, many different types of traumatic experience can lead to the condition. In response, they have developed symptoms that can include obsessive, unwelcome thoughts about the event, and feelings of intense anxiety or panic. The condition can impact seriously on their ability to function in everyday life.
People with PTSD can often feel quite despairing and worry that their lives will never be as they were before they experienced the traumatic event. Particularly if they have been dealing with PTSD for many years, they may feel that they are permanently damaged. Many try to deal with the condition on their own, often resorting to using alcohol or other substances to attempt to ameliorate symptoms.
Cognitive Behavioural Therapy (CBT) can help people with PTSD manage their symptoms effectively. Whilst some people might benefit from short-term use of medication, CBT offers a better long term way to manage their symptoms and improve their wellbeing. In therapy, people will often see benefits quickly, but also experience longer term benefits as CBT provides them the tools they need to rebuild their lives after trauma.
CBT for Panic Disorder
It is normal and healthy to feel panicky and afraid when we really are in a dangerous situation, but people with Panic Disorder often panic even when there is no danger or risk in their environment at all. The result for both their mental and their physical health can be considerable. Our bodies naturally produce substances such as cortisol and adrenaline when we are at risk, but when we produce elevated levels all the time, it can be very dangerous for our health.
CBT helps people with panic disorder by teaching them how to recognise the things that trigger the disorder in them, and how to manage their symptoms more effectively, greatly reducing the impact on their quality of life and on their health.
In therapy a person will work with their therapist to figure out when they tend to panic, and what behaviours and reactions to triggers in their environment seem to make things worse. As they become more self-aware, they become enabled to develop new, more useful, behaviours in response to the situations that they associate with panic and feelings of intense fear.
CBT is about self-empowerment rather than developing a long-term relationship with a therapist. Therefore, patients are given the opportunity to practice and develop skills on their own, with a view to ensuring that their time in therapy is limited. They are taught techniques to reduce the impact of Panic Disorder on their lives and encouraged to practice them at home and to keep a record of their progress over time. Gradually, most patients become empowered by therapy and their own progress. They will find that their panic attacks become much less frequent, and that they are more in control of their fear.
CBT for Health Anxiety
People who suffer with Health Anxiety, which has been traditionally known as Hypochondria, typically experience great anxiety about their health, to the point whereby the impact on their quality of life can be considerable.
Up to a point, we are all concerned about our health. However, Health Anxiety goes far beyond normal health concerns. Someone with Health Anxiety sees symptoms of illness where there are none, or assumes that minor symptoms mean that there is something terribly wrong with them, even when their doctors assure them they are fine.
Anyone with Health Anxiety who continues to suffer despite being physically well can benefit from CBT, which will give them the tools they need to manage their symptoms on their own, and to improve their quality of life.
In therapy for health anxiety, a person usually works with their therapist to understand what situations trigger their health anxiety,, and what behaviours and reactions to triggers in their environment seem to make things worse. As a person learns new skills and becomes more self-aware, they develop new, more useful, behaviours in response to these triggers.
CBT is about self-empowerment rather than developing a long-term relationship with a therapist. Therefore, patients are given the opportunity to practice and develop skills on their own, with a view to ensuring that their time in therapy is limited. They are taught techniques to reduce the impact of Health Anxiety on their lives and encouraged to practice them at home and to keep a record of their progress over time. Gradually, most patients become empowered by therapy and their own progress, and start to see a marked reduction in symptoms.
CBT for Low Self-Esteem
The term “self-esteem” refers to a person’s subjective evaluation of themselves and what they are worth. Persistent low self-esteem can be extremely damaging to the individual’s quality of life, impacting on their ability to form positive relationships with others, to progress at work, and much more.
Cognitive Behavioural Therapy (CBT) is a proven technique to help people with low self-esteem to learn how to think about themselves in a different way.
It can be difficult for people with low self-esteem to accept that they need therapy. They may be so used to thinking of themselves as having little worth that they simply accept this as the truth, and continue behaving in a way that reflects this belief, such as engaging in constant self-criticism or living with a generally negative outlook on life. However, CBT offers a real and meaningful way forward to anyone whose low self-esteem is holding them back from having a happy and rewarding life.
CBT helps the person with low self-esteem to challenge their entrenched views of themselves. By providing them with practical tools, such as positive thinking techniques and learning how not to engage in negative self-talk, they gradually become more able to manage difficult emotions relating to low self-esteem on their own, and often to completely eliminate problematic symptoms.
CBT for low self-esteem is usually short-term, as the aim is to provide a person with greater tools and techniques to increase their self-esteem. In therapy, people are usually encouraged to practice new skills at home and to keep a record of their progress over time, so they can notice positive changes. Gradually, whilst accessing CBT for low self-esteem, most people will find that they acquire higher levels of self-esteem, with a corresponding enhancement in their quality of life.
CBT for Tics
Tics, which often begin in childhood and persist throughout the individual’s life, can be a challenge to well-being, and a considerable cause of stress. Tics do not typically respond well to conscious, unguided efforts to repress them, and are generally made worse when sufferers are ridiculed or punished for behaviours that they have no control over.
Tics can originate in a combination of both neurological and environmental factors. Therefore, by working with environmental issues, and at the same time retraining the brain, we can dramatically reduce the extent to which individuals display tics. We know from scientific research that the human brain remains “plastic”, retaining the potential for change, throughout the lifetime, and that the interactions between the individual’s neurological make-up and the environment are complex and nuanced. This means that just because someone may have a neurological predisposition to display tics, they can still learn how to respond differently to the triggers in their environment.
While medication is sometimes used to treat tics, with varying degrees of success, an approach called Cognitive Behavioural Intervention for TICS (CBIT) has been clinically proven to dramatically improve the manifestation of tics in both children and adults.
CBIT takes the form of a structured therapeutic session over a fixed period of time, such as ten weeks, with a session every week. There are three major elements to CBIT:
- The patient learns how to be more aware of their tics and of the feeling that they need to engage in tic behaviour.
- They learn how to engage in a different behaviour when they become aware of the urge to display a tic.
- They make simple changes to their lives that can help them to reduce their symptoms.
During sessions, the therapist works with the patient around the three issues highlighted above. For example, someone who feels the urge to cough, blink, or roll their eyes can be taught techniques such as mindful breathing to help them to short-circuit the urge, and then to use a different behaviour, instead. They can also work to identify the factors in their lives that seem to trigger or exacerbate their tics and introduce techniques to help them to reduce their stress levels during those incidents. For example, a patient might notice that their tics are worse when they have to speak in public. They will benefit from using stress-reducing techniques, such as mindfulness, to lower their stress levels and thereby reduce the temptation to engage in tics.
While many people with tics can suppress their tics on their own for a period of time, this can be a very frustrating experience for them, that adds to their feelings of stress and can actually make things worse in the longer term. Instead, the goal of CBIT is to integrate new behaviours such that, over time, they become second nature, and therefore remove the need to engage in voluntary suppression. As the person’s ability to understand and manage their tics grows, they become more confident and self-empowered, and less inclined to react to situations that used to trigger them. Over time, the “new” behaviours that they learn to replace tics often also fade away as their ability to manage their condition develops.
Healthcare professionals from a range of backgrounds, including general practitioners and nurse practitioners, can offer help for people with tics, but CBIT—which offers proven long-term relief from the condition—can only be effectively provided by therapists who have been specifically trained in this field.
How can I find out more about CBT therapy?
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