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Adult CBT

CBT can be very helpful in tackling problems such as:

  • anxiety
  • depression
  • post-traumatic stress disorder
  • low self-esteem
  • OCD
  • chronic fatigue
  • panic and social anxiety related problems

Cognitive Behaviour Therapy (CBT) is a type of therapy that aims to help you manage difficulties and problems by changing the way you think, feel and act. The therapist works together with you in a collaborative manner to help you make sense of and develop new insights and understanding about the ways you think about yourself, how you think and relate to others and view the world that in turn influences how you feel and what you do.

CBT helps people to identify the links between thoughts, feelings and behaviors and is goal orientated. The therapist helps you to identify unhelpful or negative thought patterns and behaviors that may be having a negative emotional impact on yourself or in your relationships. We will then develop strategies and practical tools with which to challenge problematic thought patterns, manage emotions and change behaviour.

CBT has a proven record that it is effective and helpful in the psychological treatment of problems such as anxiety, depression, post-traumatic stress disorder, low self-esteem, obsessive compulsive disorder (OCD), panic, social anxiety and phobic related problems. CBT is recommended as the treatment of choice by the National Institute of Clinical Excellence Guidelines (NICE).

CBT differs in several ways from traditional counseling because it focuses primarily on the issues you have now rather than issues from your past and helps you find practical ways you can deal with them to improve your day-to-day life, relationships and state of mind. The emphasis, different to other therapies, is on collaboration (working together as a team) and engaging in therapy practice tasks between sessions with the aim of you becoming your own therapist.

What we experience in our lives and what has happened to us in the past has a significant influence on our personality development and therefore shapes and influences how we relate to ourselves, those around us and how we function in daily life. Therefore, whilst the focus of CBT is primarily on the present, exploration and consideration of past issues and events are important to help us make sense of the here and now.

During times of difficulties and emotional stress the way we see, think about ourselves and deal with things can alter. Things tend to become extreme and unhelpful as we can view things through dark lenses like lenses in glasses. It can then become difficult to think about things in usual ways and we may see things differently and it becomes hard to think about things from other perspectives. At times of change or emotional stress we can lose the ability to gain balance and flexibility in our thinking as it becomes stuck in overly negative patterns.

We can become stuck in certain ways or patterns of thinking, feeling and behaving. Negative ways of thinking about others and ourselves can then worsen how we feel and we may inadvertently behave in ways or use strategies to cope that are unhelpful and that prolongs their distress such as avoidance or withdrawal that often maintains and keeps problems going.

How can CBT help?

CBT can help to make sense of, gain new insight and understandings into problems that can often feel overwhelming. It does this by helping break things down into specific areas that make it easier to see how things are linked and how they affect us using ways that seem both manageable and changeable.

When we encounter problems, events or difficult situations we will have certain thoughts about it, thoughts about ourselves (ability to cope or be self critical) and thoughts about others; which then may lead us to experience emotions and physical feelings that may be unpleasant which in turn may lead us to engage in a behaviour or action that helps us to cope and feel better. In this way we can see that one aspect leads to another in a sequence, and a cycle is established that is self-maintaining. In CBT we often refer to this as vicious cycles:-

Adult Cycle

Each of these specific areas affects the others and are connected; we can see that how we think about a problem affects our feelings that may be unpleasant physical symptoms that can then influence or alter what we do or how we respond. There are helpful and unhelpful ways of reacting to most situations that are dependent on how we think about them. How we think about, make sense of and respond to situations in the present is very much influenced by what we have experienced in the past. Events, experiences and relationships we have and have had all contribute to our development and emerging different perspectives and unique interpretations.

CBT can help us to identify, and then begin to question and change how we think (cognitive), learn ways of managing unpleasant emotions (feelings) and learn ways of coping and change what we do (behaviour). In doing this we break and dismantle vicious/maintaining cycles that can lead to significant improvements in how we function and lead our lives.

What is involved in CBT sessions?

The purpose of the first appointment is for us to meet to determine whether I am the right therapist as it is important that you feel safe, comfortable and that you can relate to me as a therapist. It is important that you are confident that I have an understanding so you feel reassured and you feel able to talk to me. Without a good therapeutic relationship no meaningful work can take place.

Initial appointments provide an opportunity for assessment; that is to meet and gather information by providing an opportunity for you to discuss your difficulties in detail and to establish what you hope to achieve by engaging in psychological therapy. It also provides an opportunity to ask me any questions, and discuss how CBT works in more detail and how it may apply be applied to your difficulties.

We can think together and establish if CBT is the most suitable psychological therapy for you and the difficulties you are experiencing. If we decide, for whatever reason, it is not we can think together about the type of therapy that might be most helpful.

Together we will aim to understand how influences, events and experiences from your past may have contributed to the development of current problems that may be having an adverse effect on functioning, relationships or the quality of your life. We will think about goals and how these can be devised to enable you to live the life you want for yourself which may be to improve relationships, manage anxiety, improve your moods or deal with traumatic experiences or stress.

As previously stated CBT is not like traditional counselling in that it is not just a talking therapy. It is very much an active and doing therapy requiring the therapist and client to work together, in collaboration, as a team. Home practice therapy tasks are a central aspect of CBT, without this little meaningful change work will occur. This will vary from session to session, depending on the focus at the time.

Some examples of therapy home practice include reading information that will enhance understanding and learning about particular problems, keeping a diary or record sheet to self monitor, completion of questionnaires, integrating new ways of thinking or behaving by experimenting and trying out different ways of responding and learning relaxation training.

We will always discuss therapy home practice so that you have a clear understanding and reason for doing it. Between therapy tasks require commitment and we will need to ensure that this is manageable by considering commitments and influences that may be demanding on your time. You will not be told what to do, rather we will decide jointly and we will decide together on the pace.

Generally at the beginning of each session we will start by reviewing the previous session and there will be an opportunity to update on therapy home practice, events and any new learning developed through the week. Together we will decide and agree what we are going to discuss and focus upon in the session to ensure that this meets your needs and enhances progress towards goals.

As therapy progresses and you become more adept and skilled at becoming your own therapist using developed insights and understanding, putting into practice strategies and techniques we will think about ending therapy and focus on putting this altogether in a therapy relapse prevention plan.

This will help you to consolidate what has been learned in therapy and help you to continue to practice and develop your skills, even after therapy sessions have finished. This makes it less likely that your symptoms or problems will return. It is difficult to unlearn new ways of thinking and responding and this will be a reminder of what has helped and been effective as a guide in the future in the event of any setbacks.

How many sessions are needed?

We will discuss and agree together the number of sessions that may be needed and consider the frequency of sessions. CBT usually involves meeting weekly or fortnightly initially and then reduces over time as therapy progresses and you begin to become your own therapist integrating and applying new insights, understanding and learning new ways of coping into your every day life.

The exact number of sessions required depends (and varies) and very much relates to the difficulties or problems that you are facing. CBT treatment usually lasts from 8 weeks to 6 months but can be longer. We will agree a number of sessions from the outset that we will review at regular intervals throughout the course of treatment to ensure that therapy sessions are proving beneficial.

I hope that have found this information of interest and that it has answered any questions you may have. Please feel free to contact me to discuss further or to make an appointment to meet for assessment.

Please note: I have no responsibility for the accuracy or content, and do not endorse any specific website. I invite you to make your own decisions on what is relevant to you and your family. The sites listed above are widely used within local health services.

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