CBT in a Nutshell
Here is a nutshell guide to CBT counselling and how it can help you crack life’s problems.
CBT therapy is a set of skills that can help us live more effectively. Rather than being so busy working in life it helps us take a step back and work on life. It has also been shown to be helpful when mild to moderate problems develop into clear difficulties such as anxiety and depression.
The basic premise is how we think and behave in trigger situations strongly influences how we feel.
Take a well known CBT therapy example. You are waiting in a coffee shop for a friend who is 15 minutes late.
- If you think “she’s probably just stuck in traffic” you might send her a text and go back to reading your book.
- Or if you were to think “It’s Sarah. She’s always 30 minutes late – I’ve got another 15 minutes to go” you might order another coffee.
- If you think “what if she has been in an accident?” you might repeatedly ring her until you get through all the while feeling highly anxious.
The important factor here is we don’t know where Sarah is but our past experience will likely influence how we think, respond and feel in this situation.
Most situations in our lives do not cause problems and we get on with life successfully. However, it is common for us to get stuck in one particular area that we just can’t move forward with. By paying attention to our thought and behaviour patterns in these trigger situations we can use CBT strategies to ultimately change them and feel better.
So, in our coffee shop example it might go through our mind that something bad has happened to Sarah to cause her to be late. With CBT we can learn to slow ourselves down, look at the evidence that supports our thought and the evidence against it. We can then develop a better way of coping until we know more about why Sarah is late. So a balanced thought might be more like:
“No wonder I’m anxious about Sarah because she’s late and it’s not impossible that something bad has happened. But it’s more likely that she’s stuck in traffic so I’ll give it another half an hour to see if she shows up.”
CBT therapy is therefore about weighing up the evidence and developing more realistic and helpful ways of thinking and coping. It is not about ignoring our negative thoughts and ‘thinking positively’ nor about brainwashing ourselves into believing things that are not true.
The other part of CBT counselling involves examining behavioural patterns. Once we figure out a balanced thought we need to act on it to find out what happens. In the example above, we might try NOT ringing Sarah but simply waiting half an hour to ride out the anxiety. Instead, we might order another coffee and chat with the person at the next table instead.
CBT therapy is:
- collaborative – you work together with your CBT therapist as a team
- focused on the present (though the past is referred to when necessary)
- tailored to your unique situation and needs
- shorter in duration than other types of therapy
- trains you to be your own therapist so that you can help yourself in future
- structured with sessions having an agreed agenda moving towards your goals
- Proven – see the NICE Guidelines for social anxiety, panic attacks, excessive worry, OCD, bulimia.
There is obviously a lot more to CBT counselling and the example given applies to anxiety. However, CBT has also been found to be the approach of choice for recovering from eating problems, low mood and depression, low self-esteem and perfectionism. Unfortunately, if left alone many of these problems simply become worse over time. Generally, CBT involves between 8 and 20 sessions depending on the type of difficulty.