What is CBT?

Above all, Cognitive Behaviour Therapy is a very practical form of treatment

The word 'Cognitive' is from the same root word as the word 'recognition' and means 'thinking'. 'Behavioural' relates to 'doing' and 'Psychotherapy' effectively means 'talking treatments' and is frequently shortened to merely 'Therapy'. Therefore Cognitive Behaviour Therapy (CBT) means a 'thinking and doing, talking treatment' - but what does that mean in real terms?

CBT is based on the assumption that our thoughts affect the way we feel and what we do towards ourselves and others. The following is an example by way of illustration:

Jonathan was already very nervous at the prospect of giving a presentation to the Managing Director and his team. They had flown in especially to hear him, "what if I make a fool of myself?" he thought as he noticed his stomach start to churn. He tried to look at the situation rationally but this only made matters worse "I will get kicked out, and then where will I be?". Jonathan lay awake all night and by the morning was very tired - too tired to go to work. He was pleased in a funny sort of way as he phoned in sick "someone else will have to give the talk".

This example shows a few of the powerful ways our thoughts and behaviour interact. Notice the way the final behaviour was dependent on a chain of thoughts which, in themselves, were very negative. Calling in sick got Jonathan out of confronting his anxiety - "he was pleased in a funny sort of way" - indicates short term relief from anxiety. This is a major problem since he is already learning that avoidance leads to anxiety reduction. This 'easy way out' is likely to be a strategy used time and again. Not only that but Jonathan assumed he would fail catastrophically, but gave no evidence - "what if....." turned into "I will....." and then he didn't go into work to prove - or more importantly, disprove his assumptions. CBT is based on the knowledge that many of our psychological problems are caused and maintained by unhelpful, and frequently downright inaccurate, beliefs about ourselves and others around us. These beliefs are learnt through our past experiences and interactions with others. At the time, like Jonathan, they may have helped us cope, but now they merely hinder us - we feel controlled by our anxiety.

What happens in therapy?

The therapist and client work together. The aim is to understand and then alter the beliefs that underpin the problem, as well as understand how these beliefs affect current behaviour, in order to change that behaviour and reduce anxiety in the long term. This sounds complicated but isn't - it is a very logical approach to problem solving.

Based on an agreed understanding of the client's problem, the therapist and client identify the problem, the cycle of maintenance that keeps the problem going and targets to be aimed at. They then agree a plan of treatment to take place over a specified number of sessions with the client also working on the treatment plan between sessions. The orientation of therapy is 'present-to-future' - the client has a problem now (present) - what are we going to do about it (future)? Once targets have been achieved, the therapist and client often agree to a number of follow-up appointments to be certain that therapy gains are being maintained.

If you have any further questions about CBT then please feel free to ask. It may help to look at the FAQ page first, but if you cannot find your question answered there, then feel free to email us.