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CBT Content Supplied by NHS Choices
Introduction

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.

It is most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.

CBT cannot remove your problems, but it can help you deal with them in a more positive way. It is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.

CBT aims to help you crack this cycle by breaking down overwhelming problems into smaller parts and showing you how to change these negative patterns to improve the way you feel.

Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

Read more about how CBT works.

When is CBT used

CBT has been shown to be an effective way of treating a number of different mental health conditions.

In addition to depression or anxiety disorders, CBT can also help people with:

CBT is sometimes used to treat people with long-term health conditions, such as irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS). CBT cannot cure the physical symptoms of these health conditions, but it can help people cope better with their symptoms.

Finding a CBT therapist

If you think you have a problem that may benefit from treatment with CBT, the first step is usually to speak to your GP.

Your GP may be able to refer you for CBT that is free on the NHS, although you may have to wait. Find psychological therapy services (IAPT).

If you can afford it, you can choose to pay for your therapy privately. The cost of private therapy sessions varies, but it is usually 40- 100 per session.

If you are considering having CBT privately, ask your GP if they can suggest a local therapist. The British Association for Behavioural & Cognitive Psychotherapies (BABCP) keeps a register of all accredited therapists in the UK and The British Psychological Society has a directory of chartered psychologists, some of whom specialise in CBT.

What happens during CBT sessions

If CBT is recommended, you will usually have a session with a therapist once a week or once every two weeks. The course of treatment will usually last for between five and 20 sessions, with each session lasting 30-60 minutes.

During the sessions, you will work with your therapist to break down your problems into their separate parts - such as your thoughts, physical feelings and actions.

You and your therapist will analyse these areas to work out if they are unrealistic or unhelpful and to determine the effect they have on each other and on you. Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.

After working out what you can change, your therapist will ask you to practise these changes in your daily life and you will discuss how you got on during the next session.

The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life. This should help you manage your problems and stop them having a negative impact on your life - even after your course of treatment finishes.

Pros and cons of CBT

There are a number of advantages and disadvantages of CBT.

Research has shown that CBT can be as effective as medication in treating some mental health problems. Compared to other talking therapies, CBT can also be completed over a relatively short period of time.

However, to benefit from CBT, you need to commit yourself to the process. A therapist can help and advise you, but they cannot make your problems go away without your full co-operation.

Also, due to the structured nature of CBT it may not be suitable for people with more complex mental health needs or learning difficulties.

Read more about the pros and cons of CBT.


Things to consider

Research has shown cognitive behavioural therapy (CBT) can be as effective as medication in treating some mental health problems.

The treatment can help you manage problems, such as anxiety and depression, and make them less likely to have a negative impact on your life.

There is always a risk that bad feelings you associate with your problem will return, but with your CBT skills it should be easier for you to control them. This is why it is important to continue practising your CBT skills even after you are feeling better and your sessions have finished. 'Refresher' CBT courses are also available if you feel you need to go through skills you have learnt again.

Nevertheless, CBT may not be successful or suitable for everyone. Some advantages and disadvantages of the approach are listed below.

Advantages of CBT

  • Can be as effective as medication in treating some mental health disorders and may be helpful in cases where medication alone has not worked.
  • Can be completed in a relatively short period of time compared to other talking therapies.
  • The highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books and computer programmes.
  • Skills you learn in CBT are useful, practical and helpful strategies that can be incorporated into everyday life to help you cope better with future stresses and difficulties even after the treatment has finished.

Disadvantages of CBT

  • To benefit from CBT, you need to commit yourself to the process. A therapist can help and advise you, but cannot make your problems go away without your co-operation.
  • Attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time.
  • Due to the structured nature of CBT, it may not be suitable for people with more complex mental health needs or learning difficulties.
  • As CBT can involve confronting your emotions and anxieties, you may experience initial periods where you are more anxious or emotionally uncomfortable.
  • Some critics argue that because CBT only addresses current problems and focuses on specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood.
  • CBT focuses on the individual's capacity to change themselves (their thoughts, feelings and behaviours), and does not address wider problems in systems or families that often have a significant impact on an individual's health and wellbeing.

'It can be agonising in many ways'

Carol Cattley had cognitive behavioural therapy (CBT) after the death of her husband. She found it to be a painful experience at times, but it gave her the confidence to continue helping herself.

"I had CBT in the millennium year, a couple of years after my husband died. My husband's death hit me really badly, because we had been together for so long. I had suffered from depression as a teenager and was feeling extremely down again.

"One of the things about CBT is that it's a very emotional experience, because as you work through it, you relive painful experiences. It can be agonising in many ways.

"I had eight or so treatments by the time I finished the course, and I had definitely shaken a lot of things out of myself. It's given me the confidence to be able to help myself.

"The CBT worked for me because I understood what was happening. It was a clearly defined exercise that was obviously leading somewhere, and the truth is that deliberately raking everything up achieved something.

"The psychiatrist gave me a book called Mind over Mood with exercises that you can do on your own. It's a very good book for depression.

"I think CBT is a vital treatment as an alternative to antidepressants.

"It's such a different experience. You feel as if you're in control of your destiny. It's a sensible, rational thing you can do to help yourself."

 
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