Cognitive Behaviour Therapy (CBT) is a problem-focused, time-limited, talking treatment (or psychological therapy) that can be used to help improve the way that we feel emotionally, and physically.
The word “cognitive” simply refers to anything relating to our thoughts, or perceptions, or our particular “view” of things. Behaviour, in this context, as you may well already have guessed, refers to the actions that we take or the things that we do. Essentially, CBT helps people to alter unhelpful patterns of thinking and behaviour in order to produce change in how they feel. It is the process of changing thoughts and actions that constitutes the CBT therapy itself. Importantly, of course, therapy also takes account of the person’s overall life-circumstances and the challenges that they may be facing.
Breaking problems down
When people encounter difficulties CBT can be used to look at each of the factors (thoughts, emotions, physical feelings, actions, circumstances) that combine to make up their experience of the situation that they are in. The CBT framework is used firstly to identify which factors are contributing to the maintenance of those difficulties. Secondly, the therapist and person work together to identify which of those factors are changeable. Thirdly, the person and therapist then agree on a strategy for altering one or more of the factors in order to effect change.
Cognitive behavioural treatment techniques can then be used to tackle problems across each of the factors. For example, unhelpful behaviours and extreme thinking may be changed by trying out new behaviours and gathering evidence to support the development of more helpful thinking and responding. Problem-solving techniques may be used to generate alternative strategies to deal with real-life circumstances. Physical symptoms (depending upon their nature) may also become a focus for treatment.
The relationship between the therapist and the person seeking help in CBT is very important. The treatment is collaborative, that is, the client and therapist work together to agree upon ways of dealing with the problems. It is important that this way of working together makes sense to the client so that they are willing to try out new ways of approaching old problems. It is usual in CBT to set goals at the beginning of a course of treatment. This ensures that the treatment has focus and direction from the outset and both the client and the therapist are clear about the aims for treatment.
Becoming your own therapist
A crucial part of CBT is helping the client to become their own therapist. This means that when active treatment has stopped the client can continue to use the techniques and principles that have been learned to in order to continue to make progress and address any new difficulties that may be encountered. Once the active treatment period is complete in CBT it is good practice to make a therapy “blueprint” and relapse prevention plan for the client to refer back to should they encounter any setbacks.
Completing "out of session work" in order for the client to become confident in using the treatment techniques is an integral part of CBT.Out-of-session work is completed by the client and builds on what has happened in the previous therapy session and before. Beginning to do things alone, without a therapist can be difficult, so for some people this independence is something that is worked towards gradually, over time.