What does CBT involve
CBT can be done individually or with a group of people. It can also be done from a self help book or a computer programme and there are a number of online courses available. One site for anxiety, Fear Fighter is for people with phobias or panic attacks, while the Depression Learning Path is a free resource for people with mild to moderate depression.
This will usually involve seeing a therapist for anywhere between 5 and 20 sessions – depending how long treatment is funded for. These sessions are often fortnightly, but sometimes weekly if the patient is in need of intensive help. Most sessions last for about an hour.
In the first session or two the therapist will want to get to know you and give you a chance to feel at ease with him/her. The therapist will take a history of your problems from you in order to determine how to proceed with therapy.
The important point is that you decide what you want to deal with in the short, medium and long term.
As you start to work with the therapist you will begin to break each problem into separate and more manageable chunks. This makes it easier to cope with than thinking you need to get better from everything all at once. Your therapist may ask you to keep a diary as this will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.
Together you will look at your thoughts, feelings and behaviours to work out if they are unrealistic or unhelpful and how they affect each other, and you. The therapist will then help you to work out how to change unhelpful thoughts and behaviours.
It is usually easy to talk about doing something, but much harder to actually go ahead and do it. So, your therapist will probably recommend ‘homework’ – these would be things you practise in your every day life. Depending on the situation, you might start to:
- Try one new food if you are anorexic.
- Practice positive ways to manage thoughts you get if you feel a compulsion to binge.
- Question a self-critical or upsetting thought and replace it with a positive (and more realistic) one that you have developed in CBT.
- Recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.
At each meeting you discuss how you’ve got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don’t seem to be helping.
They will not ask you to do things you don’t want to do – you decide the pace of the treatment and what you will and won’t try. The success of CBT lies in the fact that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.
Visit the British Association for Behaviour and Cognitive therapies (BABCP) for further information and to find a registered therapist.