What is CBT (cognitive behavioural therapy)?


Cognitive Behavioural Therapy (CBT), or Cognitive Therapy as it is known in the USA, is the most endorsed form of psychological therapy in the UK.

 

It 'treats' or addresses psychological difficulties though talking. It is separate from medication (though many people seeking CBT will also be taking medication such as antidepressants).

 

While CBT is getting a fair bit of coverage in the media these days, it has been around since the early 70s. The name Cognitive Therapy was first introduced by Aaron Beck in the USA when he was working on treatments for depression.

 

Since then, it has been shown to be the best or equal best treatment for a range of psychological disorders (e.g., anxiety, depression, OCD - a fuller list and description is found on the London Psychology Cliinic Specialties page).

 

CBT helps to address the problematic emotions, thoughts, behaviour (or lack of action) and bodily sensations.

 

The key targets are usually the thoughts and behaviour, as the name Cognitive Behavioural Therapy suggests. 'Cognitive' is the term used to capture our thinking. This has two parts:

 

1. Our actual thoughts:

  • The verbal stream, e.g., "I'm useless"
  • Or an image, e.g., of making a mistake and being laughed at

 

2. Our thought processes:

  • How we distort things so they fit our view of ourselves, other people and the world
  • How our memory becomes biased
  • How minimise and magnify our experiences so they 'fit'
  • Our awareness of our thinking

 

 

CBT teaches us the practical skills to:

  • notice
  • question
  • evaluate
  • and change

your problematic thinking and behaviour.

 

In doing so it enables you to influence our mood (e.g., anxiety, depression...) in a positive way.

 

Simplified CBT model example


LPC CBT diagram

CBT also considers other important elements that aren't captured in the model above. These other elements help to better describe what is going on for us in such a situation. These typically include:

 

  • How we may systematically distort the information and our experience
  • Important learning in childhood or later
  • Key experiences
  • The factors which trigger the problematic situation (the thinking, behaviour, bodily sensations and emotion)
  • What this difficulty means to us
  • How we cope with this situation when anxious and at other times...

 

 

CBT's just about positively thinking, right?

 

No. Hopefully by now you can see that CBT isn't just about positive thinking, or flipping a negative self-statement into a positive. E.g.:

 

From: "I feel terrible."

To: "I feel brilliant."

 

From: "I'm scared."

To: "I'm bursting with confidence."

 

From: "I'm having a heart attack."

To: "My heart is stronger than anyone's ."

 

If we believe these first statements and experience them automatically, then we are very unlikely to believe the opposite (such as in the examples above). It would be nice if it were only that simple.

 

(Read more about the benefits of psychological therapy, and CBT in particular, on the Benefits of CBT page).