Cognitive Behaviour Therapy (CBT) is an approach to help people experiencing a wide range of mental health difficulties. The basis of CBT is that what people think affects how they feel emotionally and also alters what they do. During times of mental distress the way the person sees and judges themselves and the things that happens to them alters. Things tend to become more extreme and unhelpful. This can worsen how the person feels and causes them to act in ways that keep their distress going.
Therapists will aim to work jointly with the person to help them begin to identify and then change their extreme thinking and unhelpful behaviour. By doing this, the result is a significant improvement in how the person feels and lives their day to day life.
How CBT Works
The approach usually focuses on difficulties in the here and now, and relies on the therapist and client developing a shared view of the individual’s problem. This then leads to identification of personalised, usually time-limited therapy goals and strategies which are continually monitored and evaluated. CBT is inherently empowering in nature, the outcome being to focus on specific psychological and practical skills (e.g. in reflecting on and exploring the meaning attributed to events and situations and re-evaluation of those meanings) aimed at enabling the client to tackle their problems by harnessing their own resources. The acquisition and utilisation of such skills is seen as the main goal, and the active component in promoting change with an emphasis on putting what has been learned into practice between sessions (“homework”). Thus, the overall aim is for the individual to attribute improvement in their problems to their own efforts, in collaboration with the psychotherapist.
CBT in Practice
CBT can be used to help anyone irrespective of ability, culture, race, gender or sexual preference. Cognitive and/or behavioural psychotherapies can be used on their own or in conjunction with medication, depending on the severity or nature of each client’s problem. The effectiveness of CBT is supported by evidence from randomised controlled trials (RCTs), uncontrolled trials, case series and case studies. It is used in the treatment of common mental health problems, including the anxiety disorders, generalised anxiety, panic, phobias, obsessive-compulsive disorder, posttraumatic stress disorder, bulimia and depression as identified by a host of recent reviews by NICE, SIGN and other review bodies. CBT models have also been developed for use in an increasing range of mental health and health difficulties including severe and enduring mental health problems, such as psychosis, schizophrenia, bi-polar disorder, anger control, pain, adjustment to physical health problems, insomnia and organic syndromes, such as early stage dementia.