What is Cognitive behavioural therapy (CBT)

CBT is a talking therapy that aims to identify how the link between our thoughts (cognitions) and behaviours impact and maintain our emotional difficulties.

Founded by Albert Ellis and Aaron Beck, cognitive behavioural therapy (CBT) is an evidence-based therapy treatment delivered in either one-to-one or group based sessions. CBT therapy involves helping people to become more aware of their unhelpful thought patterns and behaviours that often lead to experiencing negative emotions. CBT also attempts to help people understand and adjust the underlying belief patterns which may be maintaining the unhelpful thinking processes and behaviours they are engaging in. CBT involves learning various skills to challenge cognitions and modify their behaviour, this can then lead to a significant improvement in the mood of the individual.

Cognitive behavioural therapy is considered one of the most effective methods of therapy, with some in the industry regarding it as the gold standard technique of psychotherapy. Only CBT and Eye movement desensitization and reprocessing (EMDR) are recommended by National Institute for Health and Care Excellence (NICE) guidelines for depression and anxiety disorders.

How does CBT work?

CBT works on the belief that problems manifest themselves in five areas:

• Situations
• Physical sensations
• Emotions
• Thoughts
• Actions

Each of these areas interact with one another. For example, your thoughts on a certain situation (like visiting the doctors) might lead to negative emotions (panic or dread) or certain physical responses (racing heart, sweating) from your body that might then affect your actions. A CBT therapist will work with you to find solutions to your current difficulties. This leans into another key principle of CBT - that these thought processes and behavioural patterns can be changed for the better.

At the end of a series of CBT sessions, you’ll be able to draw on a number of practical ways to improve your state of mind and have a more positive outlook. You’ll also have the skills to cope with any negative thoughts as they surface, helping you to avoid any more damaging symptoms related to your mental health condition.

CBT is a structured, action-oriented and problem solving approach, which helps you to manage your thoughts, behaviour and mood more effectively. It can be delivered either as an outpatient, where you’ll meet with your therapist on a weekly basis for a period of roughly 6 – 20 sessions, or as part of a more intensive inpatient programme.

What techniques are used with CBT?

CBT therapists make use of a wide variety of evidence-based techniques. Your therapist will make an assessment of which techniques will be the most effective for your individual needs.

Some of the techniques that are most often used with CBT include:

1. Cognitive restructuring or reframing

A process that looks to identify any negative or self-destructing thought patterns, which are then re-directed or reframed in a positive manner.

2. Guided discovery

A therapist will work with you to uncover your outlook on life and your current situation, plus how you process information. By reflecting on these questions and challenging your perceptions, your mind can be opened to a whole host of alternative ways of thinking.

3. Exposure therapy 

Desensitising yourself to situations that cause anxiety, fear or distress is known as exposure therapy or situation exposure. When CBT is used to treat anixety, you gradually expose yourself to the things you fear, and the negative feelings around them should subside. 

4. Journalling

In between sessions, you might be asked to keep a journal where you can record negative thoughts, emotions and feelings as they happen. This can be a great place to start when delving into your state of mind in your next session.

5. Relaxation and stress reduction techniques

Things like mindfulness, meditation and breathing techniques can be taught to give you the tools to deal with stressful or anxiety-inducing situations better.

6. Goal setting

Setting attainable short, medium and long-term goals can be an effective technique when recovering from a range of mental illnesses. CBT therapists will help you to identify and set goals, often using the SMART (specific, measurable, attainable, relevant, time-based) method.

7. Positive activities

Away from the session itself, a CBT therapist might suggest you organise activities throughout the week that you enjoy. These small, pleasurable activities all add up to promote better wellbeing and reduce negative thoughts and emotions each day

8. Exposure and response prevention (ERP) 

ERP involves making the choice not to do a compulsive behaviour once the thought, image, object or scenario that triggers anxious thoughts presents itself

Whatever techniques the therapist adopts, it will also include the fundamentals of the practice. These include: identifying problems or issues in your life, building awareness of the negative thought processes that circulate around the problem, and developing and implementing behavioural practices that deal with these problems.

What Are the Different Types of CBT?

There are lots of different therapeutic practices that involve CBT. These are known as third wave CBT therapies. The most significant ones include:

• Cognitive analytic therapy (CAT): helps you learn how to identify harmful ways of thinking and works to change them
• Dialectical behaviour therapy (DBT): focuses on people who struggle with regulating their emotions or have displayed self-destructive behaviour
• Rational emotive behaviour therapy (REBT): looks at dealing with irrational beliefs and better management of emotions and thoughts
• Stress inoculation training: trains you to quickly deal with anxiety and fear when it is triggered by certain situations. Often used to treat post-traumatic stress disorder (PTSD)
• Multimodal therapy: based on the idea that seven interconnecting modalities must be simultaneously addressed to overcome psychological issues. The modalities are: behaviour, affect, sensation, imagery, cognition, interpersonal relationships, and drugs or biology.

What are the benefits of CBT?

In many cases, a course of CBT can be just as effective as medicine when treating various mental health problems. It has a range of other great benefits too, such as:

• Opening your mind up to new ways of thinking
• Teaching you effective strategies that can be used in everyday life
• A structured nature, meaning it can be used individually, in groups, or online
• Collaborative approach means the therapist works together with the client to support recovery
• A pragmatic nature, which focuses on your current problems in life and working to bring about solutions
• Building self-esteem and confidence
• Developing a rational, balanced thought process
• Tends to be a shorter, less intense therapy intervention than other methods

What can CBT treat?

CBT is most commonly used to help treat mental health concerns like anxiety and depression. However, it can also be used to treat a long list of psychological disorders including:

• Addictions
• Anger management problems
• Body dysmorphic disorder (BDD)
• Chronic fatigue syndrome (CFS)
• Chronic pain
• Eating disorders
• Obsessive compulsive disorder (OCD)
• Panic disorder
• Personality disorders
• Phobias
• Post-traumatic stress disorder (PTSD)
• Psychotic disorders
• Relationship problems
• Self-harm
• Sleep disorders
• Stress

Supporting your recovery: CBT at Priory

At Priory, we offer couples, group and individual CBT for a wide range of difficulties including anxiety, depression, anger and eating disorders. Groups are based on a CBT approach and include psycho-education, together with tools and strategies to help you to manage your behaviours and mood more effectively.

We are able to deliver CBT, alongside a wide range of other therapy types, in an outpatient, day care or inpatient capacity. We can also provide therapy services at a time and place that is convenient to you with online therapy.

Our services are conducted in line with guidelines set out by the National Institute for Health and Care Excellence.

No matter your circumstances, you’ll find the best therapy treatments, delivered by the best therapists, at the Priory. Contact us via the number below, or using the following enquiry form, to speak to a mental health professional and begin your road to better mental health.