CBT for You...
At CBT for You, specialised cognitive behavioural therapy is delivered as a treatment for various mental health conditions, including stress, anxiety, generalised anxiety disorder (GAD), social anxiety, health anxiety, depression, panic disorder, phobias, low self-esteem, self-confidence issues, obsessive compulsive disorder (OCD), intrusive thoughts, perfectionism and post-traumatic stress disorder (PTSD).
In addition to CBT, schema therapy can be provided for other longstanding issues including childhood trauma (see schema therapy section below for more details).
What is Cognitive Behavioural Therapy?
It is a way of talking about how you think about yourself, the world and other people. It is the most requested therapy of all and CBT recognises that what you think affects how you feel and behave. CBT is based on the concept that thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap people in a vicious cycle. CBT aims to teach clients to deal with overwhelming problems in a more positive way by breaking them down into smaller parts. CBT can help you to change how you think (Cognitive) and what you do (Behaviour). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now. CBT is problem focused (undertaken for specific problems) and action orientated where the therapist assists the client in selecting specific strategies to help address the underlying problem.
CBT is completely different from the older more traditional Freudian (1856-1939) psychodynamic approach, where therapists look at human functioning based upon the interaction of drives and forces within the person, particularly the unconscious, and between the different structures of the personality. In essence, psychodynamic therapists look for an unconscious meaning behind the behaviours and then diagnose the client.
Recommendations for CBT
Increasingly over many decades, CBT has become the first choice of therapy encouraged and recommended by the British Government, Doctors and many other mental health professional bodies. It is also advocated by clients who have reaped the benefits of CBT and recommended it to others. It is now the therapy of choice and most General Practitioners (GPs) will encourage their clients (who have mental health issues) to seek help from a Cognitive Behavioural Therapist. CBT has the greatest efficacy of all the ‘talking therapies’. Anyone researching the best treatment for mental health conditions will find the answer is consistently defined as CBT.
The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. NICE advocate that CBT is the treatment of choice for a number of mental health difficulties including depression, anxiety, obsessive compulsive disorder and post traumatic stress disorder (PTSD), amongst others. Whilst NICE is an English organisation, the Scottish equivalent, SIGN (Scottish Intercollegiate Guidelines Network) also recommend CBT for all mental health difficulties.
How does CBT work?
CBT therapists recognise that the way we think directly affects how we feel. So, if we think good things about ourselves, e.g. “I did that well” or “I am good enough”, then we will feel positive and good about ourselves and our life. However, if we have unhelpful thoughts such as “I am not good enough” or “I am useless, unworthy or unlovable”, then we are going to feel negative and bad about ourselves. This in turn affects how we behave as we are likely to feel unmotivated. This can cause distress and problems. CBT helps to identify clients’ common unhelpful thinking styles.
These thinking styles are then challenged and techniques are taught to enable the client to examine the evidence for and against the thoughts and to formulate a more helpful, rational way of thinking. When clients learn this technique it can make a tremendous difference to the way they think about themselves and their world. Of course, this is just one example of a CBT technique. Each client will have unique needs and problems and a treatment plan including relevant strategies and techniques will be individually formulated according to these needs. The overriding goal of CBT is not to diagnose a person with a single particular disorder or issue, but to use a more holistic approach taking the client’s ‘journey’ into account. The therapist and client decide together what needs to be addressed.
Cognitive Behavioural Therapy has 3 main aims:
To relieve symptoms and to resolve overwhelming problems by breaking them down into smaller parts.
To help the client acquire skills and coping strategies.
To help the client modify underlying cognitive structures in order to prevent relapse.
In essence my aim is to enable you to better understand yourself and to encourage you to use your new coping techniques and strategies to the best of your ability... to be your own therapist and to have a happier and more fulfilling life.
The Therapeutic Relationship
Cognitive Behavioural Therapists work together with clients to help identify thoughts, feelings and behaviours which can cause difficulties in the client's life. Therapists aim to gain a thorough understanding of their clients' concerns or goals and then help them achieve those goals. Therapists are empathic, caring and non judgemental and the therapist's role is to ask questions, listen, facilitate and support. The client's role is to express concerns, learn, and put into practice some of the techniques and strategies discussed. Cognitive Behavioural Therapists do not tell clients what to do. Instead, they teach skills to increase wellbeing and the ability to identify more helpful ways of coping with difficulties. The success of CBT depends on the active participation of the client in the whole process. The more a client is able to ‘open up’ and enable themselves to be vulnerable the more they are likely to engage well and reap the benefits of therapy. It is about the client and therapist working together collaboratively.
What is Schema Therapy?
In addition to CBT, Schema Therapy may be included if it is found that the client has deep rooted childhood issues that continue to impact the here and now, influencing how they see themselves and how they feel. For example, if a client had a critical parent who made them believe that they were not good enough, this could result in an ingrained feeling of defectiveness which could influence the client throughout their life. Schema therapy helps the client to examine this belief and explores ways to counteract it with a healthy adult voice.
The Initial Consultation
Your engagement with CBT starts with an initial consultation to ensure that CBT is the right therapy for you and that you are completely comfortable with the proposed process. At the initial assessment you will be asked lots of questions to enable an understanding of you and your life and what is preventing happiness or fulfilment at this point in time. If you are anxious or depressed, you will be asked whether these issues interfere with your family, work and social life. You will also be asked about events that may be related to your problems, treatments you have had, and what you would like to achieve through therapy. You will be asked if you have had any previous therapy and if you are taking any medication for your mental health issues.
Short questionnaires will be used to ascertain a baseline clinical measure for anxiety and depression. If CBT is deemed an appropriate therapy, Dr Ross will let you know what to expect during therapy sessions. Your issues and needs will be analysed and an individualised treatment plan will be discussed. If CBT is not deemed appropriate, or you do not feel comfortable with it, alternative treatments may be recommended.
Once the initial assessment has been completed, we will start working together to break down your problems into their constituent parts (situations, thoughts, emotions, physical feelings and actions). Homework is usually a part of CBT and clients who are willing to do assignments at home seem to get the most benefit. Homework assignments will be agreed between the therapist and the client and might include the client keeping a diary of thought and behaviour patterns or practicing new skills or engaging in relaxation exercises. Once treatment has been formulated you will be sent any paperwork for use in sessions electronically in advance.
What is accreditation and why is it so important?
The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the lead organisation for Cognitive and Behavioural therapies in the UK. Accreditation means that a CBT Therapist has both core professional mental health training as well as specific CBT training over a 2 year course at University. To be Accredited, BABCP members must commit to maintaining high standards of clinical practice, clinical supervision and continuing professional development. Accredited members are regularly audited to ensure that they continue to meet these expectations.
Accreditation is a very important consideration when accessing CBT services. The majority of Mental Health practitioners, therapists or counsellors offering CBT are not Accredited by the BABCP but may be Accredited with another agency such as the BACP (British Association for Counselling and Psychotherapy). It should be considered that Accreditation by an organisation other than the BABCP does not serve to guarantee the same level of expertise, training or professional development in CBT.
Accreditation by the BABCP guarantees that a practitioner's practice meets or exceeds the stringent standards set by the BABCP. Their website below explains this:
Other therapists, practitioners or counsellors may have had little or no formal training in CBT but may offer it under the psychotherapy umbrella. They may use terms such as “I use a CBT approach" or "I incorporate CBT techniques”, but they are not fully qualified and Accredited CBT Therapists.
It is advisable to check qualifications to ensure you engage with a fully accredited CBT Therapist. Please note that just because someone has joined the BABCP as a member (anyone can) it does not mean they are formally Accredited. You can check if your therapist is fully Accredited on the BABCP website link below: