What is cognitive behavioural therapy?

Cognitive behavioural therapy (CBT) is a type of psychotherapy (talking therapy) treatment that can help you to identify negative thoughts, emotions and behaviours that affect how you manage difficult situations, helping you to view them more clearly. It focuses on how our thought patterns affect our emotions and behaviours. CBT can be used on its own or in combination with other treatments, such as medication. 

Cognitive behavioural therapies are a treatment option often used by psychologists.

What are the different types of cognitive behavioural therapies?

CBT uses a range of techniques and approaches that address the underlying thoughts, emotions and behaviours that cause distress. The different types of therapeutic approaches used in CBT include:

Cognitive therapy:

The focus of this therapy is to identify and change distorted thought patterns, emotional responses and behaviours.

Dialectical behaviour therapy:

The focus of this therapy is to acknowledge and change detrimental thought patterns and behaviours, learning that it is possible to both accept difficult feelings and be able to replace them with better coping mechanisms that wil help you, such as emotional regulation.

Multimodel therapy:

The focus of this therapy addresses seven aspects of an individual: behaviour, affection, sensation, imagery, cognition, interpersonal relationships and biological/drug factors.

Rational emotive behavioural therapy:

The focus of this therapy is to identify and challenge irrational ideas, learning to address these thoughts with coping mechanisms. 
 

How does cognitive behavioural therapy work?

CBT aims to help you break down problems into smaller parts to change your perspective to one that is more positive. By making your problems more simple to handle, you will be able to identify and change harmful thoughts and behaviours. Changing negative thinking patterns will change how you feel and how you think about yourself, improving your quality of life.

As opposed to other forms of psychotherapy, CBT focuses on your current problems instead of past problems. It looks to improve your mental wellbeing on a daily basis, in a practical manner.

For CBT to work effectively, you will need to be able to commit to the treatment and be willing to share your thoughts and emotions with your therapist. This might involve analysing and keeping a record of your thoughts, feelings and behaviours in a journal at home. This can take up a significant part of your time, but it is important for the progression of your treatment. 

Throughout treatment, you will create a working relationship between you and your therapist based on trust and understanding. For this reason, it is important that you choose a therapist that you feel safe and comfortable with.
 

Which mental health conditions can cognitive behavioural therapy help with?

As well as anxiety and depression, CBT can help with the following conditions:

• bipolar disorder
• borderline personality disorder
• eating disorders 
• obsessive-compulsive disorder
• panic disorder
• phobias
• post-traumatic stress disorder
• psychosis
• schizophrenia
• sleep disorders
• alcohol misuse and substance use disorders

In some cases, CBT can also help to manage the mental and emotional impacts brought on by long-term health conditions, such as irritable bowel syndrome, chronic pain, fibromyalgia and chronic fatigue syndrome. It is important to know that CBT will not treat the physical symptoms of these conditions. 

What can be expected with cognitive behavioural therapy?

CBT can be done as a one-to-one session with a psychotherapist, or as a group session with your family members.

During your first therapy session, the therapist will gather information about you and find out what you are looking to work on. They might also decide whether it would be beneficial for you to be taking medication alongside CBT.

During CBT, your therapist will encourage you to talk about your thoughts, feelings and actions, and will focus on specific problems using a goal-oriented approach. Your therapist will help you to break down your problems into different parts, including:

• situations
• thoughts
• emotions
• actions
• physical sensations

Breaking down your problems into smaller areas to work on will help you and your therapist determine if there are areas that are affected by distorted or unhelpful thought patterns, and the effect that these have on your wellbeing.

After working out what you can change, your therapist will ask you to implement these changes into your daily life. This might include recognising and challenging negative thoughts or behaviours, to be able to replace them with more helpful responses next time. You will discuss how you got on with these changes and what the process felt like during the next session that you have with your therapist.

During each therapy session, your therapist will check if you are comfortable with the pace of treatment and the progress that you are making, and will ask for your feedback. 

At the end of treatment, the therapy sessions will have given you the tools that you need for addressing any daily situation that leaves you feeling anxious. You will be at a point where you can tackle your problems and stop them from negatively affecting your life, without the help of a therapist. 

How long does cognitive behavioural therapy go on for?

CBT is usually short-term, with people requiring anywhere between 5-20 sessions that last 30-60 minutes each. Sessions are done once a week or once every two weeks. 

Despite this, it can take several months for you to understand and successfully manage negative thoughts and behavioural patterns. It is also common to feel worse during the initial part of treatment, as you confront and treat emotional issues that are difficult to work on. Several therapy sessions may pass before you start to see an improvement in the way you feel. 

How can I have cognitive behavioural therapy?

You can have CBT on the NHS. You can speak to your GP and ask for them to refer you. 

If you can afford to pay for it, you can have private CBT sessions. The cost of private sessions can range from £40 to £100 per appointment. 

The British Association for Behavioural & Cognitive Psychotherapies keeps a register of all of the accredited therapists in the UK.