A Guide to Cognitive Behavioural Therapy (CBT)

It can be difficult to know where to look for support or what to do to feel better if you are dealing with a mental health problem. You might visit your family doctor, or a mental health professional, and one of the first things they might offer is Cognitive Behaviour Therapy (CBT). CBT is a proactive, problem-focused, goal-oriented psycho-social therapeutic treatment that offers a unique approach to address how your thoughts affect your feelings and behaviours.

CBT has been found to be effective in the treatment of a wide range of mental health illnesses, including depression, anxiety disorders, substance abuse, marital problems, eating disorders, and other serious mental illnesses. According to research, CBT dramatically enhances functionality and quality of life. It has also been demonstrated in numerous studies to be equally successful, if not more so, than other types of psychological treatment and medications.

The Theory Behind CBT

The foundation of CBT relies on the premise that our thoughts, emotions, and behaviours are intertwined. In other words, the way we perceive or think about a situation can affect the way we feel and behave. CBT accomplishes this by addressing how your thoughts influence your feelings and behaviours and by teaching coping mechanisms to handle various issues.

To break it down:

• Cognitive Therapy – examines the things you think

• Behaviour Therapy – examines the thing you do

Let's look at an example: imagine you failed a really important test. This may lead to negative thoughts and emotions, such as having feelings of worthlessness and inadequacy. This might make you act in ways such as withdrawing, yelling at your loved ones, or attempting to avoid situations that you fear might turn out poorly. This cycle of negative ideas, feelings, and behaviours might have occurred so frequently over a period of time, that it develops into a habit.

Now, a CBT therapist could help you in ending this vicious cycle and overcome negative thoughts, low mood, and resultant maladaptive behaviours via directed changes in behaviour, thought exercises and changes in physical activity.

Phases of CBT

-   Stage 1: Psychological assessment and forming an alliance with your therapist

• This is the time for you and your therapist to get to know each other during your initial CBT therapy session. Your therapist will probably ask you questions about your health and explain how CBT works. Be specific when describing the issues that most concern you. Your therapist might also ask what you aim to achieve from this experience. A helpful advice is to set and write down your personal goals before your first session.

• By the end of the first or second session, the therapist usually has an idea for a treatment strategy which helps them in determining how many sessions you will require for treatment. It is important to keep in mind that there is no fixed pattern or duration in CBT treatment. Each treatment plan is designed keeping in mind the client's needs and can change along the way depending on unexpected improvements or deteriorating mental health.

-   Stage 2: Understanding your thoughts

• In this phase of CBT, you learn how to comprehend and regulate your thought process. Although CBT focuses mostly on the present, dwelling into the past might help your therapist understand your current thinking pattern. Sometimes you approach problems in a certain way because that seems to be the only approach that makes sense to you. Your therapist can question whether the ways in which you perceive problems are actually realistic. You and the therapist can work on these together and come up with exercises that help you think in a more reasonable way.

• You are likely to see a change in your thought process after a few sessions. Furthermore, you should be able to identify the relationship between your thoughts and the symptoms you are attempting to treat more clearly. With the help of your therapist, you can come up with strategies to better manage your thoughts and control your reaction to them. 

-   Stage 3: Understanding your behaviour

• Your main objective at this stage is to learn how your behaviour affects your thoughts, and vice versa. You should also work on developing cognitive or behavioural patterns that will help you manage your symptoms more effectively.

• Clinicians might teach their clients new and healthier ways to cope with difficult situations by engaging in activities that are connected to these new patterns during or in-between therapy sessions.

• Learning new and healthier ways to cope with situations and applying it to real life situations, should help reduce the likelihood of a relapse.

• Stage 4: Exercising Self-Therapy

  To be your own therapist, you must take the initiative to learn and put into practise the abilities required to better foresee and handle mental health issues. This is one of the key distinctions that separate CBT from other therapeutic treatments - CBT teaches you to practice self-therapy. If CBT successfully treats your illness, you can continue to practise it on your own in the future. It can help deal with relapses or different challenges that may crop up in your life.

Results

CBT may or may not work on everyone or fully cure one’s condition. However, it can give you the strength to handle your problems in a constructive manner and enhance your sense of self-worth and life satisfaction. Here are some suggestions to make the most of your therapy and ensure its effectiveness:

-   Take a collaborative approach to therapy. Being an active participant, and contributing to the decision-making process are key to a therapy's effectiveness. Make sure to see that your primary concerns align with the therapists’ treatment approach. Decide on your goals with the help of the therapist and monitor your progress over time.

-   Be open and honest. Being open to new ideas and methods of doing things, as well as your openness to communicate your thoughts, feelings, and experiences, are essential for success in therapy. Let your therapist know if you're hesitant to discuss some topics because of upsetting feelings, humiliation, or concerns about their reaction.

-   Speak to your therapist if therapy isn't making a difference. After a few sessions, if you still don't feel like CBT is helping, discuss it with your therapist. You might choose to adjust something or attempt a different strategy with your therapist.