The Cognitive Behavioural Model (In a Nutshell)

What is Cognitive Behavioural Therapy?

Cognitive Behavioural Therapy (or CBT) is an evidence based, NICE recommended psychotherapy that is used to treat a variety of mental health difficulties and concerns. It is a talking therapy but I like to think of it as a 'doing therapy' too. Cognitive Behavioural Therapy is underpinned by a model that helps us to understand that our thoughts, emotions and behaviours are all interlinked and impact each other. In therapy we call these vicious cycles and we can easily get trapped in them. The Cognitive Behavioural Model (In a Nutshell) Let's look at an example of how this might work. Let's say you are out with your child, and they have a tantrum in the supermarket. You might experience some thoughts such as 'everyone is staring at me', 'they think I am a bad mother' or 'they think I can't control my child'. This would understandably cause some anxiety and frustration (and we've all been there, right?). You might notice yourself feeling flushed, hot, sweaty or perhaps your heart starts racing and notice the urge to get yourself out of there. So you grab your child and leave the supermarket without buying what you went in there for. This kind of thing is not unusual when you have small children, however, there is a potential for this to become a vicious cycle. Perhaps you start to notice yourself feeling anxious about going to the supermarket with your child for fear of a tantrum, so you avoid taking them. This could then snowball into other areas and you might start to feel anxious about taking them out at all. Eventually this cycle might cause you to lose confidence in being able to manage your child's behaviour and you never get a chance to challenge or evaluate your thinking. How can CBT help me? Now we have gotten a little more familiar with the model, we can start to think about how CBT therapy might be able to help you. In CBT we learn to identify unhelpful thoughts and look at your behaviour in more detail to identify whether it is helpful or unhelpful. Once you are more aware of the thinking traps that pull you in and how your behaviour might be reinforcing what is going on then you know what it is you need to change. Overcoming unhelpful thoughts starts by understanding that thoughts are not absolute truths, or facts. Our mind experiences more than 6,000 thoughts a day, but we tend to latch on to ones that cause a strong negative emotional response. We learn strategies to challenge thoughts and to unhook ourselves from them so instead of letting your thoughts drive your life, you can get yourself back in the drivers seat. I already told you that CBT is a doing therapy, right? The best way to help overcome unhelpful thoughts is to start doing something different. What would happen if you had just carried on with your shopping? You don't get to learn something new unless you are prepared to do a few behavioural experiments to test things out. A wise psychiatrist I once worked with used to say 'if you keep doing what you've always done, then you'll keep getting what you've always got'. What's A CBT session like? In sessions we will set out an agenda at the beginning of the appointment, this agenda is collaborative and keeps us both accountable to helping you achieve your treatment goals. The agenda might include things like reviewing what you have been working on from the previous week, working on new skills together or drawing things out so that we can improve our understanding of the problem. Homework is a phrase I am not too fond of but you will hear it in the context of CBT therapy. It refers to the work that you do between sessions and it's an important factor in determining how successful your therapy will be. Let's say you want to learn to play an instrument, so you buy the instrument and go to a few classes but you don't practice at home. How can you expect yourself to develop or improve as much as someone who practised outside of sessions? It makes sense when you think about it. Ok, so what next? If you have decided that some CBT is for you (in which case, yay! I'm excited for you to start this journey), then there are a few options for you to consider. You can see your GP and request a referral to your local Improving Access to Psychological Therapies (IAPT) provider. A lot of these providers will also accept self-referrals so it is always worth doing a quick search on the internet for providers near you (I have popped a link at the end of this blog). Another option is to pursue private therapy, some people prefer to do this to avoid the wait for an NHS appointment. Waiting times will vary depending on your location. The benefit of private therapy is that you can usually get started right away. If you are seeking private CBT therapy in the UK or Ireland then ensure that your therapist is accredited by the BABCP (British Association of Behavioural & Cognitive Psychotherapies) or the IABCP (Irish Association of Behavioural & Cognitive Psychotherapies). This ensures that your therapist has met the strict standards expected from the BABCP including post graduate level training in CBT theory and practice, and several hundred hours of supervised clinical practice. If you want to check whether the therapist you have chosen is BABCP accredited then you can search them by surname through this link: https://babcp.com/CBTRegister/Search#/ I hope that this blog has answered some questions and helped to clarify whether CBT might be for you. If you are interested in exploring private CBT therapy with me then please follow the 'online booking' tab to book a free 15 minute consultation, it would be great to hear from you.

Kezia Mathiason

Useful links: https://www.nhs.uk/service-search/mental-health/find-a-psychological-therapies-service/