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Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a talking therapy that looks at the way our thoughts and feelings affect the way we behave. 

CBT is based on the idea that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. It aims to help you crack this cycle by breaking down overwhelming problems into smaller parts and showing you how to change these negative patterns to improve the way you feel.

Unlike some other talking therapy, in CBT the focus is on your current problems, rather than issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

CBT can have a beneficial effect on relationships with friends, family, school and in the workplace. 

Who it’s for

Cognitive behavioural therapy can be used for children of seven years and over, adolescents and adults. 

Issues we can help with

Cognitive behavioural therapy can help with a range of issues including:

  • anxiety
  • depression
  • phobias (including social phobia)
  • obsessive compulsive disorder
  • post-traumatic stress disorder
  • eating problems
  • relationship difficulties

Length of treatment

Cognitive behavioural therapy (CBT) is offered in treatment blocks ranging from 6 to 20 sessions. 

Individual CBT takes place on a weekly or fortnightly basis and each session lasts half an hour to an hour. Group CBT takes place on a weekly basis and each session lasts one to two hours. 

In the first few sessions your therapist checks that you can use this approach and that you are comfortable with this way of working. As you come to the end of treatment sessions are more spread out to give you a chance to put what you have learnt into practice. This helps build your confidence to manage without ongoing therapy. 

Assessment

Assessment starts with a meeting to understand what the difficulties are. We look at how your difficulties developed and what keeps them going. We talk about the most appropriate treatment for you. 

Although cognitive behavioural therapy tends to focus on the here and now, you are asked questions about your background and earlier experiences, as you may need to figure out how they affect you now. Your therapist is interested to know what has helped before now. 

With your therapist you develop a shared understanding of your difficulties, agree some goals for the therapy and develop a treatment plan. 

You are asked to complete questionnaires during the assessment that help you and your therapist to monitor the progress of your work together over time. 

Therapy sessions

You can be seen individually, in a couple or in a family or group for cognitive behavioural therapy (CBT). 

Each session follows a similar structure:

  • agree an agenda for the session
  • review what you covered in the previous session
  • discuss whether you managed to practise in between or complete homework tasks
  • explore alternative ways to think so that it improves how you feel
  • consider how you might put new ideas into practice and start to test them 

At the end of the session you go over what you have covered and plan how you can test out the ideas.

You are encouraged to think about whether there is someone in your family or support network that could help you, if appropriate.

Towards the end of your treatment, you are supported to manage future challenges as they arise, to reduce the likelihood of your difficulties coming back.

Children and young people

When we see children, we invite parents and carers to participate in the therapy, as this can improve the outcome. Parents and carers can be offered support sessions alongside the child’s therapy. With your consent, the therapist may work alongside other services, such as your child’s school, to support the treatment. 

In a typical session, you and your therapist use different ways to think together about your difficulties. This might include talking, drawing, writing things down, or acting things out. 

Effectiveness

Research shows that cognitive behavioural therapy (CBT) can be as effective as medication in the treatment of some mental health problems. CBT can also be completed over a relatively short period of time compared to other talking therapies.

However, to benefit from CBT, you need to commit yourself to the process. A therapist can help and advise you, but they can’t make your problems go away without your full co-operation.

Due to the structured therapy sessions it may not be suitable for people with more complex mental health needs or learning difficulties.

Risks and side effects

Cognitive behavioural therapy (CBT) is not a quick fix. In CBT you need to confront anxiety to overcome it. This can make you feel more anxious for a short time and your therapist helps with this. 

If you are feeling low in mood, it can be difficult to get motivated and to concentrate. 

Alternatives

Cognitive behavioural therapy is not for everyone. There is a range of alternative treatments that your therapist talks to you about during assessment. 

Other psychological treatments include: 

  • child psychotherapy
  • psychotherapy
  • group therapy
  • family therapy

In some cases patients are helped by medication which can be prescribed by a doctor and on rare occasions by our staff. 

Patients may choose not to take up any form of professional help for their issue and manage the problem themself. 

Questions or worries

Therapy can bring up difficult issues. We want you to feel able to discuss any questions or worries with your therapist. This is important to progress your therapy. 

If you would like to discuss any concerns with someone independent of your therapy please contact our patient advice and liaison service.