Cognitive Behavioural Therapy teaches practical strategies to change unhelpful thoughts and behaviours. Experts explain why it’s become the NHS’s most widely used psychological treatment
Back in 2016 the University of Oxford published a study that had found 43 per cent of those who had received Cognitive Behavioural Therapy (CBT) reported “at least a 50 per cent reduction in symptoms of depression,” compared with those using purely anti-depressants or non-clinical forms of care.
This, along with a general societal shift to how we approach mental health, saw CBT skyrocket as a treatment for people experiencing a range of mental health issues including depression, postnatal depression, anxiety, phobias and obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), eating disorders, and personality disorders to name a few.
The combination of success and its apparent ability to work in a variety of instances is why it has become the most frequently prescribed course of therapy on the NHS. But many people still know less about various types of psychotherapy than they do physiotherapy.
With that in mind, we’ve spoken to Rebecca Light, Chief Accreditation Officer and Registrar for the British Association for Behavioural and Cognitive Psychotherapies (BABCP) to get a sense of what you need to know about Cognitive Behavioural Therapy, and whether it might be useful for you.
What is Cognitive Behavioural Therapy?
Cognitive Behavioural Therapy “works on the principle that our thoughts, feelings, physical sensations and behaviours are all connected, and that changing one can shift the others like a domino effect.” Light says.
What this means in practice is that therapy focuses on learning to identify and examine unhelpful thinking patterns (this is where the word cognitive comes from), “the kind of automatic thoughts that tell you you’re failing, that something terrible is about to happen, or that you’re not good enough.” Light offers as examples.
The behavioural element then involves changing what you do, and how you aim to think about the situation. For instance, this might be gradually facing the thing that is giving you anxiety, confiding in loved ones if you have been dealing with self-esteem issues, or perhaps building activities that improve mood and confidence.
“In practice, most CBT combines both, tailored to what you’re dealing with. It is time-limited, usually between six and twenty sessions, goal-oriented and collaborative in that you and your psychotherapist work together.” Light says. Typically, there is work for the client to do between sessions to put strategies into practice.
Which mental health issues can CBT help with?
As mentioned, there’s a fair few instances in which people prescribe a course of CBT – owing to the fact that it is goal-oriented and can help with initial mental resistance to doing the things that make you feel better. Because it is about changing thinking, “CBT has the strongest evidence base of any psychological therapy for a wide range of conditions” and is often used as a first-line treatment for depression, generalised anxiety, OCD, and panic disorders.
Light says that “for men specifically, it is worth noting that CBT’s structured, problem-focused approach tends to suit those who want to understand what is happening and do something practical about it, rather than simply talking about their past or reflect on their feelings.”
Behavioural approaches are also particularly effective for depression, “where low mood leads to withdrawal, which deepens the low mood further.” Light says. This makes sense, as CBT is specifically designed to break this cycle.
The cognitive element of “identifying and challenging unhelpful thinking patterns, tends to be especially effective for anxiety disorders, where catastrophic or distorted thinking is driving the distress,” Light says.
Do I have to do therapy in person?
In short, no. Both in-person and remote CBT (whether by video or even telephone) have good evidence behind them. For most people, the most important factor is finding a psychotherapist you trust. We’ve written about how to find the right therapist here.
If you find you have been in a bit of a negative space, your thoughts are pessimistic, anxious, or generally making life feel less than great, CBT is a sensible first port of call for therapy. And this doesn’t have to have been long-term; often, we use therapy to treat issues but CBT can even be preventative.
