Cognitive Behavioural Therapy in London (CBT)
What is CBT?
Cognitive behavioural therapy is a form of psychotherapy which combines cognitive and behavioural therapies in the aim of helping individuals change how they think, act and therefore feel. The cognitive element looks specifically at how our thoughts can create our feelings and mood, and the behavioural therapy component examines the relationship between our behaviours and thoughts. Together, CBT focuses on the thoughts, beliefs and attitudes we hold (our cognitive processes) and how this interacts with our behaviour to create our emotional problems. Unlike other forms of psychotherapy, CBT focuses specifically on the problems and difficulties in the present, rather than issues based in the past.
CBT is a way of talking about:
- How you think about yourself, the world and other people
- How your actions affect your thoughts and feelings.
Our Cognitive Behavioural Therapists in London can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. For example, your thoughts about a problem can affect how you feel physically and emotionally, and consequently how you act upon it.
What does CBT look like in practice?
Cognitive behavioural therapy differs from most other types of psychotherapy in several key ways:
- It is pragmatic: CBT helps identify specific problems and an attempt is then made to overcome them.
- It is highly structured: Rather than talking freely about your life, you and your therapist will discuss your specific problems and set goals for you to work towards.
- It is focused on current problems: Unlike some other therapies that attempt to explore and possibly resolve past issues, CBT is mainly concerned with how you think and act in the present.
- It is collaborative: Your CBT therapist will not tell you what to do. They will work with you to help you find ways of managing your current difficulties.
CBT can be done individually, in groups or can be undertaken from a self-help book or computer program. The computer programs available are 'Fear Fighter' (for individuals with phobias or panic attacks) and 'Beating the Blues' (individuals with mild to moderate depression). However, these methods are more likely to be effective if you receive additional support from a trained professional.
A CBT Session
In undertaking CBT you will usually meet with a therapist for a number of weekly sessions, with each session lasting approximately 50 minutes. Initially the therapist will be assessing how suitable the therapy is for your issues, and how comfortable you feel with undertaking the therapy together. Thereafter, you and your therapist will begin to break each problem down into its separate parts. Your therapist may ask you to keep a diary to help you identify your personal patterns of thoughts, emotions, bodily feelings and actions to help with this process. Together you will then begin to look at your thoughts, feelings and behaviours to work out if they are unrealistic or unhelpful and how they affect each other and you. Once you have identified what you can change, your therapist is likely to recommend ‘homework’ so that you can practise these changes in your everyday life outside of the session. This could include questioning upsetting thoughts and replacing them with more helpful ones or recognising when you are going to do something that will make you feel worse and instead doing something more helpful. It is important to remember that the therapist cannot force you to do things that you do not want to. You decide the pace of the treatment.
An example of CBT at work
Below is an example of how certain thoughts, feelings and actions can trap you into a negative spiral, making you feel increasing more distressed:
'Claire’s boyfriend has just ended their 4-year relationship. She thinks that she is completely useless at relationships, a rubbish girlfriend and that no one else will find her attractive. These intensely negative thoughts lead her to feel hopeless, depressed and physically exhausted. Eventually, Claire begins to stop seeing her friends or going out and instead sits at home on her own, feeling increasingly depressed and anxious.'
CBT can help prevent these negative cycles by showing you ways of changing negative thoughts and composing alternative ways of thinking about a situation. Fundamentally, CBT is based on the theory that it is not the events themselves that upset us, but the meanings we attach to them. Thereby, our thoughts can prevent us from seeing things that do not fit with what we believe is true. In effect we continue to hold on to the same thoughts and fail to see the alternative explanation. In the case of Claire, an alternative way of interpreting the situation would be to accept that many relationships end, and that there are plenty of new people with whom she may get along. These more positive thoughts may lead to Claire feeling more confident, energetic and more socially active.
How many CBT sessions do I need?
The number of cognitive therapy sessions depends on your presenting issues. Cognitive behavioural therapy tends to be short term when the presenting issues are non-complex. At the first consultation you can discuss how many sessions may be indicated.
What evidence is there for CBT?
Cognitive behavioural therapy is an evidence-based treatment based on the idea that thoughts, feelings and behaviours are interconnected. The essence of cognitive therapy is to examine underlying thoughts behind the emotional problems and to generate alternative, more balanced thoughts. Cognitive therapists aim to work on your thoughts and behaviours to help improve how you feel. The government-produced NICE guidelines recommend CBT as a treatment of choice for a number of mental health issues. This is based on numerous studies showing its effectiveness.
What issues are suited to CBT?
CBT is one of the most effective treatments available for conditions where anxiety or depression is the main problem, even matching the effectiveness of antidepressants in some cases. However, it has also been successful in a variety of other problems including, obsessive compulsive disorder, phobias and panic disorder, post-traumatic stress disorder, eating disorders, anger problems, habits (such as facial tics), drug and alcohol abuse, relationship problems, sleep problems.
CBT has also been used to help individuals with chronic health conditions such as arthritis and irritable bowel syndrome. Although it cannot cure these physical problems, it can help individuals who have long-term conditions to be better able to cope with their symptoms.
CBT is not a quick fix and by no means an instant miracle cure. While a therapist can support, guide and encourage you, they cannot ‘do’ it for you. Similarly, when you are feeling down, anxious or upset concentrating and motivating yourself can be difficult, but one of the greatest benefits of CBT is that you can use the skills learnt outside of therapy to prevent escalating spirals of negative thought.
Cognitive Behavioural Therapy at Harley Therapy™ London
The counselling psychologists at Harley Therapy have many years of training and clinical experience in delivering cognitive behavioural therapy. They have studied in the top UK institutions and offer CBT for all conditions including: depression, stress, anxiety, trauma, eating issues, low self-esteem, anger management, relationship difficulties, sexual problems, work/career issues, phobias and obsessive compulsive disorder.
If you are looking to embark on a course of CBT sessions in London, then please contact us now for more information on how we can help you or to book an initial consultation at one of our clinics below.
We look forward to helping you!