Generally, the duration of therapy is 10-20 sessions
enabling you to 'becoming your own therapist', which is an important part of
Cognitive Behavioural Psychotherapy. However, with complex problems Cognitive
Behavioural Psychotherapy can last up to 5 years and sometimes more. Both the therapist and the
patient work together in a collaborative transparent way, with clients taking
an active role, carrying out "homework" between sessions. The client
will often be asked to keep a diary of their thoughts, feelings and behaviours
in the situations that they find stressful / distressing, and listen to audio recordings of
the session to help the client remember what was discussed.
Tasks are set to test personal ideas that might be
maintaining the problems i.e. if I avoid my anxiety my health problem will get
better. Initially homework tasks will involve finding out information about
your problems, for example reading an information leaflet, or guided self help
material or books.
The foundations of this form of psychotherapy is
the relationship between the therapist and the patient, with the therapist
treating your difficulties with understanding and sensitivity, and being
non-judgemental, accepting you as the person and an individual. Therapy focuses on the presenting
problem that you want to deal with, not the therapist’s interpretation of your
problems. Initially your therapist helps you identify a list of your problem(s),
and corresponding realistic goals that you would like to reach by the end of
therapy and beyond. Psychotherapy is paced at your rate so as not to move too fast or too
slow.
Most patients meet with their therapist weekly to
review previous homework, explore and analyse individual thinking, and to
continue to set weekly tasks / experiments / homework etc. Sessions usually last
between 50 and 55 minutes.
The therapist can be seen as a guide, colleague,
expert, and consultant who has experience and training in dealing with
emotional problems. The emphasis is on finding solutions, and changing how the
client views themselves, other people, and the world, so every patient
becomes their own therapist, learning to apply new skills and techniques,
independent of a health care professional.
Below are some problems that Cognitive Behavioural
Psychotherapy can help you with: Anxiety and Depressive problems including,
Anxiety, Depression, Phobias, Generalized Anxiety Disorder, Social Phobia /
Anxiety, Obsessive Compulsive Disorder, Body Dysmorphy, Health Anxiety,
Hypochondrias, Somatoform, Panic Disorder, Agoraphobia, Eating Disorders, Post
Traumatic Disorder, Sexual Disorders, Binge Eating Disorder, Bulimia Nervosa, Perfectionism,
Chronic Low Self Esteem, Anger and Irritability, Chronic Pain, Chronic Fatigue
Syndrome, Sleep Problems, Habits and Tics, Unexplained Medical Problems, or learning to cope with various Health Problems. It is unusual for a patient to
come with a named problem as given above. Most patients come to Nottingham CBT
Service with a variety of symptoms and the therapist helps you to understand
your symptoms in a meaningful way that makes sense to you.
If,
following your initial assessment, the therapist concludes that CBT is not
appropriate, time will be given to explain the reasons, and alternative
suggestions will be offered. These may include a different form of
psychotherapy, seeing a specialist to discuss medication issues or perhaps
recommending some literature.
CBT is one of many types of psychotherapy ('talking
treatment'). Unlike some types of psychotherapy it is not a lie back on the
couch and tell me your problems.
Cognitive Behavioural Psychotherapy tends to deal
with the 'here and now', and helps patients change behaviour, cope with emotions and thoughts. Though, if needed, CBT also addresses and helps heal past
issues, as it is recognised that events in your past, particularly thought
patterns, memories and behaviours learnt in childhood, can shape the way that you
currently think and behave. CBT is also different to counselling which is meant
to be non-directive, empathic and supportive; although the CBT Psychotherapist
will offer support and empathy. Finally, CBT therapy has a clear structure, and
is problem-focused and practical.
Cognitive Behavioural Psychotherapy has been shown
in hundreds of clinical trials to help ease symptoms of various health problems. For
example, research studies have shown that a course of CBT is just as effective
as medication in treating depression and anxiety disorders. With the long-term
benefits of CBT appearing to outstrip a good number of medications in reducing
relapse. CBT as an approach helps combat problems for the rest of
your life, and it also helps keep symptoms managed. However, for certain problems
sometimes a combination of medication and cognitive Behavioural Psychotherapy
is required.
CBT is constantly evolving and synchronized with the latest recommendations
from research, suggesting what works best, and assimilating the most effective treatment
interventions from other psychotherapies. Though, it is beyond the scope of
this website to present a comprehensive list of the evidence for CBT.
National Institute of Clinical Excellence (NICE) is
the independent organisation responsible for providing National Health Care
Guidance to the NHS on various health related problems, regarding which treatments have research to support effectiveness.
There are various NICE guidelines for Mental Health
Problems predominantly emphasising the use of Cognitive Behavioural
Psychotherapy as the Psycholoigcal treatment of choice.
Please see the Department of Health NICE Guidelines
for specific mental health problems.
