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What is Cognitive Behavioural Therapy (CBT)?

The way we think about a situation affects the way we feel emotionally. The way we respond emotionally can then affect physical symptoms and behaviours, which in turn affect our thoughts. It's a continuous cycle, and if negativity is introduced into the cycle, it can lead to depression or anxiety.

Cognitive behavioural therapy (CBT) works to break that pattern by helping you to recognise the cycle and adapt how you to think and behave in response to situations.

CBT is now-focused, giving you the tools to deal better with situations as they happen. It’s designed as short-term therapy to empower you in the long term. Typically patients will attend 8 – 12 sessions over around 3 months.

Common CBT techniques include recognising irrational beliefs and either deciding not to endorse them or replacing them with alternative ones; helping the patient become and stay active, relaxation techniques and controlled exposure.

The vicious cycle

Someone who is suffering from depression or anxiety may experience a situation in this way:

  • Example event: They have a high workload and receive a poor appraisal
  • Interpretation: 'I am a complete failure'
  • Emotion: This leads to a low mood/depression
  • Behaviour: They then cease engaging in activities they once enjoyed and become isolated
  • Physical effects: Depression and a lack of activity result in poor sleep, low energy levels and poor appetite
  • Further interpretation: Adding to the initial feeling of being a complete failure, the isolation, lack of activity and low energy levels result in thoughts of hopelessness - 'There is no point'

Thoughts, behaviours, physical symptoms and mood are all interlinked in this cycle. But small changes can make a huge difference in breaking the negative pattern and improving emotional wellbeing.

Typical cognitive behavioural treatments

CBT aims to give the patient a toolkit of skills and coping techniques so that they essentially become their own therapist.

The focus is on adapting behaviours and thinking, as well as utilising physical interventions and mindfulness techniques. There are many CBT treatments that can be used to support emotional wellbeing, some examples include:

Behavioural techniques

When someone has reached the stage of feeling helpless, the therapist would start by looking at the behaviours and implementing quick fix changes as a form of urgent intervention. The patient may be asked to keep a diary of their week, explaining what they did and how they felt doing it, to help to identify patterns in how their behaviour influences their feelings.

Typically in anxiety and depression there is a lack in activities that deliver a source of achievement or pleasure. The therapist and patient would then work to introduce positive experiences back into the patient's life. They would identify obstacles and solutions, and set goals for the next week's activities. Week on week this becomes a schedule that gives achievement and pleasure and as a result improves mood, acting as a blueprint to maintain their mood.

Thought techniques

Once a level of mood stability has been introduced the therapist would introduce techniques that can positively influence the patient's thoughts, such as cognitive restructuring.

During cognitive restructuring therapists help patients to:

  • Catch an unhelpful thought
  • Recognise it as an unhelpful thought
  • Replace it with a more useful thought

This is another tool that patients can use towards long-term emotional stability.

The CBT formula for good sleep

These cognitive behavioural therapy techniques retrain your body and mind to sleep well at night. Brendan Street explains the basic formula.

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