Cognitive Behavioural Therapy (CBT) is one of the most commonly prescribed forms of therapy on the NHS, but what exactly is it? BBC Radio 1 psychotherapist Dr Aaron Balick answers your questions about CBT.
What is CBT?
CBT is a form of therapy that deals mostly with your thoughts and how they affect your behaviour. A typical course of NHS CBT lasts between 8-10 sessions. “Thinking, stress, anxiety and depression are all linked, so CBT works by helping you learn how to think more rationally,” says psychotherapist Dr. Aaron Balick. “For example, if something goes wrong, like you don’t get invited to a party, you might think ‘this is the worst thing ever’ or ‘my life is over!‘ CBT teaches you that this is “catastrophising” and making things seem worse than they are.”
What can I expect from a typical session?
Firstly, you therapist or counsellor should listen to you to find out exactly what’s troubling you – and they should be empathic and non-judgemental. A typical CBT session will involve:
- finding out about situations or issues that are troubling you
- helping you become aware of your emotional responses to these situations
- identifying patterns of negative or inaccurate thinking
- working with your therapist to challenge these beliefs and fears
- If you’re having CBT for a specific phobia, you may be offered ‘exposure therapy’ (see below).
“Therapists will work at your pace, so don’t worry about being thrown into it,” says Dr. Aaron. “However, it does take some effort on your part, and that means it can be challenging at times. Remember your therapist is there FOR YOU and should support you through any difficulties.” For more advice on the relationship with your therapist, see our article.
What is exposure therapy?
Exposure therapy is when you are asked to do something that makes you scared or uncomfortable. This could be going into a public place if you have agoraphobia, or not double checking things if you have OCD. Through this, you learn to tolerate the horrible feelings you have when you face your fears and this helps you cope better. Graded exposure therapy means taking this slowly, with the full support of your therapist. “The therapist will discuss with you how ready you are. Facing your fears can be terrifying, but it’s only by confronting them that we realise lots of them are overblown. The feeling of accomplishment is pretty amazing. Having someone there to help you deal with them is the best way of resolving them,” says Dr. Aaron.
I’m young and don’t have much money – how do I get CBT?
Currently CBT is the most common talking therapy on the NHS. The first step to getting free CBT is visiting your doctor. If you’d rather not go through your doctor, call or email Mind (details listed in the Next Steps box below) and ask about local organisations that provide free or low-cost therapy.
Can I do CBT on my own? Does that work?
“This depends on how severe your symptoms are,” says Dr. Aaron. “Everybody can learn some CBT, but if your symptoms are very severe or if you have OCD or an anxiety disorder, then it’s best to get some guidance with it. Once you learn the skills, there’s lots you can do on your own too.” Online CBT is becoming popular – read our article to find out more. There are also books you could try, including the Overcoming series and Dr. Aaron’s own book, ‘Keep Your Cool: how to deal with life’s worries and stress’.
What if it doesn’t work? Or if I’m not better by the end of my sessions?
“We all have fears and anxieties, and we all sometimes get depressed. CBT won’t ‘cure’ this completely, otherwise you’d be like a robot who had total control of their feelings,” says Dr. Aaron. “If it’s not working you need to be clear about this with your therapist. CBT is not the only psychotherapy and different therapies work for different people. Just make sure you are always clear with your counsellor/therapist about how you feel.”
And finally, can CBT make you worse?
When you feel scared and upset, it’s common to worry that having therapy might make things even worse. You also might feel worse at the beginning of a course of therapy because it’s likely to stir up your emotions. Typical issues include:
- Trying CBT and finding it doesn’t work, then feeling like you’ve failed.
- Trying a new behaviour (for example getting on a plane) before you’re ready, and scaring yourself.
- Becoming too good at CBT! Analysing your thoughts too much, instead of just enough.
You might also get frustrated because you know your thinking is irrational, but can’t help feeling that way. “This is actually part of the process, says Dr. Aaron. “CBT should eventually help you learn to deal more gently with your own frustrations with yourself.” “The best way to prevent these sorts of things is not to hide anything from your therapist and let them know if you ever feel uncomfortable. They should be responsive to your needs,” says Dr. Aaron. “If you feel things aren’t working, try to speak to them about it. If that doesn’t work, or if you feel like you can’t, speak to a parent or perhaps the person that referred you.”
- Mind offers advice and support to people with mental health problems. Their helpline runs nine to six from Monday to Friday. 0300 123 3393
- SANE offer support and information to people affected by mental illness. 0300 304 7000
- Chat about this subject on our Discussion Boards.
- Need help but confused where to go locally? Download our StepFinder iPhone app to find local support services quickly.
Updated on 29-Sep-2015
A guide to CAMHS
What is CAMHS and what happens when you go there?
Is the news making you feel anxious?
It's good to be connected, but look after yourself too.
A guide to self care
How to keep your mind and body happy and healthy.
Telling your boyfriend or girlfriend you have a mental health problem
When to do it, what to say and how they'll react.
What is anxiety?
Feeling scared all the time? You may have an issue with ...