To consider if Cognitive Behaviour Therapy (CBT) right for you we have talked about what you want from therapy and if the CBT model makes sense to you. In this post we’ll look at the characteristics of CBT.

3. Does the CBT structure suit you?

As described in the posts below CBT is goal and change focussed. In order to make progress in this way we use a certain structure. Rather than the therapist being the expert who can ‘fix’ things for you, we work together on the problem. You bring your knowledge of yourself and your life; we bring our knowledge and experience of CBT.

Therapy is time limited because the idea is that over time you gain new knowledge and skills and move towards ‘becoming your own therapist’. This is likely to require you to put some time aside in between sessions, for example for reading or keeping notes or trying out new ways of doing things and practising what you have learned in therapy.

After an agreed number of sessions we will review therapy to ensure that what we are doing is helpful. Also, at the beginning of each session you will agree how you want to use the time; you create a structure by ‘setting an agenda’. Of course, sometimes things emerge in session which may need to take priority and you may change your plan with your therapist. At the end of the session you will have an opportunity to reflect on what you have gained from it and to give feedback. This is so we can both be clear what is, and is not, so helpful for you.

From this you can see that if you prefer a more free-flowing style in therapy overall and in each session, CBT might not feel so comfortable for you. If on the other hand you want therapy to focus on the changes you want in your life and you are happy to work towards these with your therapist CBT can really help you do this.

I have suggested that there are four aspects to consider when trying to decide if Cognitive Behaviour Therapy (CBT) would be suitable for you. Having thought about what you want to get from therapy we’ll now move on to the CBT approach.

2. Does the CBT model make sense to you?

Broadly speaking we understand our experience as relating to the following aspects:

– Our thoughts and beliefs (or cognitions): This is what is in our mind and we may or may not be aware of this at any given time.

– Our feelings or emotions: usually these can be described in one word like happy, sad, angry, anxious, upset etc.

– Our bodily sensations: such as pain, tension, butterflies in the stomach, relaxed and so on; and

– What we do, or don’t do, that is our behaviour, for example avoiding situations, shouting, ruminating, drinking, comforting, socialising etc.

Of course, what goes on for us in the here and now is influenced by our previous experiences. They have shaped our beliefs and assumptions about ourselves, the world and others and in turn influence the way we think, feel and act in the present.

As CBT therapists we seek to make changes in all these areas in order to improve the way we feel. We help you understand how these elements fit together for you and work out how to make a difference to your experience.

However, if you believe that an improvement in your situation can only happen if other people or your circumstances change, then a psychological approach such as CBT which focusses on what changes you can make, might not be right for you at this time. The aim of CBT is to help you make changes in your situation. Nevertheless, this may involve finding the best way for you to deal with givens that you are not able to change so that you can live life to the full.

CBT has received a lot of publicity over the past few years. Sometimes it appears to be hailed as the solution for psychological difficulties. Nevertheless, CBT will not suit everyone and at all times. So how can you know if it is the right therapeutic approach for you?

There are four aspects which might be useful to consider and I will look at each of those in my coming posts:

1. What you are hoping to get from therapy?
2. Does the CBT model make sense to you?
3. Does the CBT structure suit you? and –
4. What problem/s are you experiencing?

To start with I would like you to think about:

1. What are you hoping to get from therapy?

CBT is an intervention which aims to help you make changes in your present life. Is this what you want to do? And is it the right time to do this?

In CBT, we start by coming to an understanding with you of what has led to your problems and what keeps them going in the here and now. You may have had some difficult life experiences either when you were much younger, or more recently, – or both. Talking about your experiences and problems with your therapist in a safe setting is an essential part of understanding and processing them. It can be very supportive to share what’s going on in your life and reflect on it in a confidential setting.

However, this alone may not be enough to help you feel better in a lasting way. In CBT, you will be encouraged to think about what you want to be different and how you can make changes which help you get there. It might be that in order to manage the way you have felt you have used coping strategies. Some of these may have helped in the short-term but have kept your problems going. For example, if you have felt low in mood and energy you may have withdrawn from others and reduced your activities; or if you have felt anxious you may have avoided different situations. At the time, these strategies bring you relief but unfortunately they may compound matters. In CBT, we try to help you change the way you deal with things and find more helpful approaches.

However, if you prefer to have a place where you can simply offload and gain relief by having someone listen to you without working towards making changes then CBT might not be the best option for you. In this case, counselling might be more useful for you at this time.

It’s important though to consider that one of the reasons why CBT has a good evidence base for its effectiveness is that you will actively address how you think, how you feel and what you do so as to find lasting ways of dealing with them. This may involve a change in the way you view yourself, for example to help you develop more self-compassion, or trying out different ways of doing things if you struggle with anxiety. Of course, we will help you make the changes you want to make at your own pace, supporting you in a warm and non-judgmental atmosphere.

If you have any questions about any of the above please get in touch by email or telephone.

Next time, we’ll look at the CBT model to see if this approach makes sense to you.