Cognitive Behavioural Therapy (CBT)
My second article looking at the different types of counselling, looks at CBT.
Cognitive Behavioural Therapy, or CBT for short, is a form of goal-oriented, systematic psychotherapy that brings together two previously separate schools of therapy (the cognitive, and the behavioural, as you might expect!). At a basic level it is about changing how you think (the cognitive side) and what you do (the behavioural side). Putting these two together, it can look at how the way you think affects what you do, for example the way you think about things/yourself can affect your emotions and that in turn affects the choices you make in how to act. Of course, if you think-feel-act negatively this can produce a negative feedback loop and reinforce the negative feelings. CBT therapists work to explore such “helpful” and “unhelpful” thinking patterns. CBT often involves “homework” such as keeping a journal to observe how thinking patterns are affecting elements of daily life, and to work out different ways of thinking that might be more helpful.
Currently, in the UK, CBT seems to be the therapy of choice in the NHS, but personally I wonder whether this is down to its effectiveness, or simply the fact that it is brief, and somewhat cost effective in the short term. We have seen schools, for example, gearing themselves towards shaping children who can pass “SATS” rather than whole, happy, well rounded children, and my worry is that CBT, while it may be effective at treating symptoms in a way that looks good on balance sheets, may not be the holy grail of solving mental health issues. I liken it to a sticking plaster – CBT will cover up the wound on the knee and let us carry on, but it will not help us discover why we fell over and hurt our knee in the first place. My worry would be, long term, that more and more sticking plasters would be needed. So many times have I heard people say “I’ve done CBT and it really helped… But now I seem to be having problems again…” I think CBT can certainly be enormously useful, but I have heard enough people say they did not find it helpful to come to the conclusion that it is not the universal panacea CBT evangelists might like to claim it is. There are people who will respond very positively to CBT, and some who will respond much better to person-centred, or Gestalt, or other types of therapies (always with the caveat that it is often the therapuetic relationship itself which is the key determiner of success) – on the whole, a one size fits all approach to therapy and mental health is something which I find disturbing.
One positive thing, however, about CBT, is that due its nature, it is something you may be able to “try at home” to a certain extent, and perhaps even starting to think about how we may think negatively, and how that may be affecting our emotions and actions, is something a lot of us can do for ourselves, and maybe the first step into a more wide ranging encounter with therapy of whatever kind we may ultimately choose. There is a selection of books on CBT below which may prove useful as a further introduction to this form of therapy.
A Selection of Cognitive Behavioural Therapy books in the UK:
A Selection of Cognitive Behavioural Therapy books in the USA: