It’s based on the idea that our thoughts, feelings, and behaviours are interconnected and that changing negative thought patterns can lead to changes in feelings and behaviours. CBT aims to help individuals understand and change their unhelpful thought patterns and behaviours and bring about positive changes in their lives.

When is CBT used?

Research shows us that CBT can be effective for treating lots of different mental health conditions and issues, including:

• anxiety
• anxiety disorders such as generalised anxiety disorder, panic disorder, obsessive compulsive disorder and social anxiety disorder
• mood disorders such as depression and bipolar disorder
• hypochondria
• relationship problems
• eating disorders
• substance misuse, such as smoking, drinking or other drug use.
• other issues such as anger, stress, insomnia, low self-esteem and problem gambling.

Who conducts CBT?

CBT can be practiced by counsellors, psychologists, mental health social workers and therapists, either in one-on-one therapy sessions or in small group settings. A professional using CBT typically follows a structured approach to help clients address and overcome their challenges.

How is CBT implemented?

A basic overview of how a trained therapist might use CBT includes the following steps:

1. Assessment and Goal Setting: The therapist conducts an assessment to understand the client's concerns, history, and current issues. This helps in identifying specific problems and setting goals that are often focused on addressing specific symptoms or behaviours.
2. Identifying Negative Thoughts and Behaviours: The therapist helps the client identify negative or distorted thought patterns that contribute to their problems. This might involve tracking thoughts through journaling or using other techniques.
3. Cognitive Restructuring: The therapist guides the client in challenging and reframing negative thoughts to develop more balanced perspectives.
4. Behavioural Interventions: If the client has phobias or anxieties, the therapist might use gradual exposure techniques to help them confront and reduce their fear in a controlled manner.
5. Skill Development: Clients learn coping strategies, problem-solving, and self-monitoring to manage their issues.
6. Homework Assignments: The therapist assigns tasks or exercises for clients to complete between sessions. These assignments help clients practice new skills, apply what they've learned, and reinforce changes.
7. Review and Adjustment: Progress is regularly reviewed, and the approach is adjusted as needed.
8. Relapse Prevention: The therapist helps the client create a plan to maintain progress and prevent relapse.

While CBT is considered a short-term form of psychotherapy, it may still take months or longer to successfully challenge and overcome unhealthy patterns of thinking and behaviour, especially if the issue has been longstanding.

A typical CBT program lasts between 5 and 20 weeks, but this depends on the issue being dealt with. Whilst this may not be considered a quick fix, there is extensive evidence that supports the effectiveness of the treatment.

Can CBT be used for children?

CBT can be modified for use with children by simplifying language and concepts, using concrete examples, and incorporating play and interactive activities like games, drawing, and crafts to engage them in therapy.

Parental involvement is crucial, with parents often being educated about CBT principles and collaborating with therapists to reinforce strategies at home. The approach is tailored to the child’s developmental level, starting with simpler tasks and gradually progressing to more complex ones.

Behavioural techniques such as positive reinforcement, modelling, and role-playing are frequently used, along with visual and creative aids like charts, diagrams, and drawing to help children understand and express their thoughts and feelings.

CBT for children also emphasises skill-building, focusing on emotional regulation, problem-solving, and coping strategies, often through age-appropriate homework assignments. The structure of therapy is flexible, with shorter sessions and a pace that adapts to the child’s needs and attention span, ensuring that CBT is both accessible and effective for young clients.

A real-life example of CBT in action:

To further understand CBT, it is useful to consider a real-life problem and the way in which CBT is utilised. Consider the following scenario.

Situation: A client presents with severe shyness in social situations, also known as social anxiety.

Belief: The client believes that others will always find them boring or stupid.

Impact on Feelings: This belief can make the client feel extremely anxious in social situations.

Behavioural Response: Because of this anxiety, the client experiences physical symptoms like trembling, sweating, or a racing heart. The client also acts in ways that avoid social interactions.

Emotional Consequence: The anxiety and avoidance can lead to negative emotions, such as feeling ashamed, and negative self-talk, such as thinking, “I’m such an idiot.”

Cycle of Fear: Each negative experience reinforces the fear, making future social situations even more intimidating.

CBT could be used to help break this cycle and teach the client to:

Challenge Negative Beliefs: Question and reframe the belief that others will always find them boring or stupid.

Modify Behaviours: Use practical and proven strategies to manage anxiety symptoms and engage in social situations more comfortably.

Change Feelings: As beliefs are challenged and behaviours are changed, the client will start to feel more positive and open to the idea that social situations can be positive experiences.

As outlined earlier, this treatment could take anywhere from 5 to 20 weeks for full effect and might require modifications or adjustments along that journey.

Summary:

CBT’s strengths lie in its evidence-based approach, structured and goal-oriented nature, and ability to deliver practical, lasting skills. Its adaptability, short-term focus, and emphasis on client empowerment make it a widely applicable and effective therapy for a range of mental health conditions, helping individuals of all ages achieve sustainable improvements in their wellbeing.

Sources:

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy#bhc-content

https://au.reachout.com/mental-health-issues/professional-help/cognitive-behavioural-therapy

https://www.cognitivetherapynyc.com/what-is-cognitive-therapy/