Cognitive Behaviour Therapy (CBT)

CBT (Cognitive Behaviour Therapy) is recommended by the National Institute of Clinical Excellence (NICE) as a first-line treatment for many psychological disorders such as depression and anxiety. Michael Neenen, an author and expert on CBT, explains how it works, and how clients learn how to become self-therapists.

CBT starts from the premise that how we think about events has a powerful influence on how we feel about them and consequently how it affects our behaviour. For example, two men are rejected by the same woman: the first man sees this as further evidence of his worthlessness, becomes depressed and withdraws from social activity while the second man, though acutely disappointed (‘It’s a bump in the road, not the end of it’), seeks out further romantic opportunities. This individual variation to the same event depends on how it is interpreted. While the CBT model is relatively straightforward to understand it doesn’t follow that clients will always find it easy to grasp and put into practice.

CBT helps clients to identify, examine and change their self-defeating thinking and counterproductive behaviour in order to manage better their emotional upsets. Problems are discussed and clarified and specific, concrete goals are established against which to measure progress. The main focus is on how problems are being maintained rather than on how they were acquired (though links are made between past and present). Clients are encouraged to test their beliefs and behaviour in order to stimulate new ways of tackling their problems. Much of this work is carried out between therapy sessions as part of the clients developing role as a self-therapist. Towards the end of therapy, relapse prevention plans are drawn up to help clients tackle future difficulties that might arise.

A tremendous amount of research has been carried out into demonstrating the effectiveness of CBT. The recent National Institute of Clinical Excellence (NICE) guidelines for treating psychological disorders (e.g. depression, anxiety) made CBT the first-line treatment for many of them because of this impressive research record. Of course, not all clients will be suitable for or want CBT and the CB therapist will refer them elsewhere.

Michael Neenan
Cognitive Behavioural Therapist & Life Coach