Preparing for Cognitive Behavioural Therapy (CBT)
You will be working with Steve Lyon who is trained in counselling and will be working using a CBT approach. Steve is fully accredited by the British Association of Cognitive Behavioral Psychotherapists and adheres to their standards of professional conduct.
Cognitive Behavioural Therapy involves working with thoughts or beliefs, moods or feelings, actions and behaviours and sometimes the physical effects of these. It works because the mind, body and behaviour influence each other.
It is a confidential meeting. What you say to your therapist is between you and them – unless there is a high risk of you hurting yourself or others. All therapists should receive supervision where they discuss their clients in meetings called supervision meetings. This helps the therapist work to the best of their ability with you. Your name will not be revealed to them.
CBT is a tried and tested therapy that believes that our moods are affected by how and what we think about. Some simple examples may help:
Mary is sitting looking into space because she is over faced by the amount of phone calls she has to make. The more she thinks about what she has to do the more she feels weighed down by the amount of work she needs to do. It sets off a ‘vicious circle’. Before long, Mary is feeling depressed. Because Mary feels depressed she is less inclined to do the jobs she needs to do and it all builds up.
Bob is worried about relationships at work. He feels isolated from the rest of his team and thinks people are out to criticise him. The more he sits and worries about it, the more stressed he feels. Very soon he starts thinking that others are watching his every move – what do you think might be the effect of this?
Firstly, your therapist will try and find out about you and your problems. Your therapist will ask lots of questions. They will want to know what has brought you to therapy and what you want to achieve. You might want to think about this.
Your therapist may well ask you to talk about a recent distressing incident. This is done in order to get a clear picture of your problem. They may ask you to talk about what thoughts you have during a difficult incident. You may be asked about what feelings and symptoms you experience during a difficult situation. Your therapist will be interested in what things you might do that make your symptoms better.
Often the therapist writes notes and makes diagrams under the headings:
- The Event
- Your Thoughts
- Your Moods
- Your Physical Reactions
- Your Actions
In doing this, your therapist is working out an understanding of what triggers your problems and what keeps them going.
You might want to have a ‘go’ yourself – think about a recent event and what thoughts, moods, physical reactions and actions are created.
Is CBT an instant cure?
Of course not. It can be hard work. Because your therapist asks you to think about difficult situations you may feel some discomfort but it should have lots of benefits in the long run. It is quite frequent for CBT to last for 4 or more sessions and each session lasts for 50 minutes.
Sometimes therapy can result in a person feeling worse as they confront situations and emotions that they have been avoiding. This should only last for a short duration.
What has become clear with experience is that CBT works if people are given activities to do between sessions. You need to commit yourself to doing such activities if you want to make steady progress.
Keep a folder in which you can remind yourself to do activities and record the results.
Dropping out of therapy
You may be tempted to drop out of therapy if you don’t feel immediate relief or if your anxiety increases or your mood lowers. Therapy can be difficult at times but is often worth it in the long run.
This also allows your therapist to fully assess you and identify what is causing your problems and what might work for you.
If you drop out of therapy – don’t feel it is your fault or that CBT won’t work for you in the future. Sometimes people are not at the right point in their life to be able to benefit from therapy.
Getting the most from therapy
By coming into CBT, you are turning over a new leaf and deciding to do things quite differently. This requires you to put your life under the ‘spotlight’ and try out doing things differently. It’s like trying out an experiment and seeing what happens.
A first part of an experiment is gathering information. Your therapist may ask you to do some close observing on your life. A simple thing you can do is to pay attention to your thoughts and moods.
Keep a chart where you record situations, thoughts and moods. Do this on a regular basis – keep a daily log and show this to your therapist. An example of a log appears below:
- Date and Time
- What I was doing
- What was my mood /What was I thinking and feeling
Content of CBT sessions
CBT sessions can be quite organised. Your therapist will ask you what you want to cover in a session – this is called an Agenda. It usually starts with a review of what has happened since you last met – including a look at any work you have completed at home. You will also be asked to rate your mood and how it has been over the week. This can often generate things to consider in more depth and this can be added to the Agenda.
Towards the end of your therapy session your therapist may ask you to review how you feel the session went. Your therapist may work with you to decide on what you need to do during the week ahead and bring back to the next session.
Steve is committed to making CBT more affordable, this does not mean you will be getting a poor version of therapy.
Not able to turn up?
If you can, ring up and explain you cannot attend or use email.
Because you miss a session, don’t let that put you off coming to the next session.
What else do I need to know?
What if I do not like the way in which therapy is progressing or I am concerned about anything my therapist has said or done? You should feel able to talk frankly with your therapist and discuss what you are not happy about. If, however, you feel uncomfortable about tackling your therapist directly, or are not satisfied with his response to your raised concern, you are able to raise concerns with the BABCP.