Cognitive Behavioural Therapy (CBT)

What is CBT?

Cognitive Behavioural Therapy (CBT) aims to alleviate distressing negative emotions by a combination of cognitive therapy (which is based on the cognitive model) and behaviour modification. The basic cognitive model states that people’s emotions and behaviours are influenced by their perception of events (i.e. the thoughts and meanings they attach to events). CBT is adapted depending on the types of difficulties experienced; e.g. depression, social anxiety, trauma, psychosis, and so on.

In the cognitive model of depression, for example, depressive symptoms are understood to be caused and maintained by negative automatic thoughts, which are generated by dysfunctional core beliefs about oneself, the world, and other people. The aim of CBT for depression, therefore, is to identify the negative thoughts and beliefs, and then to evaluate and modify them in accordance with a more realistic and helpful perception of events. As well as their emotional impact, negative automatic thoughts will also give rise to a number of physical and behavioural responses, which may, in turn, worsen the emotional symptoms of depression. Therefore, the behavioural element of CBT is intended to modify those behavioural responses which are reinforcing the negative thoughts and beliefs.

CBT is often referred to as a ‘therapy of the here and now’, which means that it focuses on problems and situations that are currently distressing the person. The therapist will start by addressing issues of the here and now, regardless of mental health condition or diagnosis. Instead of embarking on a deep exploration of how past events might have precipitated negative emotions, the main aim of CBT is to establish how a person’s current thinking and behavior is actually helping to maintain these negative emotions. The idea is that one cannot change past events, but one can change what they make of them now.

Who is CBT for?

CBT is the most widely researched and evaluated (“talking”) therapy, and as a result is the most consistently recommended in the UK national (NICE) treatment guidelines. There is good evidence for its effectiveness in treating a range of mental health difficulties, from depression and anxiety, to eating difficulties, PTSD, and psychosis.