It’s been proven effective for anxiety and other mental health problems, but what exactly is cognitive behavioural therapy?
According to recent stats , 1 in 4 of us in the UK will experience a mental health problem each year. It’s a worryingly high figure, yet despite the numbers, many feel that they have to suffer in silence. It seems apt therefore that talking therapies could provide a valuable helping hand in overcoming them. Cognitive behavioural therapy (CBT) is one such treatment that falls under this category and has been shown to be especially far-reaching in its effects thanks to its flexibility and adaptability in tackling a variety of mental health concerns.
“CBT has been proven to be particularly effective for treating anxiety, but it is a relatively flexible therapy that can be adapted to meet your particular needs,” explains Lucy Lyus, Information Manager for the mental health charity Mind . “Evidence suggests it can be an effective treatment for a range of mental health problems including depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), eating disorders, phobias and sexual, relationship or sleep problems. However, not everyone finds a short-term treatment like CBT works for them, especially if they have more severe or complex problems.”
Could CBT help you? A useful first step towards addressing behaviours that are negatively affecting your day to day life, here are the facts that you need to know for helping best decide whether it's for you or not.
What is CBT?
An effective combination of the theoretical and practical, it focuses on breaking cyclical behaviour patterns by taking a closer look at your thought processes. “Cognitive behavioural therapy is a type of talking treatment that focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour and teaches you coping skills for dealing with different problems,” explains Lucy. “It combines cognitive therapy (examining the things you think) and behaviour therapy (examining the things you do).”
Helping break down processes that have become habitual, it proves particularly useful in highlighting the relationship between thoughts, feelings and resultant actions. “CBT is based on the idea that the way we think about situations can affect the way we feel and behave,” says Lucy. “For example, if you interpret a situation negatively then you might experience negative emotions as a result, and those bad feelings might then lead you to behave in a certain way. If your negative interpretation of situations goes unchallenged, then these patterns in your thoughts, feelings and behaviour can become part of a continuous cycle.”
Changing unhelpful mindsets, reactions and rituals that have become ingrained in our daily lives can seem overwhelming. However, CBT can help provide an escape route of sorts, to act as a useful tool with which to challenge long-held beliefs.
How does it work?
CBT can come in various forms and there’s a range of different formats available that can be spread over several months. “CBT is usually a short-term treatment, so you wouldn't be expected to continue with the treatment for a long time. For example, a course of CBT might be delivered in 12 hour-long weekly sessions, spread across 12 weeks,” says Lucy. “These sessions might be delivered individually (one-to-one with a therapist), in a group, through a self-help book or even online through computerised CBT.”
What does a session look like? “A typical structure of a CBT session may include the following,” explains Lucy:
• At the beginning of the therapy, you and your therapist may explore the problems you want to work on.
• When you have agreed which problems you want to focus on and what your goals are, you may start planning the content of sessions and talking about how you could deal with your problems.
• During the session, you might work through exercises with your therapist to explore your thoughts, feelings and behaviours. This may be in the form of diagrams or worksheets.
• With CBT you are often given work to do in your own time, so at the end of each session you might agree on some exercises to work on afterwards.
Where can you find a CBT therapist?
Your doctor is usually the best first port of call, but there are also other options available for increasing your chances of more timely treatment. “There are several different ways of accessing CBT. Many people are able to access CBT on the NHS through their local GP surgery. Some counsellors and psychologists offer CBT on the NHS at GP surgeries themselves,” Lucy explains. “You can also refer yourself to CBT in some areas through the Improving Access to Psychological Therapies (IAPT) programme. This is an NHS programme which can provide CBT as a treatment for various mental health problems, such as anxiety and depression. However, IAPT is not available in all areas and the waiting lists can be long. You can find out whether IAPT services are available near you through the IAPT website .”
“You may want to consider seeing a therapist privately – but be aware that private therapists usually charge for appointments,” cautions Lucy. “You can find a private therapist through the British Association for Counselling and Psychotherapy (BACP) , the British Association for Behavioural and Cognitive Psychotherapists (BABCP) , or The UK Council for Psychotherapy (UKCP) ."
Mind has called on the Government to commit to limiting the length of time someone has to wait to 28 days maximum
Due to high demand and stretched resources, long waiting times are increasingly becoming more of a problem. “Depending on how well-resourced services are in your local area, there can be a huge degree of variation in the length of time you can expect to wait to receive therapy," says Lucy. A treatment that should be as accessible as possible to the public, it’s a topic that Mind has been particularly vocal about in order to provoke change. "Mind has called on the Government to commit to limiting the length of time someone has to wait to 28 days maximum, but many areas aren’t even close to that yet,” says Lucy.
“A recent investigation by Mind, as part of the We Need To Talk coalition, found that one in ten people had to wait over a year before starting talking treatments. The effect of this can be hugely detrimental and, while waiting for treatment, two thirds of the people said they became more unwell, four in ten went on to self-harm and one in six attempted suicide. Although the IAPT programme has helped millions access treatment and pushed areas to excel in the standard of talking treatments they provide, the rise in demand and variability of access across the country means that too many people are still waiting too long for therapy. It is clear that significant investment will be needed to ensure that services continue to deliver a full range of high quality treatments to all those who need them.”
With this in mind, it therefore seemed inevitable that those in need would start turning to tech for the help they were looking for. Ieso Digital Health , a health tech leader in digital cognitive behavioural therapy, works with the NHS to help improve access, reduce referral backlogs and improve outcomes to psychological therapy services. It does this by providing confidential one-to-one therapy in real time, allowing patients to meet with an accredited therapist in an online secure virtual therapy room, at a time and location that suits them via a mobile, tablet or desktop. The therapist also tracks their patient's progress, to ensure their treatment plan merges the online with the more personal for a more well-rounded service. “Right now we have a crisis in mental health in the UK, and digital technology has a big part to play in widening access and the healthcare experience for those struggling with mental health conditions,” says Andy Blackwell, Chief Scientist Officer at Ieso Digital Health. “Putting a computer between a patient and their therapist creates many new and exciting possibilities, and the Ieso platform technology demonstrates how mental health technology is gaining traction to change lives by connecting patients with therapists in new ways, leading to better patient outcomes.”
On a wider scale, making mental health more of a priority in our schools too could also help reduce the growing pressure on sufferers and resources alike. Earlier in the year think tank, The Institute for Public Policy released a report saying that despite government investment, more needs to be done in order to meet the increasing demand from young people with mental health problems. Among its recommendations, it suggested that all secondary schools should have guaranteed access to at least one day per week of on-site support from a mental health professional who is able to provide targeted mental health intervention. However, only time will tell if this will make the transition from recommendation to reality in the long-term.
As far as CBT is concerned though, hopefully the increased discussion and debate surrounding the treatment of mental health problems will improve both its accessibility and affordability. With tech, experts and charities all vouching for its benefits, change could be on the horizon sooner than we think.
For further information on CBT or other forms of treatment see mind.org.uk or call 0300 123 3393.