Health Advice and Information on Cognitive Behavioural Therapy CBT

What is CBT?

CBT can help you to change how you think (“Cognitive”) and what you do (“Behaviour)”. These changes can help change the way you ultimately feel. Unlike some of the other talking treatments, it focuses on the “here and now” problems and difficulties. Instead of focussing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now. How to change the reaction, thought process and outcome of the situation into a more positive one.

How does it work?

CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

• A Situation - a problem, event or difficult situation
  From this can follow:
• Thoughts
• Emotions
• Physical feelings
• Actions

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it. We often hold on to our old thinking patterns and always end up feeling the same way, getting drawn back into the same old situation of past harms that did not heal. We still end up welling and coping in the same way that left us ill, depressed, overwhelmed, fearful etc.

Cognitive behavior therapy is a clinically and research proven breakthrough in mental health care. There has been much study and research by psychologists and psychiatrists which has brought Cognitive-behavioural approaches to the forefront of successfull treatment of the following..

Depression and mood swings
Shyness and social anxiety
Panic attacks and phobias
Obsessions and compulsions (OCD and related conditions)
Chronic anxiety or worry
Post-traumatic stress symptoms (PTSD and related conditions)
Eating disorders (anorexia and bulimia) and obesity
Insomnia and other sleep problems
Difficulty establishing or staying in relationships
Problems with marriage or other relationships you're already in
Job, career or school difficulties
Feeling “stressed out”
Insufficient self-esteem (accepting or respecting yourself)
Inadequate coping skills, or ill-chosen methods of coping
Passivity, procrastination and “passive aggression”
Substance abuse, co-dependency and “enabling”
Trouble keeping feelings such as anger, sadness, fear, guilt, shame, eagerness, excitement, etc., within bounds
Over-inhibition of feelings or expression, shyness
Addictions, including alcohol, drug, gambling, people, internet, shopping, sex (other form of addiction also)


Cognitive behavior therapy combines two very effective kinds of psychotherapy — cognitive therapy and behavior therapy. Behavior therapy helps you lessen or dispel the connections between troublesome situations and your habitual reactions to them. Reactions such as fear, depression or rage, and self-defeating or self-damaging behavior and the illnesses and problems that these reactions can cause such as alcohol, drug abuse, violence, self harm etc. It also teaches you how to calm your mind and body, so you can feel better, think more clearly, and make better decisions. Recognising these connections and the pattern, seeing the whole picture and conciously choosing a different route or path in which to digest and react to the sitauation, internally and externally will change the feelings, such as stress and anxiety and anger and the reaction or bad coping methods to these feelings. Cognitive therapy teaches you how certain learned and adopted thinking patterns are causing your symptoms. One can form an unhealthy picture of what is going on in life and happening to them, and making one feel anxious, depressed or angry for no good reason, or provoking y into unhealthily and ultimately damging chosen or reactive actions.

When combined into CBT, behavior therapy and cognitive therapy together can erase the symptoms of the problems by changing the way we react to situations.

CBT is active therapy. In CBT, your therapist takes an active part in solving your problems. He or she doesn't settle for just nodding wisely while you carry the whole burden of finding the answers you came to therapy for. A thorough diagnostic disclosure at the beginning of treatment will serve to make sure the needs and problems have been pinpointed as well as possible. This may ssem obvious as it is most certain that the client has some good ideas as to why they are seeking help in the first place, but this is a crucial step, which is often skimped or omitted altogether in traditional kinds of therapy. Doing this honestly and thoroughly results in an explicit, understandable, and flexible treatment plan that accurately reflects the individual clients own individual needs.

In many ways CBT resembles education, coaching or tutoring. Under expert guidance, as a CBT client you will share in setting treatment goals and in deciding which techniques work best for you personally. As human emotional and complex beings we are all different as our situations and reactions to different events are. Taking this into account, the recovery plan, tools and techniques are more tailor made.

CBT provides clear structure and focus to treatment. CBT sticks to the point and changes course only when there are sound reasons for doing so. As a CBT client, you will take on valuable “homework” projects to speed your progress. These assignments, which are developed as much as possible with your own active participation, extend and multiply the results of the work done in your therapist's office.You may also receive take-home readings and other materials tailored to your own individual needs to help you continue to forge ahead between sessions. Thus the therapy is not only, say once a week for an hour, the ongoing therapy and recovery is taken home and to be used in daily dealings. The ideas and tools are not left at the door of the counsellors office. The client takes a very active role in the re teaching themselves different reactions and they can witness the benefits sooner in how they feel differently and how the problems associated with how they react and feel and diminished.


Most people coming for therapy need to change something in their lives, there is illness or dissatisfaction, whether it is the way they feel, the way they act and behave, or how other people treat them. CBT focuses on finding out just what needs to be changed and what doesn't and then works for those targeted changes.

Some exploration of people's life histories is necessary and desirable, if their current problems are closely tied to “unfinished emotional business” from the past, or if they grow out of a repeating pattern of difficulty. Nevertheless, 100 years of psychotherapy have made this clear . . .
Past vs. present and future

Focusing on the past (and on dreams) can at times help explain a person's difficulties. But these activities all too often do little to actually overcome them. Instead, in CBT the aim is at rapid improvement in your feelings and moods, and early changes in any self-defeating behavior you may be caught up in. As you can see, CBT is more present-centered and forward-looking than many traditional therapies.

The two most powerful levers of constructive change (apart from medication in some cases) are these . . .

Altering ways of thinking — a person's thoughts, beliefs, ideas, attitudes, assumptions, mental imagery, and ways of directing his or her attention — for the better. This is the cognitive aspect of CBT.
Helping a person greet the challenges and opportunities in his or her life with a clear and calm mind — and then taking actions that are likely to have desirable results. This is the behavioral aspect of CBT.

In other words, CBT focuses on exactly what traditional therapies tend to leave out — how to achieve beneficial change, as opposed to mere explanation or “insight.”

CBT has been very thoroughly researched. In study after study, it has been shown to be as effective as drugs in treating both depression and anxiety. In particular, CBT has been shown to be better than drugs in avoiding treatment failures and in preventing relapse after the end of treatment. \which is some statement to be making as to the effectiveness and success of this method of treatment.

Other symptoms for which CBT has demonstrated its effectiveness include problems with relationships, family, work, school, insomnia, and self-esteem. And it is usually the preferred treatment for shyness, headaches, panic attacks, phobias, post-traumatic stress, eating disorders, loneliness, and procrastination. It can also be combined, if needed, with psychiatric medications.

CBT is usually employed by itself, without psychiatric drugs. For some people, (chiefly those with psychotic symptoms), drugs are essential and may need to be continued indefinitely. For others, short-term drug treatment is needed to obtain a partial reduction in symptoms before CBT can be fully effective.

For most people, however, it is preferable to try CBT alone before prescribing medications. This is for several reasons:

Benzodiazepine drugs such as alprazolam (Xanax), plus certain other types of tranquilizers, can be habit-forming if taken over a long time or in high doses. This is a complication that needs to be avoided if possible. Despite their reputation as “wonder drugs,” antidepressants such as amitryptaline (Elavil) and fluoxetine (Prozac) work only about 65–70% of the time. MAOI drugs (e.g., Nardil) carry a risk of hypertensive crisis, stroke or even death if common foods or beverages containing tyramine are unintentionally consumed. Finally, the mood stabilizer lithium carbonate can produce toxic reactions unless it is very carefully monitored.

In addition, research studies have revealed these other facts about drug treatment for depression and anxiety:

CBT and well-chosen drugs, when each is used alone, are about equally effective during the period of active treatment.
Adding drug treatment to CBT does not necessarily yield better results than using CBT alone.
Treatment failure is more likely when drugs are used, typically because of side effects.
Relapse after the end of treatment is more likely when only drugs have been used. This is believed to be because drugs, unlike CBT, do not encourage the development of valuable coping and emotional management skills.

Questions that are being raised about antidepressant drugs

In addition, a number of questions have been raised about antidepressant drugs — which are increasingly being prescribed for anxiety conditions as well:

Whether widespread beliefs about their effectiveness are scientifically justified.
The side effects and withdrawal symptoms they can produce.
Their use with children.
Their safety, especially when used in combination with other psychoactive drugs.
The theories about depression that support their use.
Whether they really are as likely to help as well-chosen forms of psychotherapy.
If the taking of these drugs is just a swaping or numbing of the true problem.


Most CBT patients are able to complete their treatment in just a few weeks or months, the therpay is usually quite brief, even for problems that traditional therapies often take years to resolve, or aren't able to resolve at all. Meanwhile, for people with complex problems, or who are forced to live in adverse conditions beyond their control, longer-term treatment is also available. Most people can expect to begin their treatment with weekly visits. A few, particularly if they are in crisis, may begin with two or more sessions a week until their condition is stabilized enough that they can safely come only once a week.

Follow up sessions are dependent on the individual and the view of the therapist and could be as the following

Individual sessions every other week or monthly, combined with weekly group therapy meetings.
Individual sessions every other week or monthly, without participation in group therapy.
A planned break of several weeks, followed by resumption of weekly individual sessions for a period of time.
A trial termination of therapy — with the option of resuming if the need develops. Quite often, a follow-up session or phone contact is scheduled for a future date.

Do it when you need it, and not when you don't

In addition, most CBT practitioners subscribe to the principle of intermittent brief psychotherapy, as and when needed.

In this treatment model — espoused by Dr. Nicholas Cummings, a world leader in therapeutic advancement and former president of the American Psychological Association — you don't “go into therapy” and (like Woody Allen) stay for year after year, regardless of whether you're making significant progress or not.

Instead, you consult your therapist when there's a problem you need professional help with, and not in between. After all, isn't this sensible approach the one you follow with your physician, your dentist, your attorney or accountant, and all those other professionals?