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CBT

CBT is one of the approaches Counselling4you use. We use it as a stand-alone therapy, (normally 6-20 weeks) or as part of our integrative approach.

CBT is a way of talking about:

•    how you think about yourself, the world and other people
•    how what you do affects your thoughts and feelings.

CBT can help you to change how you think ('Cognitive') and what you do ('Behaviour'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now. This of course depends on the consistency and severity of your past experiences. Some would say that no matter how much you change your thoughts and behaviour, the deeper unconscious drivers and original schemas will, in the long term re-emerge. 
 
When Does CBT Help?

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.
 
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.
 
There are helpful and unhelpful ways of reacting to most situations, depending on how you think about it. The way you think can be helpful - or unhelpful.
 
So much of a problem can be perception and irrational thinking, based on past experiences and brought into your everyday life.

An easy way to think about this is ABC.

A= activating event, (what we perceived happened or didn’t happen).
B=belief system, (I must have done something wrong or upset them)
C= consequences, (fear, anxiety, uncertainty, possibly anger and insecurity

If you go home feeling any of the above, you'll probably brood on what has happened and feel worse, possibly become depressed etc.

If you get in touch with the other person, there's a good chance you'll feel better about yourself and the situation.

If you avoid the other person, you won't be able to correct any misconceptions about what they think of you - and you will probably feel worse. This 'vicious circle' can make you feel worse and possibly even create new situations that compound the issue. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.
 
By challenging your thoughts CBT can help you to break this vicious circle of irrational thinking, feelings and behaviour. When you see the stages and sequence clearly of a particular experience you can begin to change them, hence change the way you feel. CBT aims to get you to a point where you can 'do it yourself', and work out your own ways of tackling these problems.
 
The Sessions

•    We would meet for between 6 and 18 weekly, or fortnightly sessions, each lasting 60 minutes.
•    In the first 2-4 sessions, we will check that you can use this sort of treatment and you will check that you feel comfortable with it.
•    We will ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.
•    You decide what you want to deal with in the short, medium and long term.
•    We will usually start by agreeing on what to discuss that day.

The Work

We will break each problem down into its separate parts, as in the ABC example above and problem ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.

Together we will look at your thoughts, feelings and behaviours to work out:

  1. if they are unrealistic or unhelpful
  2. how they affect each other, and you.

 

We will then help you to work out how to change unhelpful thoughts and behaviours.


It's easy to talk about doing something, much harder to actually do it. So, after we have identified what you can change, we will recommend 'homework' - you practise these changes in your everyday life. Depending on the situation, you might start to:

 

  1. Question a self-critical or upsetting thought and replace it with a more helpful (and more realistic) one that you have developed in CBT
  2. Recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

 

At each meeting we will discuss how you've got on since the last session. We can help with suggestions if any of the tasks seem too hard or don't seem to be helping.


We will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

 

Like any other therapy, CBT is not for everyone.

CBT is not a quick fix. No counselling/therapy is. We will join you on your journey and will engage with every part of it, but you have to do the work, we cannot 'do' it for you.
 
   


 

 

 

Adapted from, rcpsych