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Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is a form of talking therapy that combines cognitive therapy and behaviour therapy. It focuses on how you think about the issues in your life – your thoughts, images, beliefs and attitudes (your cognitive processes) – and how this affects the way you behave and deal with emotional problems. It then looks at how you can change any negative patterns of thinking or behaviour that may be causing you difficulties.

A course of CBT tends to be short, taking six weeks to six months with weekly sessions of 50 minutes to an hour. The therapist sets out to help the patient explore what their problems are and then to develop a plan to tackle them. The therapy aims to teach a set of principles that can be applied whenever they are needed and will, hopefully, continue to be useful long after the therapy has ended.

CBT tends to focus on what is going on in the present rather than the past, though therapists may also look at into the past to see how past experiences impact the interpretation of the world of the present. For example, negative thinking patterns can often start in childhood, and become automatic and relatively fixed. CBT aims to facilitate understanding that this is what is going on and can help patients to step outside of their automatic thoughts in order to test them out.

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) and has been shown to help with many different types of problems.

The emphasis on cognitive or behavioural aspects of therapy can vary, depending on the condition being treated. For example, there is often more emphasis on behavioural therapy when treating obsessive-compulsive disorder (OCD) - where repetitive compulsive actions are a main problem. In contrast, the emphasis may be on cognitive therapy when treating depression.

Cognitive behavioural therapy has been shown to be an effective way of treating a number of different mental health conditions.

These include:

*obsessive compulsive disorder (OCD) 

 *panic disorder 

*post-traumatic stress disorder (PTSD)

 *phobias

 *depression 

 *eating disorders, such as anorexia and bulimia

CBT can also be useful in helping people with:

*anger management problems
*habits (such as facial tics)
*drug misuse and alcohol misuse problems 
*relationship problems
*sleep problems, such as insomnia 

CBT is sometimes used to treat people with long-term health conditions, such as arthritis and irritable bowel syndrome (IBS). CBT cannot cure the physical symptoms of these health conditions, but can help people cope better with their symptoms.

It is now well accepted that patients with mild to moderate depression respond well to CBT and this is actually one of the recommended treatments. CBT aims to help people with depression change the way they think in order to improve how they feel and alter their behaviour.

Up to two-thirds of people with depression do not respond to anti-depressants and a recent study in the Lancet demonstrated that CBT can reduce symptoms of depression in people who fail to respond to drug treatment. After six months of receiving CBT, 46% of patients who had received CBT reported at least a 50% reduction in their symptoms. The improvements had been maintained for a period of 12 months, it added. CBT was used in addition to medication for some patients. This was the first randomised controlled study to show that CBT as an adjunct to usual care that includes antidepressants is an effective treatment. (It should be noted that patients with severe and chronic depression were, however, less likely to respond to CBT.)

CBT is a collaborative approach with clear goals that are agreed with you and reviewed regularly. CBT aims to provide a set of tools that you can apply during and after the course of treatment. In effect, you learn how to be your own therapist.

CBT

 
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