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Cognitive behavioural therapy (CBT)

CBT is a short-term psychological treatment that helps to challenge negative thoughts, feelings and behaviours.

CBT is a type of talking therapy. It’s a combination of cognitive therapy, which helps with your thinking processes, and behavioural therapy, which focuses on your behaviour in response to those thoughts.

Common CBT techniques include:

  • challenging negative beliefs and replacing them with alternative ones
  • problem solving
  • developing coping skills

CBT is a short-term treatment that usually lasts between six weeks and six months. It consists of individual treatment sessions, which you will usually attend every week or two. Group sessions are available, as well as remote sessions using a phone or computer. The number of sessions you have will depend on your condition and commitment to the treatment. Each session usually lasts for about 30 minutes to an hour.

CBT is most often used to treat anxiety disorders or depression. However, it can also be used to treat:

  • panic disorder
  • obsessive-compulsive disorder (OCD)
  • body dysmorphic disorder
  • phobias
  • post-traumatic stress disorder
  • eating disorders
  • anger issues sleep problems
  • persistent pain
  • sexual or relationship issues
  • schizophrenia
  • bipolar affective disorder

You may have CBT together with medicines, or on its own.

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Details

  • Finding a practitioner Where can I find a CBT practitioner?

    If you think you may benefit from CBT, speak to your GP. He or she may be able to refer you to someone who is trained in this type of therapy. A number of different health professionals are trained to use CBT. These include clinical psychologists, psychiatrists (doctors who specialise in identifying and treating mental health conditions), mental health nurses and social workers.

    Alternatively, you can find your own CBT practitioner. The British Association for Behavioural and Cognitive Psychotherapies holds a register of accredited practitioners.

    Some mental health teams and GP surgeries have access to interactive computer-based CBT programmes, some of which are available for free online. You may prefer to access CBT online and then follow up with an appointment with a health professional.

  • Benefits Is CBT effective?

    Research has shown that CBT helps people with certain conditions. For example, CBT is effective at reducing the symptoms of anxiety disorders and mild to moderate depression. It may also help to reduce your risk of getting these conditions again, which is called relapse prevention.

  • The procedure What happens during CBT?

    To start with, your CBT practitioner will ask about your background and how you are currently feeling. He or she will work with you to identify problem areas that you would like to focus on.

    You will learn to make sense of your problems by breaking them down into smaller areas. This will allow you to see how they are connected and how they affect you.

    Your CBT practitioner will use structured techniques to try to identify how you are thinking and how this can cause problematic feelings and behaviours. You will learn to challenge negative ways of thinking, and learn how to react more positively. This can lead to behavioural changes that may make you feel better.

    Your therapist may suggest that you keep a diary so that you can identify how you react to certain events or thoughts. This will help you to identify patterns of thoughts, emotions, physical feelings and actions, and see if they are unrealistic or unhelpful.

    Your CBT practitioner will usually set you homework assignments. This may include reading material, tasks where you can test and practise the techniques you learn, or gradually exposing yourself to situations you're afraid of. Your CBT practitioner may ask you to practise replacing negative thoughts with positive ones during everyday events. This isn’t always easy, but by using CBT techniques you can try out different behavioural approaches in real situations, which can help you to make changes. You won’t be asked to do anything that you don’t feel comfortable with.

    CBT aims to provide you with the insight and skills to improve your quality of life. Once you finish your therapy, you will need to continue practising what you have learnt on your own.

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  • Making a decision Deciding on CBT treatment

    Treatment can be challenging and you must feel ready to actively change your thoughts and behaviour for it to be successful. You will need to be open, persistent and brave when you have CBT and you may have to deal with some difficult emotions. How successful CBT will be for you will depend on your participation and commitment to the process. It’s important to remember that CBT isn’t for everyone and there may be an alternative treatment that you prefer and works better for you. Your doctor can discuss your options with you.

  • FAQs FAQs

    Can children and teenagers have CBT?

    Answer

    Yes, children and teenagers can have CBT.

    Explanation

    If your GP thinks CBT could benefit your child, he or she may be referred for treatment. It can be particularly helpful for children and adolescents who have anxiety disorders or obsessive-compulsive disorder (OCD).

    If your child has medication for their condition, doing CBT will not necessarily mean that he/she can stop taking it. Speak to your GP for more information.

    How confidential is CBT?

    Answer

    What you discuss in your CBT sessions won’t be discussed with other people unless they are directly involved in your treatment.

    Explanation

    Medical professionals follow a code of medical practice to ensure your details are kept confidential and are only passed on to people involved in your care. If your health professional needs to share your details, this will usually only happen with your consent.

    CBT practitioners who are members of the British Association for Behavioural and Cognitive Psychotherapies must follow the Standards of Conduct and Ethics when they provide CBT as a treatment and these include maintaining confidentiality.

    Is there any CBT you can do on your own?

    Answer

    Yes, you can do CBT using a computer programme or with self-help books. Some professionals have started to develop smartphone applications too.

    Explanation

    In England and Wales, there are two computer-based programmes that have been approved for use by the NHS. Fear Fighter is a programme specifically for people who have phobias or panic attacks. Beating the Blues is aimed at people who have depression. However, to get access to these programmes, your GP will need to refer you.

    There are a number of self help books for people with conditions such as depression – your CBT practitioner or GP may be able to recommend a suitable self-help book for your condition.

    The Royal College of Psychiatrists also suggest using the following free online CBT courses.

    • Living life to the full
      www.livinglifetothefull.com
    • MoodGYM
      www.moodgym.anu.edu.au

    If you need more information, speak to your CBT practitioner or GP.

  • Resources Resources

    Further information

    Sources

    • Jones C, Hacker D, Cormac I. Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database of Systematic Reviews 2012, Issue 4. doi: 10.1002/14651858.CD008712.pub2
    • Making sense of cognitive behaviour therapy (CBT). Mind. www.mind.org.uk, published 2012
    • Cognitive behavioral therapy for depression. eMedicine. www.emedicine.medscape.com, published 12 December 2012
    • Cognitive behavioural therapy. Royal College of Psychiatrists. www.rcpsych.ac.uk, published February 2012
    • Computerised cognitive behaviour therapy for depression and anxiety. National Institute for Health and Care Excellence (NICE), 2006. www.nice.org.uk
    • CBT: therapy worth talking about. British Association for Behavioural and Cognitive Psychotherapies. www.babcp.com, published October 2012
    • Find a therapist. British Association for Behavioural and Cognitive Psychotherapies. www.cbtregisteruk.com, accessed 1 May 2013
    • Cognitive behavioral therapy for depression technique. eMedicine. www.emedicine.medscape.com, published 12 December 2012
    • Standards of conduct, performance and ethics. British Association for Behavioural and Cognitive Psychotherapies. www.babcp.com, published November 2010
  • Related information Related information

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Bupa Heath Information Team, June 2013.

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