What is cognitive behavioural therapy (CBT)?

CBT is a brief psychological therapy that can help you understand the way you think about:

  • yourself
  • the world
  • other people.

CBT can help you to change:

  • how you think (cognitive)
  • what you do (behaviour).

These changes can help you to feel better. Unlike some other talking treatments, it focuses on problems or difficulties you are experiencing "here and now" rather than past symptoms or causes of distress.   It can help you to make sense of overwhelming problems by breaking them down into smaller parts; linking your thoughts, feelings and behaviours.


Who is it for?

CBT is one of the National Institute for Clinical Excellence’s (NICE) treatment of choice.  It has been recommended for a number of mental health difficulties including anxiety, depression, panic, agoraphobia, social phobia, bulimia, obsessive compulsive disorder, post-traumatic stress disorder and schizophrenia.


What preparation is needed?

None – but it may help to think through what you feel your main difficulties are and what you hope to gain from therapy before you start. You also need to be able to make a commitment to attend regular weekly appointments.


What happens at the first appointment?

The clinical psychologist or CBT therapist will talk with you about your reasons for seeking therapy and explain more about the CBT approach.  The initial assessment session allows you and your therapist to see if CBT is suitable for you, if you are happy to work together, and to answer any questions you may have about the therapy.


What does the therapy involve?

In the initial sessions the therapist 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 will then agree short, medium and longer term goals.  

Together with your therapist, you will develop a shared understanding of the links between your thoughts feelings and behaviours. 

You and the therapist will usually start each session by agreeing on what to discuss that day.  This will include highlighting areas of difficulty you have encountered during the week and identifying useful strategies to challenge these difficulties in the future.

The strength of CBT is that you can continue to practise and develop your skills each week after the sessions have finished. This makes it less likely that your symptoms or problems will return.


How long does it last?

You will usually meet with a therapist for between five and 20 sessions, usually held on a weekly basis. Each session will last between 50 and 60 minutes.


What are the benefits?

Skills you learn in CBT are useful, practical and helpful strategies that can be incorporated into everyday life to help you cope better with future stresses and difficulties, even after the treatment has finished.


What are the risks?

As with any talking therapy, focusing on your problems may make you feel worse before you feel better.  Talking therapy can sometimes affect your relationships with your friends and family in negative as well as positive ways especially if you are making changes that others do not like. 

The Department of Health booklet, “Choosing Talking Therapies?” gives a useful guide to talking therapies and the risks involved.


What are the alternatives?

There is a range of alternative psychological therapies which include, among others, interpersonal therapy, cognitive analytic therapy, psychodynamic and psychoanalytic therapy.  It may be useful to read the information leaflets available to help you decide which approach may be best suited to your needs. 

Your care co-ordinator or mental health worker, psychologist or doctor may be able to discuss this with you.                                                                     


Where can I find more information or support?

British Association for Behavioural and Cognitive Psychotherapies http://www.babcp.com/


How to be referred

You can discuss possible referral for CBT with your care coordinator, mental health worker or medic.


Copies of letters and reports

Recent Department of Health guidance states that you have a right to receive copies of letters and reports sent by us to your referrer and your GP.

If you wish to receive these, please let us know when you come for your first appointment or at any subsequent time.



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