Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is a talking therapy approach which is evidence-based and commonly used to treat a variety of mental health issues.

C stands for cognitive (thoughts) which in CBT you learn to challenge and replace negative or unhelpful thoughs. B stands for behaviour (actions) which you solve the problems, set your goals and changing unwanted behaviour such as avoiding fearful situations. T stands for therapy which CBT is a learning process of adaptive thinking and behaviour to help you cope with the difficulties in life and recovering from mental health issues.

Cognitive Behavioural Therapy usually takes about 12-20 sessions on average although some issues might require longer or more intensive treatment. Sessions usually take place weekly. However, in the later stages of therapy, the frequency of sessions may decrease to once every two weeks or once a month.

• Anxiety Disorders
• Depression
• Bipolar Disorder
• PTSD
• OCD
• Eating disorders
• Phobias
• Low self-esteem
• Work related stress
• Sleep Difficulties
• Physical health problems

According to the Cognitive Behavioural Therapy approach, our thoughts, feelings and behaviours are all connected and when we can change one, we can alter the others as well. Our feelings are not directly shaped by the situation we are in, but they are shaped by the way we perceive the situation. When we feel low or stressed out, we easily fall into the maladaptive and negative thinking patterns or unhelpful behaviours which then lead to mental health issues. If we can change how we approach to a situation, we can think more neutrally (not negative or overly optimistic), find better strategies to cope with the situation and behave accordingly.

Psychotherapy can help you to change external circumstances if that is what you would like to do by setting goals and coming up with strategies to help you achieve your goals.  It also equips us to deal with the external challenges while making them less challenging for us. In other words, if we can learn more adaptive thinking and behaviour patterns, we will be able to cope with difficult situations better, be more resilient and no longer suffer from mental health issues. For this reason, a variety of techniques are applied to change the way you think and behave in order to solve problems that disturb you in CBT sessions.

CBT helps by reducing complex problems into easy to target smaller chunks such as thoughts, behaviours and feelings. When we have problems, we might easilly engage in unhelpful thinking which are named as thinking errors. Addressing the unhelpful thinking patterns would help to think more neutrally and assess the difficult situation better.

Many negative or useless thoughts come to our minds rapidly during our daily lives and we accept their validity without questioning their accuracy. Evidence shows us that when we find ourselves in a stressful situation or dealing with mental health problems such as anxiety, low mood, intrusive thoughts, traumas, we become much more likely to make thinking errors.

• Black and white thinking: It is the tendency to think in the extremes rather than seeing the shades of grades which are other potential scenarios.
• Overgeneralization: This negative distortion takes one instance in your life and generalizes it as a pattern.
• Jumping to the conclusions: When we think that we know the outcome of the situation without analysing the situation well and making a conclusion based on little or no evidence.
• Fortune-telling: The distortion takes place when you assume that you know what the other person has on their mind without listening the other person well enough to collect evidence to evaluate the outcome realistically.
• Personalization: As the name of the distortion is very self-explanatory, when we start taking things personally and take the blame for the things which we have no or little impact.
• Catastrophizing: The distortion makes you to think the worst-case scenario although the worst-case scenarios rarely happen.

However, if we could stop these thoughts and test their accuracy, we are going to realize that many of our thoughts do not reflect the reality fully. Sometimes the thoughts that come to mind are true, but unhelpful. For example, the topic you are reading may seem really complicated to you. However, thinking like this is not helpful as it can reduce motivation to read and make it even more difficult for you to learn the subject. Especially when we struggle with mental health issues such as anxiety and low mood, we tend to think more negatively or maladaptively which as a result make the situation more difficult.

• Do you avoid certain situations due to extreme anxiety or fear such as social situations or having phobias?
• Do you struggle with keeping up with healthy habits such as balanced eating or exercising?
• Do you struggle with taking action to reach out your goals?
• Do you struggle with making friends or having relationships?

CBT can help with targeting and changing unwanted behavior. During our sessions, we are going to set goals, assess the current challenges in your life and we are going to support you with some homework to implement small changes once you feel ready.

CBT brings recovery while focusing on finding the unhelpful thinking and behaviour patterns and replacing them with the adaptive, useful and resilient ones.

We will have the initial consultation session to understand the issues you struggle with, get to know you and find out more about your past to see whether CBT is the right fit for you. Although CBT doesn’t focus on the past, it is still important to know how past issues might have shaped current issues and to decide whether you can benefit from CBT. In sessions 2-4, we are going to set psychotherapy goals and come up with a plan to work with CBT to help you recover.

We will to have weekly meetings preferably at the same time. We will check in to see how you have been doing and set the agenda for each meeting. If there is homework, we are going to review it to see the challenges so I can help you better as well as to see the achievements you have made.

When we notice that you are doing really well and you are about to reach your psychotherapy goals, we are going to decide together when is the right time to end psychotherapy. In the ending session, we will work on a personalised plan for you continue your wellbeing journey and focus on how you will continue implementing the new coping tools you learned from psychotherapy.

CBT can be delivered online and I have worked with many people offering virtual CBT sessions. Recent scientific research shows that receiving CBT online is as effective as in-person meetings.

It is a personal choice to receive CBT online or in-person which you need to take some factors into consideration. Many people have barriers to therapy such as making time for it, commuting, family and work commitments. Receiving CBT online can be the best choice for people who have limited time and have other commitments. When you have online CBT sessions, it can easily fit into your life, and you can have psychotherapy from the comfort of your house.