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CBT in York - A guide to understanding CBT

Matthew Cole now provides CBT for Leeds, CBT for Hull and
CBT for Harrogate.

Behavioural and Cognitive Psychotherapies are psychological approaches which are based on scientific principles and which research has shown to be effective for a wide range of problems. Client and therapists work together to identify and understand problems in terms of the relationship between thoughts, feelings and behaviour. The approach usually focuses on difficulties in the here and now, and relies on the therapist and client developing a shared view of the individual's problem. This then leads to the identification of personalised, time-limited therapy goals and strategies which are continually monitored and evaluated. Behavioural and Cognitive Psychotherapists work with individuals, families and groups. The approaches can be used to help anyone irrespective of ability, culture, race, gender or sexual preference.

Behavioural and Cognitive Psychotherapists are usually health professionals such as nurses, psychologists, doctors, social workers, counsellors etc. Whilst all behavioural and cognitive psychotherapists share the above principles, individual therapists may call themselves Cognitive Psychotherapists, Behavioural Psychotherapists, Cognitive Behavioural Psychotherapists or Rational Emotive Behaviour Therapists. These different titles often reflect the preference and training of individual therapists for specific techniques which address problematic thoughts, assumptions and beliefs directly (Cognitive Psychotherapists), address behaviour directly (Behavioural Psychotherapists) or a combination of techniques aimed at addressing thoughts and behaviour (Cognitive Behavioural Psychotherapists, Rational Emotive Behaviour Therapists). Whatever title they use, the approach is commonly referred to as CBT. Most importantly, all therapists aim to help clients achieve desired change in the way they think, feel and behave.

Here is an example of how our thoughts, feelings and behaviour can affect us.
'Sue was nearly asleep and by the time she managed to pick up the phone it had stopped ringing. She had been suffering from anxiety and depression for some time. Her daughter Liz, who had recently moved to London, immediately came to mind. Sue thought: "Something must have happened to Liz! That was the police calling to inform me that Liz has had a serious accident." She felt her stomach churning and her heart pounding at the thought that something could have happened to Liz. Her thoughts raced uncontrollably and she feared she could be losing her mind. She rang Liz's home number several times but there was no reply. Sue took this as further evidence that something bad had happened to Liz. Sue felt so panicky that she stayed up all night, despite taking extra medication. She felt dreadful thinking of all the things that could have happened and even thought of ringing some of the London hospitals. Sue found out from Liz the next morning that she had stayed the night at one of her friends' houses and was fine. Nevertheless, she remained distressed and unsettled and felt unable to go to work.'

What Happens in Behavioural and Cognitive Psychotherapies?

In behavioural and cognitive psychotherapies the therapist and the client work together to

  • develop a shared understanding of the client's problem
  • identify how these affect the client's thoughts, behaviours, feelings and a daily functioning

Based on the understanding of each client's individual problems the therapist and the client will then work together to identify goals and to agree to a shared treatment plan. The focus of therapy is to enable the client to generate solutions to their problems that are more helpful than their present ways of coping. This often involves the client using the time between therapy sessions to try things out.

Therapy is organised over an agreed number of sessions. The number of sessions needed will differ depending on the nature and severity of a client's problem. Typically, sessions are weekly, last an hour and take place over a period of between 10 to 15 sessions, but this can be significantly shorter or longer. After treatment completion client and therapist usually agree to a limited number of follow-up sessions to maintain the progress achieved.

What sort of problems can CBT help with?

Research on behavioural and cognitive psychotherapies has been carried out extensively. This has shown it to be an effective form of psychotherapy, particularly for the following:

  • Anxiety & Panic Attacks
  • Phobias (e.g. agoraphobia, social phobia)
  • Chronic Fatigue Syndrome
  • Depression
  • Obsessive-Compulsive Disorder
  • Eating problems
  • Sexual and relationship problems
  • Child and adolescent problems
  • General Health problems
  • Chronic Pain
  • Habit problems (e.g. tics)
  • Anger
  • Drug or Alcohol problems
  • Schizophrenia and Psychosis
  • Problems associated with a learning disability
  • Bipolar Disorder
  • Post Traumatic Stress Disorder
  • Sleep Disorders

Individual leaflets are available from the British Association for Behavioural and Cognitive Psychotherapies (BABCP) about many of the above problems.

Behavioural and cognitive psychotherapies can be used on their own or in conjunction with medication, depending on the severity or nature of each client's problem.

How do I find a therapist that can help me using these approaches? 

A good starting point is often to talk to your General Practitioner about your problems. Most General Practitioners know of psychotherapists working within the National Health Service, who are trained to use the approach. These can be professionals, such as Clinical Psychologists, Psychiatrists, Clinical Nurses, Counsellors, Social Workers or others. It is important that you are referred to a therapist who has been properly trained in the use of behavioural and cognitive psychotherapies.

Many trained Behavioural and Cognitive Psychotherapists operate within National Health Service or Social Services settings. Alternatively you may want to consider a referral to a private Behavioural and Cognitive Psychotherapist. Whichever referral, public or private, there may be a waiting time for therapy.
Sometimes private therapy can also be arranged by your General Practitioner or, if not, you may need to find a therapist on your own. If you do this, it is important that you ensure your therapist is properly qualified, receives regular supervision and has appropriate training.

A directory, which lists approved and qualified Behavioural and Cognitive Psychotherapists, is maintained by the British Association for Behavioural and Cognitive Psychotherapies (BABCP).

All of these psychotherapists are also eligible to be on the National Register of Psychotherapists available from the United Kingdom Council for Psychotherapy (UKCP).

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