Have you heard about CBT before? Do the letters seem familiar but you’re not quite sure what it really stands for, and what it means? Never fear! Today’s post is the first in a long line of a new series I hope to write, explaining key concepts found in the therapeutic world. CBT happens to be one of them and probably something I explain every day in my job as a therapist.
In ‘What’s It All About’, I’ll be sharing a new concept, strategy, therapeutic technique or even mental health topic that you may or may not have heard about. I’ll outline a brief history, what it entails, and where you can go for next steps! I definitely won’t be able to do these topics their full justice but consider this a sampler menu, or reference for your education. You can look forward to future posts that might go into more depth on key topics and ideas, but for now, this will outline the bare bones. So let’s jump in!
The question I receive most when talking about my services is whether I offer CBT – Cognitive Behavioural Therapy. I pleasantly reply that Yes! I do offer CBT… and then I ask what they know about that process and how they heard about it. And the answer is invariably that they don’t know much, but just heard it was the best treatment.
I love hearing that my clients are researching, asking questions, and looking things up online but this trend worries me a bit. Why does everyone know CBT is what they need, when they don’t even really know what it is?
Well buckle up kids. It’s time for some learning.
What is CBT?
Cognitive Behavioural Therapy (CBT) is a talk-based therapy that focusses on the links between our thoughts, feelings and behaviours. CBT involves looking at how the things we think, or the things we do, influence our feelings. And vice versa! Imagine it like a triangle; all of these three things play off one another and can either impact you for the better or for the worse!
Most people want to FEEL better – they want to feel less anxious, feel more confident, feel motivated, or in control. But trying to just replace one feeling with another can seem impossible. CBT acknowledges that if our thoughts, behaviours and feelings are all interconnected, it would make sense that changing you thoughts (how you see situations, what you think of yourself or others), or the things you do (how you handle relationships, your reactions to events, or your own self care) can then have a ripple effect and change your feelings (your anxiety, stress, feelings of self esteem).
As an example, let's meet June:
For June, her morning went from bad to worse because of a few things: we can see some of her thoughts (“I’m stupid for sleeping in!”, “This traffic is terrible!”, “My boss will hate me!”, “This morning was awful!”) made her become anxious, angry, and pessimistic.
Her behaviours didn’t help either (Watching Netflix too late, skipping breakfast, driving erratically).
CBT would look at this for examples of different ways to approach the same scenario, by changing her thoughts to more neutral or balanced ones (“My boss will hate me!” could become “My boss may be upset but he won’t likely hate me”), or by focussing on building healthier habits (like setting a decent bed time, a more relaxed morning routine with extra time for traffic, or using breathing exercises to regulate her stress while behind the wheel). This won’t magically make a difficult morning perfect, but it may be the difference between losing it on a co-worker, or being a little more relaxed and being able to keep your cool.
CBT found its roots in the shift from intensive psychoanalysis (picture laying on the couch, talking to Freud about your mother multiple times a week for years of treatment) to shorter term forms of psychotherapy. It has since been heavily tested and researched and found to be a highly effective means of tackling all the most common mental health struggles. It was developed by Aaron T. Beck in the 1960’s and fairly quickly rose to being the ‘gold standard’ of psychotherapy. There’s been hundreds of journals and endorsements to back this claim, so it’s no wonder you’ve probably heard about it.
CBT is effective in addressing motivation, depression, anxiety, self esteem and much more. Perhaps that’s why it’s so widely sought after and touted as a primary focus for many therapy sessions – it seems to be a Jack of all Trades!
But maybe what you don’t know is how that therapy happens, or what you could expect from it yourself! So here’s the key tenants of CBT to guide you.
CBT is Educational – The main goal of CBT is to teach you to be your own therapist! You will be learning skills, strategies and concepts that you will then practice with your therapist in session, use in your daily life, and then modify and adjust until you’re confident you’ve got it! Wash, rinse, repeat. Your therapist will teach you about the links between behaviour and thoughts, and how changing these patterns of being and thinking can make you feel better. You’ll learn about ways our thoughts can be distorted to see things in certain ways, and how to ‘untwist’ those thoughts. You’ll be focussed on changing behaviours like improving self-care, using self soothing techniques, addressing relationships and general problem solving. Once you have the formula down, you’ll be encouraged to keep practicing in your daily life.
CBT is Time Limited – The first thing I want people to know about CBT is that this is a model of therapy that you should learn, apply and move on with. It is not a form of therapy you will need to have weekly, for years and years. The goal is to teach you some very valuable information and techniques and then see that you can use them daily in your usual life and say your goodbyes. This is not an exploratory therapy. It is best done short term, meaning something like 8-20 sessions if you are specifically visiting with your therapist to use CBT.
Now, many times CBT is used in conjunction with other therapies and modalities – so your therapist may help you learn these skills and still do other forms of talk therapy, like narrative or trauma based approaches. CBT can be a great addition to many others forms of counseling you may be doing!
CBT is Problem Oriented – When you come to work with CBT, be ready to dive head first into change! We really want clients to accept the concept that your thoughts are not facts; therefore they are changeable and you will be treating them as such in this form of therapy. We will look at your thoughts and behaviours with a solution focussed sort of lens. So that means you can anticipate that most of your discussions will be around solving the problem of the thoughts and behaviours in your life that aren’t helping you: and it will be your job to change them. Sound challenging? Don’t fret. You will be taught how to take a step back from your ways of thinking and behaving to see the bigger picture.
CBT is Collaborative – I cannot stress this point enough: what you put into CBT is what you will get out of it. CBT is famous for having homework, and you can tell you’ve found a real trained CBT practitioner when they give you assignments to complete at the end of each session. But bear with it! This is the reason CBT is so effective. This form of therapy relies on you and your therapist working hard together, with honesty and compassion and humility, to look at your life, your thoughts, your actions and reactions and making solid plans for how to change them for the better. So it makes sense if you’ve got a plan, you need to follow through on it and homework can keep us honest! You will need to practice this new way of thinking and acting. You will need to find out how you can apply this to your day to day. Remember how I said CBT was time limited? Well, you need to use your time wisely, so practicing your skills outside of therapy and completing thought records, or practicing problem solving skills will help you see any hiccups that come along the way. Then, you can review these challenges with your therapist and find a solution.
Not to mention, practice makes perfect! Homework helps us solidify our learning, and fine tune our approach. Your teacher didn’t make you practice your multiplication tables all the time in grade school for nothing. It was to help you remember, so you could remember 4×6 without needing to think too hard. Now wouldn’t that be great if you could do the same for challenging a negative thought? That you could feel calmer right in the moment that negative thought happens instead of days later? Yea. That’s why homework helps.
CBT is a therapy where the more you work with your therapist, and trust their suggestions, the better you will feel. So if you feel like you can really commit to this sort of work, and are willing to see yourself change, CBT might be just the therapy for you!
Reach out in the comments below with your thoughts on this kind of therapy and any other questions you may have!