What is CBT?

The acronym CBT stands for Cognitive behavioural Therapy. It is a kind of psychological therapy in which the aim is to modify the Cognition i.e. how one thinks and interprets things and Behaviour which results in improvement in symptoms.

The therapy takes place in various phases after you are assessed for suitability. In the initial phase rapport is built and the person is assessed for any cognitive errors/distortion.

The cognitive errors are systematic pattern of thinking which are linked with faulty interpretation of what is happening around and thus lead to a state of depression or anxiety etc. An example of cognitive error is all or None thinking which means that the person ignores the middle path and focusses on the extreme possible outcomes of the situation. For example, someone who is abstinent from alcohol for some time takes a single drink at a party and thinks that they are a complete failure for breaking the abstinent attempt thus starts to drink regularly next day onwards. Resultantly, something which was a single lapse of one drink turns into a full relapse of the previous pattern of alcohol use.

In the later sessions the therapist and the patient work together to get into the core beliefs behind these errors and help the person to work their way to modify these errors to get relief from symptoms.

Core beliefs: These are central beliefs held by the person to the core. They may or may not be apparent to the person in starting of the therapy. Person’s thinking errors originate from these beliefs.

Automatic thoughts: These are actual thoughts that go through a person’s mind in various situations automatically.

Reaction: It is the action taken by the individual as a result of this thought process.

An example of the core belief could be “I am incompetent”; the automatic thought could be “I cannot control my drinking” and the reaction could be “daily alcohol use”.

The person in therapy may be asked to maintain a thought diary and may also be given some tasks/homework in order to better understand their thoughts and help them change.

When should one get CBT?

CBT is proven to work in a wide variety of disorders including:

1. Depression & stress
2. Anxiety, panic & phobias
3. Bulimia
4. Obsessive compulsive disorder
5. Post-traumatic stress disorder

What is the course of CBT?

The course of treatment usually ranges from 6 weeks to 6 months. There are 30-60 minutes sessions each with a frequency of weekly or fortnightly. These figures are a little flexible and depends on the initial assessment. One may choose to not take CBT and ask for alternative means of treatment.

Is it better than drugs?

CBT is an effective treatment for mild to moderate depressive symptoms, anxiety symptoms and other conditions mentioned above. It should be however kept in mind that CBT does not give immediate relief and takes some time. Whenever suited the doctor may prescribe some medicines or other alternative therapy for quicker relief.

How it is different from other therapies?

CBT mainly focusses on the current pattern of thinking rather than emotions or relationships. The aim is to identify the errors in pattern of thinking and how they influence the emotions and the behaviour. Further the person works their way to modify these behaviours to get symptom relief.

CBT does not take into account the person’s past nor does it analyse dreams. Recent research has focussed more on the role CBT in treating various psychiatric illnesses because it is short term, easier to study and practice. However, this does not mean that other therapies like Psychodynamic therapy or client cantered therapy do not work or are less effective. The evidence is almost equal for different kind of therapies.

If a person thinks that their current problems are related to their past issues (e.g. childhood trauma, bullying etc.) a psychodynamic approach may be more suited. Those who have significant relationship problems are more likely to benefit from interpersonal therapy.

One should consult a psychiatrist to know what kind of psychotherapy is suited for their problem. While CBT is more suited for someone in which current problems are not believed to be directly linked to their past.

Where should I seek help from?

If you or your dear ones are having significant distress or problems in carrying normal activities, you should consult your GP or psychiatrist immediately. The psychiatrist will evaluate thoroughly and evaluate for the need for treatment, whether you require CBT or not and order any investigations if required.

Recommended Reading:

• Cognitive Behavioural Therapy (CBT) | Royal College of Psychiatrists [Available from: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/cognitive-behavioural-therapy-(cbt)

• Willson, R., Branch, R., 2019. Cognitive behavioural therapy for dummies. John Wiley & Sons.