What does Cognitive Behavioural Therapy involve?

The sessions
Cognitive Behavioural Therapy effective individually or in a group of people, or studying a self-help book or computer programme.
 
In England and Wales, two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks; Beating the Blues is for people with mild to moderate depression.
 
If you have individual therapy:
  • You will usually meet with a therapist for between 5 and 20, weekly, or fortnightly sessions. Each session should last between 30 and 60 minutes.
  • In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will confirm that you feel comfortable with it.
  • The therapist will also ask you questions about your past life and background. Although CBT concentrates on the present, at times you may need to talk about the past to understand how it is affecting you now.
  • You decide what you want to deal with in the short, medium and long term.
  • You and the therapist will usually start by agreeing on what to discuss that day.
The work:
  • With the therapist, you break each problem down into its effective parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.
  • Together you will look at your thoughts, feelings and behaviours to work out:
    • if they are unrealistic or unhelpful
    • how they affect each other, and you.
  • The therapist will then help you to work out how to change unhelpful thoughts and behaviours. This is called, re-framing.
  • It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend 'homework' for you to practise these changes in your everyday life.
Depending on the situation, you might start to:
  • Question a self-critical or upsetting thought and replace it with a more helpful (and more realistic) one that you have developed in CBT.
  • Recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.
  • At each meeting discuss how you've dealt with situations since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don't seem to be helping.

They will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try.

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

Facing a fear of flying

Step 1: Look at photos of planes.

Step 2: Watch a video of a plane in flight.

Step 3: Watch real planes take off.

Step 4: Book a plane ticket.

Step 5: Pack for your flight.

Step 6: Drive to the airport.

Step 7: Check in for your flight.

Step 8: Wait for boarding.

Step 9: Get on the plane.

Step 10: Take the flight.