CBT is a form of counselling and psychotherapy that stands for Cognitive Behavioural Therapy.

CBT is proven to be particularly effective for those who are experiencing depression and low mood, or anxiety and related issues such as social anxiety, health anxiety, panic, phobias, and obsessive compulsive disorder.

It was developed by American psychiatrist Dr Aaron Beck and looks at how our thoughts, our behaviour, our emotions and feelings, and what arises for us in our body are all closely linked and interconnected.

CBT Diagram

A simple everyday example

You arrive at work and say a warm hello to your work colleague. However your colleague does not say hello back, they just keep their head down and keep working. The thoughts that you have in response to this will greatly affect your feelings, your behaviour, and what you experience in your body.

For example if your thoughts automatically jump to the conclusion that you must have done something to upset your colleague and now they do not like you (thought), this thought will lead you to feel a particular way – perhaps rejected (emotion). Rejection is a strong emotion, and all emotions can be experienced in the body. Rejection might be experienced as a draining feeling in the body (body), and you may behave by avoiding or ignoring your colleague for the rest of the day (behaviour).

In reality, you cannot know for sure why your colleague did not say hello, and in actual fact there are countless explanations. Through CBT we seek to look at situations and ourselves in ways that are more grounded in reality, and that break the vicious cycle that can arise as a result of automatic negative thoughts.

How does CBT work for depression and anxiety?

Psychoeducation is an important part of CBT. Unhelpful thinking patterns and behaviours are very often at the heart of depression and anxiety related disorders. Through CBT a person develops awareness and understanding of how their thoughts and behaviours contribute to distressing emotional states such as depression and anxiety.

With a CBT approach unhelpful thinking patterns and behaviours are identified, explored and challenged in an effort to cultivate more helpful thoughts and behaviours that are more grounded in reality and that can significantly reduce symptoms associated with anxiety and depression.

For example, in the case of depression, without realising it, a person’s behaviour may be reinforcing their depressive state in subtle and unhelpful ways. While the journey to recovery from depression is not straightforward, through the use of CBT there may be a number of small but very significant ways that a person could adapt their behaviour in order to lift their mood and to become more motivated to overcome the difficulties that they are experiencing.

In the case of anxiety, a person may not be aware of how their thinking has become distorted and irrational in certain aspects of their life. For example in the case where a person is experiencing panic attacks, a thinking distortion known as “catastrophizing” is at the heart of what is reinforcing and perpetuating the panic attacks.

What might a CBT counselling session be like?

In the first session a counsellor will seek to gain an understanding of the challenges that the person is facing and to determine if CBT appears to be a relevant therapeutic approach for a client and their particular difficulties.

In the sessions that follow, a counsellor will introduce a person to specific tools and techniques to address their particular issue, and where relevant will share CBT concepts and principles with the person.

Over time a person develops the relevant skills and insights to work through their struggles associated with depression or anxiety. One of the goals of CBT is that an individual learns to become like their own therapist by drawing upon these skills and insights long after counselling has ended. This also significantly reduces the likelihood of a person relapsing into depression or anxiety.

CBT is different from other forms of counselling in that a person will often be given tasks to complete in between sessions that are discussed and explored the next time they meet with their counsellor.

Many individuals benefit greatly from as few as six sessions of CBT counselling. However, in some cases, where an individual’s issues are more complex or where they feel they would like to explore their issues at a deeper level, a person may decide to continue with CBT counselling sessions for a longer period of time.

CBT is not about positive thinking

I have found that there can be a misperception that CBT is simply about thinking positively instead of thinking negatively. This is not the case. CBT is much more than this. It is about looking at our thoughts and asking ourselves is what I am thinking really true? Are there facts or evidence that support this thought? Are my thoughts about this helpful to me or are they dysfunctional?

By asking these questions often we may find that there are alternative ways to look at situations and at ourselves that are more balanced and that are more likely to contribute positively to how we feel about ourselves.

You mainly feel the way you think. Albert Ellis

Learning CBT skills and tools without a counsellor

Although visiting a counsellor or psychotherapist is generally the most effective way to benefit from the principles of CBT, there are some excellent books available that you may wish to purchase if you are not currently in a position to attend counselling.

These include books that are part of the Overcoming Series, many of which can be found here, and also Mind Over Mood by Greenberger and Padesky.

A lot can also be gained simply by beginning to see if you can bring awareness to the link between your thoughts, feelings, behaviour, and your body. For example next time you find yourself feeling particularly bad in a situation or towards an aspect of your life, see can you get a sense of what you are thinking in this situation and whether this has an effect on the emotions you experience, or on how you behave. Ask yourself if there is a more helpful way to look at the situation or at yourself?

So much more to explore!

CBT is a very broad and important area of counselling and psychotherapy and a great deal more could be explored and discussed in relation to it as a therapeutic approach. The purpose of this article is to provide a brief overview of CBT and how it might be helpful in working through difficulties and issues such as depression and anxiety.

If you have any specific questions that you would like to ask in relation to CBT please don’t hesitate to get in touch – esther@presentmoment.ie.

Greenberger, D., & Padesky, A. (1995). Mind Over Mood. New York: The Guildford Press.
Beck, J., (2011). Cognitive Behaviour Therapy – Basics & Beyond. 2nd Edition. New York: The Guildford Press.

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