What is CBT?

There is no one “Cognitive Behavioural Therapy”.

Cognitive Behavioural Therapy (or CBT), represents a family of talking therapies. They are all based on the idea that our thoughts, emotions, actions, and how our bodies feel, are all connected.

This family of therapies share a commitment to scientific excellence in the alleviation and prevention of suffering.

What this means to the client, is that psychologists or psychotherapists who practice CBT are using an approach which has research-based effectiveness for the treatment of a range of problems. It works for lots of different people and problems, and is widely recommended by national treatment guidelines across the UK, EU, and North America.

The National Institute for Health and Clinical Excellence (NICE) provides independent, evidence-based guidance for the NHS on the most effective, proven treatments. CBT is recommended in NICE guidelines for many different problems, including:

There is also good evidence that CBT is useful in helping people cope with or manage many other problems, including physical health conditions such as:

CBT is a collaborative therapeutic approach. Clients work together with their CBT therapist in a direction that is meaningful to them, and on mutually agreed goals. This requires active engagement with the process. CBT is most effective when clients work on things in between sessions as well as during them.

CBT approaches can be helpful for children and young people, adults, and older adults

The therapies that are “members of the CBT family” also have some differences.

‘Traditional’ CBT

Some therapies, like Cognitive Therapy, often aim to help us directly change the way that we are thinking so that we might have a more rational, positive, or functional outlook.

Other types of therapy, such as traditional Behaviour Therapy, use very direct methods of confronting feared situations to help overcome phobias, rituals and other problems.

Traditional CBT combines aspects of both cognitive and behaviour therapy to help us notice and change problematic thinking styles or behaviour patterns so we can feel better. For example, when we’re low or upset, we often fall into patterns of thinking and responding which can worsen how we feel.

Traditional CBT tends to be focussed on the here-and-now. However, it may also focus on previous life experiences and belief systems that could be could be impacting the current problem.

Structure is an important aspect of traditional CBT sessions. Typically, therapy begins with agenda setting – agreeing together what that session will concentrate on. However, a CBT therapist will not tell someone coming for therapy what to do or what to talk about.

(Above adapted from the British Association for Behavioural and Cognitive Psychotherapies, BABCP)

Today, a quiet revolution is taking place.

Emphasis is on recent advances in CBT that represent the further growth of psychological research and practice. These directions involve mindfulness, acceptance, and compassion.

This movement has provided an opportunity for ongoing advancement in the way that we can treat psychological and behavioural difficulties.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) is a transformative approach with origins in traditional behavioural therapy. ACT helps us to step out of harmful patterns of action and entanglement with painful thoughts, so that we might move forward with courage towards meaning, purpose, and fulfilment in life.

ACT has been widely studied in recent years, and has a strong evidence base for the treatment of depression, anxiety, and a host of other health problems.  

Developed within a coherent theoretical and philosophical framework, ACT is a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behaviour change strategies, to increase psychological flexibility.

Psychological flexibility means contacting the present moment fully and consciously at any given time, based on what the situation affords, and changing or persisting in behaviour in the service of values.

ACT highlights the ways in which language can entangle us in futile attempts to wage war against our own inner experiences.

Through metaphors and experiential exercises, ACT can help us to make healthy contact with thoughts, feelings, memories, and physical sensations that have been feared and avoided. ACT allows us to gain greater clarity about personal values and what is meaningful to us, guiding needed behaviour change.

(Above adapted from the Association for Contextual Behavioural Science, ACBS)

Compassion-Focussed Therapy (CFT)

Shame and self-criticism make life very difficult for people with a range of different problems. People who intensely experience them may struggle to feel reassured, relieved, or safe. This lack or emotional ‘safeness’ can make it challenging to live a meaningful and rewarding life.

Research suggests that a specialised emotion regulation system underpins feelings of reassurance, safeness, and wellbeing. It is believed to have evolved with human attachment systems and in particular, the ability to register and respond to calming, and a sense of being well-cared for.

We experience this emotion system as a felt sense of compassion. Compassion can be directed towards others and ourselves.

In CFT, it is believed that this emotion regulation system is less accessible to people that struggle with high levels of shame and self-criticism. For these people, the ‘threat detection’ component of their emotion regulation system may dominate orientation of their inner and outer worlds.  

CFT is an integrated and multimodal approach that draws on Evolutionary, Social, and Developmental Psychology, and has a robust Neuroscientific evidence base. CFT aims is to incorporate compassionate mind training (developed by Prof. Paul Gilbert) to help people work with experiences of inner warmth, safeness and soothing, through compassion and self-compassion.

(Above adapted from the writings of Paul Gilbert, founder of CFT)

Get in touch to learn more about my therapeutic approaches.

CBT Is a family of therapies. Each member is linked by a shared history, but diverse and able to offer unique benefit to the world.