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Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is the most researched therapeutic approach used in counselling

CBT works on the premise that if we can introduce more helpful ways of thinking then we will in-turn feel better and adapt more helpful ways of behaving.

Therapist works with the client to address what the client’s issues and goals are. Ideally what they would like to change. Using specific situations as examples the therapist works with the client to identify what they were thinking, feeling and how they behaved. Then the therapist challenges the client’s unhelpful thoughts with questions like “What evidence is there to support that?”. Then the therapist encourages the client to explore other possible ways to think about a situation and entertain what may happen if they did choose to adopt the more helpful way of thinking. How would they feel? What might they do? Then the challenge is for the client to practice these new ways of thinking and put it into practice over and over with the hope that they will adopt a more permanent change in helpful ways of thinking.

Therapeutic interventions would include asking the client to do “homework” such as keeping a diary of situations where they wished It had been different. The client is asked to record what they were thinking at the time, how they felt and what action they took. As therapy moves along the client would be asked to document alternatives to their unhelpful thoughts.

CBT is used to treat many things such as depression, anxiety, eating disorders, phobias, relationship difficulties etc. CBT is not suitable for people with more serious psychiatric needs such as schizophrenia. Also, CBT does not address why the unhelpful thoughts have started. It just deals with the here and now. Ideally effective therapy will use CBT at times combined with other therapeutic techniques. Clients report that CBT on its own may not be enough to create long lasting permanent change.

Sarah Dwyer, PDC Counsellor

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