What is Cognitive Behavioural Therapy (CBT)?

Cognitive Behavioural Therapy (CBT), also known as talking therapy, is a goal-oriented type of psychotherapy, which involves mental health professionals, i.e., psychologists. It is one of the most common and widely used psychotherapies with a lot of evidence globally. CBT indicates that thoughts, emotions, physical symptoms, and behaviours all interact with each other. Constant negative thoughts can lead to feeling down and avoiding social situations. CBT helps challenge those negative thoughts and replace them with positive or realistic thoughts.

When should CBT be recommended?

CBT is often recommended when a person is dealing with mental health challenges such as depression, anxiety, OCD, PTSD, ADHD, phobias, personality disorders, eating disorders, substance use, bipolar disorder, psychosis (schizophrenia), insomnia, migraines, IBS, etc.

Cognitive Levels and Formulation of CBT

CBT was based on the cognitive model developed by Beck. The cognitive levels in CBT consist of core beliefs, dysfunctional assumptions, and Negative Automatic Thoughts (NATs).

• Core beliefs: deep-rooted global beliefs

• Dysfunctional assumptions: conditional rules

• Negative automatic thoughts (NATs): situation-triggered reflexive thoughts

This hierarchy of cognitive levels shows how early life experiences shape core beliefs, which activate maladaptive assumptions and NATs in specific situations.

Formulation is building a personaliSed hypothesis of what maintains a client’s issues. The ‘hot-cross-bun model’ helps in visually mapping connections between thoughts, emotions, physical symptoms, and behaviour to understand and intervene in current cycles.

What happens in Cognitive Behavioural Therapy (CBT)?

• Early sessions involve identifying the problems the client is facing and understanding how their thoughts, feelings, behaviours, and physical symptoms are connected.

• Collaborative empiricism: the psychologist and client collaboratively build a formulation, which is a personalised explanation of how the client’s problems developed and are being maintained. Trust, openness, and mutual respect are fundamental.

• Problem and present focused: sessions are structured exclusively around current problems and setting SMART goals (specific, measurable, achievable, realistic, time-limited).

• Homework: critical to reinforce learning and application of skills outside sessions.

• Generally, time-limited, spanning between 5 to 20 sessions for typical anxiety or depression; longer when additional complexities.

  
  

Techniques used in CBT

Cognitive strategies include Guided Discovery and Socratic questioning - a gentle, educational method that helps individuals uncover errors in thinking by asking thoughtful questions. Behavioural techniques can include activity scheduling, exposure exercises, and behavioural experiments to test out beliefs in real life.

Conclusion

Clients are taught skills to become their own therapists, enabling long-term resilience and independence in managing mental health challenges. CBT empowers individuals to break the cycle of distress by changing how they think and act, leading to improved emotional well-being and daily functioning.