Understanding CBT: What to Expect

CBT stands for Cognitive Behavioural Therapy

1.       CBT focuses on the relationship between thoughts, behaviours, emotions, and physical sensations. This includes what we imagine (such as images in our mind’s eye or sounds in our mind's ear, smells, tastes, felt sense that we perceive internally), as well as the words and sentences that run through our minds. These four areas constantly interact with each other — and changing one can influence the others.

CBT Five Areas Model illustrating links

2.       CBT explores new ways of understanding problems.  Through a gradual process of discovering things that we may not be aware of or may not be considering, we can start to understand things in new ways, re-frame them. We test out our new ways of thinking about things, and new ways of behaving using “behavioral experiments”. This can often involve us facing our fears and we can think together about how to do this in a way that feels manageable. In this way we can evaluate the usefulness of re framing how we think about things and doing things in different ways. We use worksheets to help us develop awareness of our thinking, our behaviour and how we feel.

3.       CBT is collaborative. CBT isn’t something that’s done to you. Therapist and client work together as a team. This partnership is crucial to the process — meaningful change is much less likely without it.

4.       CBT helps you become your own therapist. Over time, CBT equips you with tools to manage challenges independently. Bringing a notebook to sessions can be useful to record ideas or strategies you want to remember.

5.       CBT teaches practical skills. These skills are practised during and between sessions. Initially, your therapist will guide you — but eventually, the goal is for you to use them confidently on your own. Practice really is key!

6.       CBT sessions are structured. We usually begin with an agenda to focus the session on what matters most to you. Sessions often include reviewing or setting between-session tasks. You’re encouraged to bring topics that feel relevant to your goals for change — for example, exploring certain thought patterns or behaviours, or thinking about how to include in your life the things you'd like to do more of.

7.       CBT focuses on the present — but values your past. While CBT is largely focused on current thinking and behaviour patterns that maintain difficulties, your history matters too. Understanding how past experiences have shaped current responses can be a helpful part of making lasting change. We therapists are very interested in learning about your history! 

8.       Between session exercises (homework!) is a very important part of CBT. Repeated practise in between sessions of the new skills that you will learn is incredibly important for change. Without it, meaningful, lasting change is very unlikely.

CBT is just one approach I use in therapy, but learning about it on its own can help us better understand it and make the most of it. It can be useful to be aware that while CBT is a general approach to treating mental health issues , TF-CBT (Trauma-Focused Cognitive Behavioral Therapy) is a specialised form of CBT designed specifically to help people overcome the impact of traumatic experiences, you can read more about trauma, PTSD and TF-CBT here.

If you'd like to know more or discuss whether therapy could be helpful for you feel free to get in touch here.