Short-term Cognitive Behaviour Therapy CBT
5th March, 2008
Cognitive Behaviour Therapy (CBT) is based on the simple idea that the way you think about a situation will have a major impact on how you feel and behave.
Say you were in a situation where a lot of pressure was being put on you at work and you’re getting very stressed and you’re thinking ‘I must get everything right’, it’s likely you will get even more stressed. If this gets really bad you may get depressed, stop going into work, and this in turn could affect your eating and your sleeping and there could also be psychosomatic symptoms – for example backache or headaches.
Getting into a Negative Cycle
If this situation persists it can lead to a negative cycle in which all the factors are working against you – the way you’re thinking that you must get it right, the stress and the physical feelings, and also behaving in a way that doesn’t deal with the situation at work, leading to a sense of increasing pressure and things getting even more difficult.
The aim of CBT is not so much to understand and emphasise what appears to be the obvious link between the situation at work and the consequences – feeling anxious and depressed, missing days at work and not eating and sleeping properly, but the thoughts that see the situation in a problematic or negative way. ‘I can’t do this’ or ‘I must get everything right’ and if this negative cycle gains in strength, ‘I always make a mess of things’ and finally, ‘I’m a mess’ or 'I’m a failure’.
Changing Negative Thoughts and Behaviours
Once you’ve begun to understand these negative thoughts, it becomes possible then to question them and put them in a context where they lose this very critical quality and in turn make them more relative. ‘I must get everything right’ can become ‘It is true I do want to get things right and do it well and sometimes I will make mistakes, but that doesn’t mean I’m a failure’. And not only do you work to change and relativise the negative thoughts, you also think about how you can change some of the behaviours that are contributing to the problem.
This could involve thinking about strategies that would help you manage the work load in a less stressful way, or perhaps talking to your boss about making some changes that could help, rather than thinking you have to do it all by yourself. Likewise you may have got into the habit of not eating properly or exercising, and you could address this in a more creative manner.
The key is that though you can’t change the outside events, or it’s much harder to change the environment around you, you can make changes about how you think and behave. In doing this, a step at a time, you move from a place in which everything is linked in a negative way, to a more positive cycle.
CBT then is an approach that emphasises the importance of defining what the problem is and working towards a solution. It is usually short-term, emphasises a collaborative approach in which the client learns how to be their own therapist - in other words how to use the techniques of CBT themselves. This can happen in the sessions, with the therapist showing the client how to understand and change their own negative thoughts, but also carrying out graded tasks between sessions, - for example starting to change certain negative behaviours, like putting off things that need to be done, and keeping a diary so as to become more aware of your responses to problems as they arise. And then to start thinking about other ways of responding that are more realistic and adapted to the difficulties you are facing.
Advantages and Disadvantages of This Approach
The great advantage of this approach is that it can quite rapidly, through changing negative thought patterns and behaviours, find a more creative and satisfying way of dealing with a problem. The disadvantage is that the problem may have deeper roots, for example issues that go back into childhood, which would take more time to understand and work through, and which may not be amenable to this more active approach with its emphasis on finding a solution. It is also a question of what the client wants. Different therapeutic approaches suit different clients
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