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Expert view: What is CBT?

How is CBT delivered and what difficulties it can be used for? Watch Professor Shirley Reynolds explain more.
CBT is a talking therapy. It’s usually delivered one-to-one with a therapist and a client, but there are other ways of doing it. It’s usually a specific number of sessions. About 10 or 12 is typical, but you can go as low as six or more, but you generally would know how long treatment was going to last. And usually therapy lasts for about 50 minutes and you would see a therapist once a week or so. So that’s very much like a lot of different therapies, but one of the things that’s very distinctive about CBT it’s about partnership between the therapist and the client. What you do in therapy and how you do the therapy is decided by the therapist and client together.
It’s quite active and problem-solving. It focuses very much on what’s happening now, why problems continue, and what can be done to change that. So what doesn’t happen too much is a lot of thinking about the past. The main focus of therapy is to help you live better now and to help you live better in the future. So it’s very practical. It appeals to people who want to get on with things and get over problems in a focused kind of way. Traditionally, CBT is delivered one-to-one, so a therapist and a client together in a room. But because CBT is quite structured, it also lends itself to being delivered in other ways.
So for example, some people will deliver CBT on the telephone, which is great if you live a long way from somebody and you can’t get in and see somebody once a week. It’s also done on the computer sometimes. So that can be done through internet exchanges, or it can be done with a computerised programme, where everybody does the same programme, and it’s just delivered purely by computer. And also, sometimes CBT is done in a group. So normally it would be individually, but for some people a group setting is much better because they get to hear about people’s experiences, support from group members, and people can really get a sense of community from others.
So I think the thing to emphasise really is that there’s no one right way. Most people will fit better with one way or another. But the important thing is there’s a choice of methods, and people can get an opportunity to try those out. CBT can be used to treat a range of different disorders. So originally it was developed specifically to treat depression, and that was what it was for. Very quickly then, it was developed to treat anxiety disorders. Then it was developed to treat other mental health problems, including eating disorders and more serious mental health problems.
But one of the very interesting breakthroughs I think that we’ve seen much more recently is the use of CBT to help people who’ve got chronic physical health problems. These would include people who would have, for example, heart failure, breathing problems, diabetes, chronic pain, all sorts of symptoms that really interfere with how well you can live your life. So using CBT in those contexts can help people manage their symptoms much more effectively. That makes them much more able to do the things they want to do. They get more out of life, and sometimes we also see the physical symptoms reduced as well, which is a real bonus.
So what we really see is a picture CBT developing and being applied in different areas with a very strong research base going alongside that to make sure that it is effective. CBT has been very widely researched, and that’s one of its core strengths. So right from the start there was an effort to make sure that when treatment was offered, people would benefit from it. And so patients and therapists have always been involved in research on CBT. We can always improve it, but essentially CBT is a very, very well-evidence-based treatment. So it works for a wide range of problems and is being improved all the time.

Please watch this video, where Professor Reynolds introduces you to CBT and explains how it can be delivered and what difficulties it can be used for. You’ll find out some of the key points in this clip. Essentially:

  • CBT is a type of psychotherapy (or ‘talking’ therapy). You can read more about this approach on the NHS website.

  • CBT was pioneered by Aaron T. Beck in the 1960s. You can find more information about the history of this approach on the Beck Institute website.

  • It is a very collaborative treatment with active involvement from both therapist and patient. It focuses on the patient’s current difficulties and what is maintaining them.

  • It is typically delivered face to face with a therapist over 10 to 12 sessions, each being around 50 minutes (although this may be less).

  • It can also be delivered in a variety of other formats including over the phone, over the internet (eg using an online programme) or within a group setting).

  • It was originally developed to treat depression back in the 1960s. However, since then, CBT has been adapted to treat various forms of anxiety and other mental health difficulties (eg eating disorders).

  • More recently, CBT has been developed as an intervention to help manage long term physical health conditions such as diabetes and heart disease.

  • CBT is heavily researched; more than 1000 studies have demonstrated the efficacy of CBT as a treatment for mental health difficulties and it has also been shown to be an effective way of managing physical health difficulties.

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Understanding Anxiety, Depression and CBT

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