How Does CBT Work?
As the name suggests, cognitive behavioural therapy works by teaching a person to change their thoughts (cognition) and their behaviours. The aim is to assess the negative thoughts a person is having about themselves, and their view of the world, and to replace them with more positive and constructive thoughts and behaviours. By addressing the thoughts and behaviours which contribute to the development and maintenance of problems, CBT seeks to offer a holistic approach to mental health care.
In its simplest form, CBT requires only two things: learning and doing. A person undertaking CBT will learn coping skills and techniques, both ones that are pertinent to their health issue, and more general ones that will help with everyday life. They will learn about their health condition, and how it is being maintained. This aspect of CBT is founded on the adage that knowledge is power. The more someone knows about their own disorder, the better equipped they will be to recognise its symptoms and do something about it.
With this knowledge, a person will then be equipped to actively change their behaviours. They will be able to face their fears, or to deal with situations that they were previously unable to deal with. CBT seeks to enforce this relationship between knowledge and activity, in order for a person to take practical steps to alleviate their symptoms and to recover.
What Happens In A CBT Session?
CBT offers structured sessions that are designed to make the most of your time in therapy.
While different practitioners will approach CBT slightly differently, the structure will generally be fairly similar.
Before treatment commences:
- You will meet with your CBT therapist. A course of CBT generally varies between five and 20 sessions, usually offered weekly or fortnightly. This is to allow time between sessions to put lessons into practice.
- Your therapist will learn about you through questions about your life and background. The answers you provide may affect the course of action prescribed to you in your CBT sessions.
- You will decide what goals you want to achieve over the course of your treatment, and into the future.
It is important to note that, through the first few sessions, your therapist will assess the usefulness and viability of CBT for you, and will check that you are comfortable with it.
During the CBT session:
- Along with your therapist, you will start by deciding what you want to focus on during the session, and you will go over the lessons and tasks from the last session.
- You will break down each problem that you want to discuss into parts. This will help you learn about your own thought patterns, emotions, and behaviours.
- You will assess your thoughts, feelings, and behaviours to find out of they are realistic or helpful, and to see how they affect you.
- Your therapist will help you come up with ways to challenge and change any unhelpful, unrealistic, or destructive thoughts and behaviours.
- You and your therapist will agree on homework tasks that you will undertake between sessions, during which you will put in place, and practice, the coping skills and techniques that you have learned. These tasks will be designed to make you as comfortable as possible while adding a small challenge to your behaviours.
The homework aspect of CBT is one of the most vital parts of the process, so it is imperative that you actually practice the tasks set for your homework. You will learn, through undertaking the set tasks, to think positively, and challenge yourself to cope with normal situations.
What Can CBT Help With?
CBT has been successful in the treatment of many health issues, from anxiety and depression, to chronic pain and addiction. CBT has been found to be most suitable for people who have particular, identifiable issues, that can be addressed with specific tasks and goals. The practical nature of CBT makes it helpful for people who are looking for a hands-on approach to their treatment.
People suffering from the following problems could benefit greatly from treatment with CBT::
- Anxiety and panic attacks
- Child and adolescent problems
- Chronic pain
- Eating disorders
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
- Problem gambling
- Sleep problems
CBT can also be used to address other health problems. Primary health care professionals can advise as to whether CBT will be useful in the treatment of other health issues.
How Effective Is CBT?
There is a large body of evidence which shows CBT is a very effective treatment for the reduction of symptoms associated with a wide range of health issues, especially the common anxiety and depressive disorders.
Additionally, the effects of CBT don’t stop at the end of treatment. The lessons learned from CBT are ingrained through practice, and so make substantial and ongoing changes to a person’s life. The practical coping mechanisms are also transferable, so skills and techniques learned through CBT can positively affect other facets of life, like work, study, and personal relationships.
How Much Is CBT Therapy?
The cost of treatment with CBT is variable. Reasons may include:
- session costs of the treating clinician
- number of sessions required
- method of delivery, i.e. face-to-face or internet-based
- whether government health rebates are available
Other factors may affect the cost of therapy, so it can be useful to request a breakdown of costs when commencing CBT.
In Australia, even after the Medicare rebate has been applied, there is often an out-of-pocket cost for a session with a clinical psychologist. There are also additional costs, such as transportation, and absence from work, that can cause this form of treatment to become a quite expensive option.
In comparison, iCBT is often substantially cheaper than face-to-face CBT because it can be undertaken at any time, from almost anywhere, and is generally offered at a set cost for the entire course.
Who Offers CBT/iCBT?
CBT is offered by a range of certified health professionals. The following practitioners will be able to offer CBT, or if not, will be able to refer clients to someone who does.
- Mental health websites, such as THIS WAY UP, offer structured iCBT courses.