What is cognitive behavioural therapy (CBT)?
Cognitive behavioural therapy (CBT) is a structured psychological therapy that explores the relationships between thoughts, emotions, behaviour and physiological responses.
A central principle of CBT is that difficulties are often maintained not simply by what has happened to us, but by patterns that develop in response to those experiences. These may include avoidance, excessive worry, self-criticism, threat monitoring, reassurance seeking, withdrawal or particular ways of interpreting ourselves, other people and situations.
CBT helps identify these patterns and understand the function they serve. Therapy then provides opportunities to test different ways of thinking and responding, so that patterns which may once have been protective but are now maintaining distress can begin to change.
Understanding what maintains the problem
Good CBT involves more than challenging “negative thoughts.”
Your therapist will work collaboratively with you to develop an individual psychological formulation: a working understanding of the factors contributing to your difficulties and, importantly, what may be keeping them going.
This might involve exploring:
- patterns of thinking and interpretation
- avoidance and other coping behaviours
- underlying assumptions and beliefs
- emotional and physiological responses
- previous experiences that influence present-day reactions
- interpersonal or environmental factors
- cycles that repeatedly reinforce the difficulty
This formulation gives therapy a clear focus and helps determine which interventions are most likely to be useful for you
Cognitive behavioural therapy videos
Explore Teresa Lewis’s teaching videos on cognitive formulation, underlying beliefs and the relationship between thoughts, emotions and behaviour.
How CBT can help
CBT is an active and collaborative form of therapy. Rather than simply discussing difficulties, therapist and client work together to identify patterns, develop alternative perspectives and experiment with different responses.
Depending on the difficulty and your individual formulation, therapy may involve behavioural experiments, graded exposure, activity scheduling, cognitive restructuring, attention-based strategies, problem-solving or work with underlying beliefs and assumptions.
Some of our therapists also have training in contemporary third-wave approaches, including Acceptance and Commitment Therapy (ACT), Compassion Focused Therapy (CFT) and Dialectical Behaviour Therapy (DBT). Where appropriate, these approaches can broaden the therapeutic work to include processes such as psychological flexibility, self-compassion, mindfulness and emotional regulation.
Work between sessions may also be useful. This provides an opportunity to observe patterns and test what you are learning in the situations where difficulties actually occur.
The aim is not simply to “think positively” or eliminate uncomfortable emotions. It is to develop a more flexible and accurate understanding of your experiences and a broader range of ways of responding to them.
What can CBT be used for?
CBT has been extensively researched and is used in the treatment of a range of psychological difficulties, particularly anxiety and depressive disorders.
Depending on the individual and presenting difficulty, CBT may be helpful for problems involving anxiety, depression, panic, phobias, obsessive-compulsive difficulties, trauma-related difficulties, health anxiety, low self-esteem, stress and persistent patterns of worry or avoidance.
Not every difficulty requires the same form of CBT, and CBT is not necessarily the most appropriate approach for every person. Your therapist will consider your particular difficulties, circumstances and therapeutic needs rather than applying a standardised programme.
What will therapy be like?
Your first sessions will usually involve developing a clearer understanding of what you are experiencing, how it developed and what appears to be maintaining it. Together, you and your therapist can then agree priorities and therapeutic goals.
CBT is generally transparent: your therapist should be able to explain the rationale for the work you are doing and how it relates to your formulation. Therapy is collaborative rather than something that is simply “done” to you.
At Lewis Psychology, our therapists are integrative practitioners with training in CBT and other established therapeutic approaches. CBT can therefore be provided as the primary therapeutic approach where appropriate, or integrated within a broader formulation according to your individual needs.
Is CBT right for me?
You do not need to know whether CBT is the right therapy before making an appointment.
You may simply know that something has become difficult to manage, that familiar patterns keep repeating, or that the ways you have learned to cope are no longer working as well as they once did.
Your therapist can help you understand the difficulty and consider the therapeutic approach most appropriate to your needs.
Book an appointment
Appointments are available to adults throughout the UK via Zoom or telephone.
You can view current availability, choose your therapist and book directly through our secure Client Portal.
