Cognitive Behavioural Therapy (CBT)

What is Cognitive Behavioural Therapy (CBT)?

CBT TriangleCognitive Behaviour Therapy (CBT) is a psychological treatment, or ‘talking therapy’, for young people and adults troubled by emotional difficulties. Emotional difficulties, as in feelings of depression or anxiety, often arise when a person feels sure or convinced by their own negative thoughts. These negative thoughts can trap a person in feelings of misery and depression. A cycle occurs where the depression changes a person’s thoughts, feelings and behaviour.

CBT involves talking about yourself, the world and other people; about how what you do affects your thoughts and feelings. CBT helps you change the thought processes that result from these situations and experiences, changing negative assumptions into more positive scenarios.

CBT is not an instant solution to problems but a way to think and act on situations in a more positive way, allowing you to feel and respond better. Gradually and with advice and encouragement from a CBT therapist, the aim is for you to start to look at situations from a fresh perspective.

A CBT therapist will concentrate on issues that are occurring in the present rather than what happened in the past. The therapist aims to change the way you think about something (cognitive) and the way in which you act (behavioural).

How effective is CBT?

There is significant scientific evidence that CBT is an effective treatment for people with anxiety, depression and obsessional problems.

Can CBT help me?

CBT is useful to those who feel anxious, low, depressed, or suffer from stress, panic, post-traumatic stress disorder, experience constant negative thoughts or have anger difficulties or low self-esteem. They often wake early, head spinning with thoughts that become more and more negative and overwhelming, leaving them unable to face the day. They may feel anxious about meeting people and just want to hide away. Situations that arise throughout the day may have a negative impact causing undue stress just because of the way the sufferer has interpreted the situation. These are all common feelings associated with those affected by facial palsy no matter what the cause, whether it is from birth, following surgery, disease or trauma.

Because of the impact facial palsy has on our emotions and the way we feel about ourselves, help in dealing with our feelings is as important as treating the physical symptoms. If you feel any of these emotional symptoms, the best course of action is to go and see your GP, and explain how you are feeling so they can refer you accordingly.

How does CBT work?

CBT focuses on the links between thoughts, feelings and behaviour. The aim of CBT is to change some of the behaviours and thoughts, and reduce the symptoms of depression.

Most therapists begin with an assessment session so you both can decide whether CBT will be helpful. This will start to identify what feelings and thoughts you have about having facial palsy. Sessions usually last for six to twelve weeks. The first step for a person undertaking CBT is to identify the negative thought processes or habits they have.

CBT helps you make sense of the overwhelming thoughts and feelings you are experiencing, and breaks them down into smaller parts so you can evaluate how each aspect is affecting you.

There are five areas:

1. Situation : A problem, event or difficult situation

With the situation follow

2. Thoughts
3. Emotions
4. Physical feelings
5. Actions

Each area can affect the other, having an impact on how you feel physically and emotionally, and how you respond. CBT shows you how to question these areas and your response. It asks whether your response is HELPFUL or UNHELPFUL.

For example:

Situation: You go to a party where there are many people you don’t know. You enter and immediately feel everybody is looking at you. You begin to think…

CBT table
Same situation. Different outcome.

It’s important with CBT to put effort into understanding your own thoughts and responses. The more effort a patient puts into CBT and addressing their own feelings, the more successful the therapy is. It is also very important that a person is completely honest with their therapist about how they are coping.

A cognitive behavioural therapist sets homework where new skills are practised and evidence is collected; they will also suggest keeping a diary between sessions. Whenever the person feels miserable they write down the thoughts which accompany their feelings in the diary. At the next CBT session, the therapist and patient explore and double-check this evidence together for any negative thoughts. Many people with facial palsy report beliefs that others find them unattractive. CBT challenges what real evidence a person has for assuming others see them as ‘unattractive’. Evidence can also take the form of experiments, such as asking other people for feedback on your physical appearance or character, and writing down their responses. It’s important to examine the reasons why you have developed a negative view of yourself in the absence of any real evidence because this can help to develop more positives trains of thought. Positive thoughts can be used to combat negative cycles of thinking that often become a habit.

In the beginning the therapist will take the lead in sessions, but by the end the patient is more in charge. At the conclusion of the therapy the patient will have a personal list of strategies to help them manage different situations and their feelings.

How can I get CBT?

There is an increase in the availability of CBT therapists working in GP surgeries. If you feel that you would benefit from CBT then go to your GP and ask for a referral.

Other Counselling

Read about the different kinds of counselling here.

Personal experiences of CBT

Paula’s story

Becki’s story

What other CBT resources are available?

Computerised CBT

  • Computerised CBT (CCBT) is carried out via an interactive online computer program; resources such as Beating the Blues may be available through your GP.
  • CCBT is also available online via unsupervised programs such as the MoodGYM

Useful websites

Self-help books

  • Cognitive Behavioural Therapy for Dummies, by Rhena Branch and Rob Willson (2005)
  • Introducing Cognitive Behavioural Therapy (CBT): a Practical Guide, by Elaine Iljon Foreman and Clair Pollard (2011)
  • Overcoming Depression: a Self-Help Guide Using Cognitive Behavioral Techniques, by Paul Gilbert (2009)
  • Overcoming Chronic Pain: a Self-Help Guide Using Cognitive Behavioral Techniques, by Frances Cole, Hazel Howden-Leach, Helen Macdonald and Catherine Carus (2005)
  • Overcoming Chronic Fatigue: a Self-Help Guide Using Cognitive Behavioral Techniques, by Mary Burgess and Professor Trudie Chalder (2009)
  • Overcoming Anger and Irritability: a Self-Help Guide Using Cognitive Behavioral Techniques, by Dr William Davies (2009)
  • Overcoming Low Self-Esteem: a Self-Help Guide Using Cognitive Behavioral Techniques, by Dr Melanie Fennell (2009)
  • The Complete CBT Guide to Anxiety, by Peter Cooper, Roz Shafran and Lee Brosan (2013)
  • The Mood Gym: Overcoming Depression Using CBT and Other Effective Therapies, by Dr Helen Christensen and Dr Kathleen Griffiths (2011)

Last reviewed: 16-02-2020    ||    Next review due: 01-08-2020