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Maggie Winkworth BSc CPsychol FRSM AFBPsS
Counselling Psychologist
tel: 020 8994 6546 for appointment
maggie.winkworth@virgin.net


Cognitive Therapy (CBT)




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CBT case study | Will CBT work for me? | How available is CBT? | Useful reading

Cognitive therapy (CT) is more commonly called cognitive behavioural therapy (CBT). This is because it is usually practised with behavioural therapy principles.

CT is based on the idea that our thoughts create our moods. We learn that we all have inherent tendencies to certain negative thoughts that evoke unhappiness and disturbance.

Once we accept that fact, we can learn to spot these negative thoughts as they come up, and then challenge and re-think them.

Who developed it?
Cognitive therapy was first developed in America around the middle of the 20th century.

Its main pioneer was Aaron Beck, a medical doctor, psychiatrist and psychoanalyst who came to believe that he was not getting enough improvement in his patients through analysis.

He realised that often what was holding back patients were negative thoughts such as: 'I'll be hopeless at that', or 'I'm unlovable', or 'I'm stupid'.

Another therapist, Albert Ellis, was also coming to much the same conclusions about patients' negative thoughts and their tendencies to 'catastrophise' or 'awfulise'.

Ellis's work with patients also became a form of cognitive therapy, now more commonly called rational emotive behaviour therapy.

Both Beck and Ellis drew on the teachings of the stoic philosopher Epictetus who believed that: 'It's not things that upset us, it's our view of things.'

CBT Case Study
Take Tina, who worked in publishing. She met her boss in the lift and said 'good morning', but her boss didn't reply.

In no time Tina was thinking thoughts like:
• my boss doesn't like me
• no-one likes me
• I'm going to lose my job
• life is hell.
These thoughts were responsible for Tina plunging into a low mood.

Tina didn't for one minute consider that her boss may not have heard her, or that her boss might have been pre-occupied with her own thoughts.

Tina realised she was always getting upset about such situations, and she started therapy to try to sort things out.

In a few weeks she came to understand how negative thoughts were causing her to be unhappy. Tina also learned how to spot when she was jumping to conclusions in this way.

Then, with help, she was able to challenge these negative thoughts by looking for evidence to see if they were really true.

They were rarely true, so Tina was only upsetting herself by thinking in such a way. This is what many of us do.

Cognitive therapy teaches us to stop thinking so negatively, to challenge untrue thoughts and to replace them with more rational and healthy ones

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Will CBT work for me?
The benefits of cognitive therapy are well researched. CBT suits individuals with all sorts of problems including depression, anxiety, phobias, difficult relationships, obsessive-compulsive disorder and eating disorders - especially bulimia nervosa.

For many patients it has been found to be more helpful than any other kind of treatment, including antidepressants.

It does not work with adults who are not prepared to collaborate with the therapist to achieve a new way of thinking.

Treatment is also unlikely to succeed if clients stick to the view that they can't help their feelings or that they can only feel happy if someone or something else makes them happy.

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How available is CBT?
At the end of 2004, the National Institute for Clinical Excellence (NICE) published a report saying that CBT should be one of the preferred routes of treatment for mild to moderate depression.

As a consequence, an initiative was launched to train a further 10,000 CBT therapists to meet the resource implications of their recommendations.

This does mean there should be more therapy available on the NHS for anyone now considering CBT. There are also a growing number of therapists who additionally work in the private sector.

CBT is becoming the treatment of choice for a growing range of mental disorders.

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Useful reading
Unlike most other types of psychotherapy, CBT does lend itself to a self-help approach through books.

Some people may find these books useful when seeing a therapist or GP; for others, a great deal of improvement can be achieved through the books alone.

There is a whole range of excellent books written by CBT specialists and published by Constable/Robinson. They are available on line from Amazon.
• Overcoming Depression
• Overcoming Social Anxiety and Shyness
• Overcoming Low Self-esteem
• Overcoming Mood Swings
• Overcoming Panic
• Overcoming Bulimia Nervosa and Binge-eating
• Overcoming Anorexia Nervosa


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