Cognitive Behaviour Psychotherapy (Therapy) is a collection of research-based treatment processes for depression and anxiety states. When people meet with a cognitive behavioural therapist the focus of the assessment and treatment is on the way in which that individual’s thoughts (cognitions), feelings and behaviour interact. Cycles of behaviour develop when events can trigger body feelings (such as lethargy) leading to automatic thoughts (for instance ‘I’m useless’ ‘People are sick of me’) and then to behaviour (Staying in, staying away from people). Any of the three components of thoughts feelings and behaviour can drive the cycle.
This looks at the ways in which people’s thoughts and beliefs (cognitions) can affect their mood and feelings and therefore their behaviour. Cognitions can be automatic thoughts [either positive or negative], assumptions or core beliefs. If life events our actions or feelings cause discord with our assumptions about life or core beliefs then we may experience anxiety or depression.
In therapy the person is encouraged to examine the evidence for and against their beliefs about themselves and others, their negative automatic thoughts, catastrophic thoughts and negative predictions. Acceptance and Commitment Therapy encourages people to accept what cannot be changed and commit to moving forward in a new direction that incorporates acceptance of things that cannot be changed.
People tend to repeat cycles of behaviour even if they know that they are not helpful. This may be because we all feel more comfortable with what/where/who we already know, especially when we feel anxious or low in mood and vulnerable. Behaviour therapy is based upon the idea of antecedents to behaviour, the behaviour and the consequences; that behaviour will be repeated if it is reinforced (rewarded in some way). CBT also looks at the way in which unhelpful behaviours may unwittingly bring rewards. Carrying out a cost-benefit analysis helps the client to identify why unhelpful behaviours are repeated. A young person’s capacity for complexity of thought is limited as it develops with age, so research has demonstrated that behaviour therapy is more effective with children.
Feelings and emotions are experienced in our body. In therapy the client will be encouraged to relax their body and also to notice their feeling responses to thoughts, to events, actions and to relationships. Therapy enables the person to listen to and appreciate their feelings and therefore themselves. The person is encouraged to notice and feel comfortable with all feelings. Our feelings are telling us something that we need to know, such as ‘I am enjoying this and should do this more’; ‘This person is making me feel uneasy’ or ‘I am feeling sad about this but that is ok’