An introduction to cognitive behavioural therapy (CBT)

Now, more than ever, many of us are feeling overwhelmed by anxiety. Living in a period where words like “lockdown”, “pandemic” and “quarantine” are part of everyday life can be upsetting and stressful – and this is precisely why cognitive behavioural therapy (CBT) is now more relevant than ever. Since the 1960s, CBT has been used to help people with a wide range of challenges. It’s one of the most commonly used and successful psychotherapeutic treatments in existence, and is used to help people overcome difficulties such as addiction, phobias, depression and anxiety.

CBT is a useful tool that can be applied to many areas of life. Here’s everything you need to know about CBT: what it is, how it can help, and how you can use it in your daily life.

What is CBT?

Cognitive behavioural therapy is a type of psychotherapy that helps people to understand how their thoughts and emotions influence their behaviour. It combines cognitive therapy, which examines how you think, with behavioural therapy, which examines how you act. The aim of CBT is to help people learn to identify negative thoughts that have a harmful impact on the way they act and feel.

For example, someone who has a phobia of car accidents, train crashes or air disasters might start avoiding travel; someone who has low self-esteem may think negatively about their appearance, abilities or character and begin avoiding social situations, or pass up opportunities, believing they’re not “worthy”. Once you’re able to identify how your thinking influences your emotions, you can then develop coping mechanisms to help you challenge any specific problem thoughts.

CBT is usually a short-term treatment that involves speaking to a therapist to find the source of these negative thinking patterns – but it’s also something you can read up on and practice at home. The ultimate aim of CBT is to learn personalised coping skills and learn to reframe negative thoughts into positive ones, and like most new skills, this is something you can teach yourself.

The benefits of CBT

the benefits of cbt

One of the most powerful benefits of CBT is that it provides you with a coping mechanism. Being able to manage your own thoughts, emotions and behaviour is a tool you can utilise for the rest of your life – and as you feel more in control of your thoughts, you’re likely to feel calmer, more positive and more confident.

Another benefit of CBT is that it can be used in a wide range of circumstances . It’s been used to successfully treat an extremely wide range of mental health problems. Aside from anxiety and depression, CBT is also used to treat bipolar disorder, anger management, eating disorders, phobias, post-traumatic stress, psychosis, insomnia, addiction, obsessive compulsive disorder, schizophrenia, and panic attacks. It can also be used to treat physical health problems, like chronic pain, chronic fatigue and irritable bowel syndrome.

The nature of the relationship between therapist and patient is markedly different for CBT when compared to other therapies, where it can become common for patients to start relying on their therapist and feeling dependent on them. In CBT, the relationship between therapist and patient is more collaborative; the therapist stresses that the patient is the one who has the power to change – not them.

A final benefit of CBT is its quick results. Most sessions are completed within a few months. This means that by using CBT, people are able to make significant positive changes to their life in a relatively short space of time.

How can you learn CBT?

Take an accredited course

If you’re interested in learning CBT, you’re certainly not alone – we know CBT courses are very popular with Rest Less members. Courses are typically based around learning CBT to help others, but there’s no reason why you can’t simply apply what you learn to your own life.

Aside from teaching you how to plan sessions with clients and establish boundaries, courses like these also teach you to become more aware of the ways in which you communicate, to adopt new perspectives , and to understand the motivations and reasoning behind your behaviour – all of which are tools that can be applied in your personal life, career or relationships.

You can check out further CBT courses on our own Courses section. You can also browse courses on sites like The Institute of Counselling, British Association for Behavioural & Cognitive Psychotherapies and Skills Development Seminars.

But what if you don’t have the finances, time or inclination to do an accredited course? Does this mean you can’t benefit from CBT or learn these key coping skills yourself? Thankfully, no.

Teach yourself CBT at home

There are plenty of self-help books and CBT treatments you can do online – and many studies suggest that self-directed CBT can be very successful. A review of 33 studies found that CBT that was directed by the patient themselves led to considerable reductions in anxiety, and a review of 34 other studies found that when used to treat depression, self-directed CBT had similar benefits. Both studies found that the self-help approach to CBT was helpful, and while patients didn’t necessarily feel like their problems had been solved, they felt noticeably less anxious or depressed.

These studies found that another big plus of teaching yourself CBT was that the patients tended to maintain their progress over time. One of the key aims of CBT is to learn to become your own therapist – to realise that only you have the power to change the way you think, feel and behave, and to develop coping skills you can use long after your treatment has ended. These studies suggest self-directed CBT is very effective for this.

If you want to give self-directed CBT a try, there are several books that the Association for Behavioral and Cognitive Therapies have approved – you can check out the comprehensive list here. Whichever book you choose, you’ll notice that they all practice the following cognitive techniques:

  • Learning to identify your thoughts;
  • Understanding how your thoughts impact your emotions and behaviour;
  • Deciding if your thoughts are truthful;
  • Swapping subjective thoughts for more rational ones.

You can also download some helpful worksheets and exercises on CBT techniques here. Part of the appeal of CBT is that it isn’t especially groundbreaking. It’s practical, clear-cut and intuitive, meaning there’s no reason you can’t develop key skills yourself. If you choose to try self-directed CBT, be sure to follow the programme as closely as possible. It can be tempting to miss sections if you think they don’t apply to you, or won’t work – but sticking to the guidelines gives you the best chance of understanding what does and doesn’t work for you.

How you can use CBT in your life

how you can use cbt

1. Identify your negative thoughts

Rather than just accepting you feel anxious, try to uncover the thoughts behind it. If you’re suffering from anxiety, situations are often viewed as more dangerous than they actually are. Identifying your own irrational thoughts can be hard, but it’s helpful to try to pinpoint what you were thinking the moment you started feeling anxious. This can help you understand the causes behind your anxiety.

2. Challenge your negative thoughts

The next step is to challenge your negative thoughts. Here you need to question the evidence for these thoughts, analyse the irrational beliefs behind them, and test how likely your negative thoughts are to actually occur. If you feel like something terrible will happen, ask yourself the following questions:

  • “Is there any evidence for this negative thought, or am I making assumptions?”
  • “What’s the worst that could happen – and is that outcome likely?”
  • “What’s the best that could happen?”
  • “What’s most likely to happen?”
  • “Will this matter a week from now, a year from now, or ten years from now?”

Weighing up the pros and cons of your actions and determining how likely your negative thoughts are to actually manifest, helps you understand that your thoughts and emotions aren’t based on facts. Accepting and understanding this allows us to fully recognise that our negative thoughts are unrealistic.

3. Replace your negative thoughts with realistic ones

The final step is replacing the negative thoughts with realistic thoughts. It’s important to understand that the new belief doesn’t have to be positive, e.g. If you’re afraid of driving, then you don’t have to think “When I get the car, something wonderful will happen!” Trying to change negative thoughts into overwhelmingly positive ones means they won’t stay in your brain for long – and the reality is, some situations are scary. It is possible that something bad might happen.

But the negative belief must be replaced with a new, realistic belief. Once you’ve asked yourself the questions in step 2, you should have an awareness of how unlikely it is that something bad will actually happen. You should also prepare calming answers you can repeat to yourself if your negative thoughts threaten to come back – for example:

Negative thought: “What if I have a car crash when I get in my car?”
Realistic thought: “I’ve never had a car crash before, so it’s unlikely that I will today.”

Negative thought: “What if I’m so anxious I pass out?”
Realistic thought: “If I pass out, I’ll soon gain consciousness. It’s not the end of the world.”

Negative thought: “What if I lose my job and never work again?”
Realistic thought: “If I lose my job, the chances are that I’ll find another one, even if it’s different and takes a few months.”

Further skills

The great thing about learning these skills is that they can be applied to so many different psychological issues. The same techniques can be applied to depression, phobias, anger, and habits (eg. tics). For example, if you have a phobia of insects, you can use the same techniques to help manage your fear.

It’s always about the three steps: 1) Identify the feeling (“I am terrified of insects”); 2) asking yourself questions (“What’s the worst that could happen if this insect touches me?”); and 3) swapping negative thoughts with realistic ones (“If this insect comes near me I will be upset, but I won’t die.”).

Several relaxation skills are often taught in accordance with CBT, too. For example, you could try the follow deep breathing technique:

  1. Sit in a comfortable chair and place your hand on your stomach. You should be able to feel your diaphragm move in and out as you breathe.
  2. Take a deep, slow breath, in through your nose. The breath should last five seconds.
  3. Hold the breath for five seconds.
  4. Exhale slowly through your mouth for five seconds.
  5. Do this for about five minutes, and aim to do the exercise three times a day. This technique helps relax your mind and body, and once you’ve mastered it you’ll know you have the ability to calm yourself in the future, whatever stresses you might be facing.
 

A final note...

During a time when many of us are feeling stressed and anxious, the benefits of CBT are more relevant than ever. It takes time and effort to learn key coping skills, but learning techniques to be able to reduce your anxiety, improve your mood and develop coping mechanisms you can use for the rest of your life will always be worth the investment.

Have you used CBT? How did you develop your skills and have you found it useful? Email us at [email protected] or leave a comment below.

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15 thoughts on “An introduction to cognitive behavioural therapy (CBT)

  1. Avatar
    LizP on Reply

    Appetising summary- great for stimulating interest in learning about CBT.

    Would be good to pool ideas of how people have used CBT to help them.

  2. Avatar
    DENISE COATES on Reply

    I highly recommend CBT – when faced with breast cancer it helped me understand that consciously thinking positive and determined thoughts would Help me have a better impact on my journey and outcome.
    Thanks, Denise

  3. Avatar
    Mr.Patrick J. Sullivan on Reply

    Without realizing I have already to some degree used this process. I look forward to learning more.

  4. Avatar
    Gail Sutherland on Reply

    The summary of CBT has helped already turn a negative into a positive. I will look further into this.

  5. Avatar
    Millie on Reply

    Points well made – I recognise the value of CBT in helping turn negative thoughts into more realistic, rational ones but I am less sure about what it has to offer amidst the unique circumstances of the current pandemic. We are all living in limbo in what feels like an existential crisis, faced with an uncertain and hostile situation globally that has brought about severe curtailment of our daily lives and the normal freedoms we take for granted. While I accept the short-term need for this, I worry hugely about its long-term consequences for the mental health of our society, especially our young people. I worry that physical barriers will turn into mental barriers long after the physical barriers have begun to come down, that fear of infection will become society’s dominant narrative for a generation. Will we ever feel it’s okay to hug someone outside our social bubble again?

  6. Avatar
    Jacqueline on Reply

    Te comment above CBT is usually offered as a first therapy as it is quicker and has more collaborative approach. Looks good course.

  7. Avatar
    Jackie on Reply

    I suffer from very bad tinnitus at times & CBT has been mentioned along with many other things as possible aids. I have just read your article about CBT and although I found it very interesting I cannot see how it would help me. My tinnitus often occurs when I really couldn’t be more relaxed or less anxious. I’d be interested to hear any thoughts on this.

    1. Avatar
      Helen on Reply

      Hi Jackie. From friends’ experiences with severe tinnitus, I’m aware that it can be a long search to find what works for you. Whilst CBT might be great for some who suffer with it, it may not be ‘your’ thing. Or, CBT may prove to be a useful technique for other aspects of your life.

      I am sure you’ve done lots of research, but you might find other Rest Less members on our Community Forum who can share their experiences or suggestions with you. Whilst it won’t be formal medical advice (unless one of our doctor members contributes!), it may help in some way.

      Another community forum which I believe can be useful for health questions is Health Unlocked and I’ve included the link to the posts tagged with tinnitus and the British Tinnitus Association have a page on the forum.

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