Welcome to Edinburgh Therapy Service, where I, Cristina, extend a warm invitation to explore the world of cognitive-behavioural therapy (CBT). As a therapist well-versed in CBT and the third-wave therapies including acceptance and commitment therapy (ACT), compassion-focused therapy (CFT), and mindfulness-based cognitive therapy (MBCT), I’m here to guide you. Discover more about CBT and its potential to assist you on your journey to emotional well-being.
Cognitive-behavioural therapy (CBT) is a widely recognized therapeutic approach that focuses on addressing present problems while working collaboratively toward clients’ specific goals. With a unique emphasis on the intricate connection between thoughts, feelings, and behaviours, CBT equips clients with practical tools to effectively navigate psychological distress and various challenges they may be facing.
While there isn’t a definitive average for the number of sessions needed to witness progress, some individuals experience positive shifts after just a few sessions, while others might engage in months of therapeutic work. Nonetheless, the essence of CBT lies in its time-limited and pragmatic structure.
Within the framework of CBT, clients increase self-awareness and gain insights into their patterns of thought, emotion, and behaviour. They learn strategies to manage these patterns in more adaptive ways. A cornerstone of CBT is its collaborative nature – a partnership formed between the therapist and the client, fostering a safe, non-judgmental and supportive environment where progress can flourish.
Structured sessions characterize the CBT approach, ensuring that therapy is goal-oriented and focused. This structure paves the way for clients to systematically work toward tangible objectives, fostering a sense of direction and achievement throughout the therapeutic journey.
CBT’s efficacy has been scientifically demonstrated across a wide spectrum of psychological issues. It is notably effective in addressing anxiety disorders, encompassing conditions such as generalized anxiety disorder, panic disorder, and social anxiety. Depression, eating disorders, obsessive-compulsive disorder, body dysmorphia, insomnia, and stress management are among the array of concerns that CBT has proven successful in treating.
During CBT sessions, clients actively engage in insightful discussions and purposeful exercises. These components stimulate self-reflection, aiding individuals in identifying unhelpful beliefs and challenging distorted thought patterns. Consequently, clients gain the ability to replace these patterns with more balanced and realistic alternatives. By placing a strong emphasis on active involvement, CBT equips clients with pragmatic tools, empowering them to effectively navigate the complexities of daily life while fostering enduring emotional well-being.
Aaron Beck‘s cognitive model is the foundation of cognitive therapy and cognitive-behavioural therapy (CBT). At its core, this model emphasizes the concept that thoughts, emotions, behaviours, and physical sensations are intricately intertwined, with alterations in one area affecting the others. CBT hinges on the premise that while we may exert limited control over our emotions, we possess the ability to reshape thought patterns and behaviours. By targeting unproductive thoughts and behaviours, CBT aims to provoke changes that alleviate distressing emotional states.
At the core of Beck’s framework lies the notion of core beliefs. These deep-seated convictions about the self, others, and the world emerge primarily in childhood, shaped by interactions with caregivers and authority figures. Core beliefs wield substantial influence, impacting how individuals interpret events and navigate their emotional responses and actions. Common core beliefs encompass sentiments like “I am worthless,” “I am inadequate,” and “The world is dangerous.”
Core beliefs, often forged in youth, can lie dormant until activated by later life events. These triggers resurrect deeply embedded beliefs, reshaping contemporary thought patterns, emotional reactions, and behaviours.
Beck’s cognitive model offers a structured lens through which to comprehend the interplay of thoughts, emotions, and behaviours. By identifying and reshaping automatic thoughts while challenging distorted core beliefs, individuals can cultivate more adaptive emotional reactions and constructive behaviours.
CBT can be highly effective in various ways:
Increased self-awareness: This type of therapy fosters heightened awareness of your thoughts, emotions, and behaviour patterns. This awareness enables you to recognize when you’re slipping into unhelpful patterns and empowers you to intervene effectively.
Mind and behaviour knowledge: In CBT, there exists a fascinating journey of learning– an exploration into the mechanics of the mind. Through psychoeducation, you gain valuable insights into how the mind operates, shedding light on the inner workings that drive thoughts, emotions, and behaviours. The significance of this learning lies in its power to cultivate self-awareness. Armed with the knowledge of how thoughts influence feelings and actions, you embark on a journey of recognizing once-elusive patterns.
Cognitive changes: CBT equips you with tools to identify and challenge negative thought patterns. By recognizing and altering these patterns, you can cultivate a more balanced perspective on situations.
Behavioural changes: It guides you in transforming unproductive behaviours, gradually replacing them with constructive actions. This transition involves taking incremental strides towards more beneficial habits, a process that, in turn, influences your thoughts and emotions. As an illustration, suppose you’ve been avoiding certain places due to fear. Through CBT, you can embark on the journey of facing these situations. By doing so, you begin to recognize your capability to handle these scenarios more effectively than anticipated, resulting in a reduction of your fear and anxiety. This showcases how altering behaviour initiates a positive ripple effect on both your cognitive outlook and emotional well-being.
Emotion regulation: This approach assists in understanding and managing intense emotions. By addressing distorted thinking, you can gain better control over your emotional responses. Furthermore, it provides techniques to manage anxiety and stress.
Problem-solving: CBT fosters problem-solving skills, enabling you to approach challenges constructively and systematically.
Relationship improvement: It enhances communication skills and assists in resolving conflicts by altering ingrained thought and behaviour patterns.
Self-esteem enhancement: CBT challenges self-critical thoughts, fostering a more compassionate self-view and improved self-esteem.
Enhanced resilience: It assists in developing resilience by altering how you perceive and respond to setbacks, helping you bounce back more quickly.
A CBT session is a collaborative and structured process that aims to address specific challenges and foster positive changes in your thoughts, emotions, and behaviours. During a session, you engage in a dynamic dialogue with your therapist, guided by the principles of CBT. Some of the things you can expect in a CBT session include:
Collaborative exploration: Together with your therapist, you delve into the specific challenges you’re facing. This involves discussing thoughts, emotions, and behaviours associated with these challenges. Your therapist may ask questions to gain a deeper understanding of your experiences.
Identifying patterns: Through open conversation and practical observation, you identify patterns of thought, emotion, and behaviour that contribute to your challenges. This might involve recognizing automatic negative thoughts or unhelpful beliefs.
Challenging distorted thinking: Based on the identified patterns, your therapist guides you in examining the accuracy of your thoughts. You work together to challenge distorted thinking and replace it with more balanced and rational perspectives.
Learning skills: Your therapist introduces and teaches you practical skills and techniques tailored to your challenges. These could include relaxation exercises, cognitive restructuring, exposure techniques, communication skills and problem-solving strategies.
Review of progress: If it’s not your first session, you might review the progress you’ve made since the previous meeting. This can involve discussing changes you’ve noticed, challenges you’ve encountered, and successes you’ve achieved.
Home practice: At the end of the session, you and your therapist collaboratively set homework assignments. These are exercises or tasks designed to practice new skills and apply them in real-life situations between sessions.
Empowerment and support: Throughout the session, your therapist creates a safe and non-judgmental space where you can openly express yourself. They offer guidance, support, and empowerment, helping you take charge of your progress.
Each CBT session is customized to your unique needs and concerns. The collaborative nature of the process ensures that you actively engage in your therapeutic journey, working alongside your therapist to achieve meaningful and lasting change.
Research has shown that CBT is effective in addressing a wide range of psychological issues. Some of the prominent issues that CBT can help with include:
‣ OCD, body dysmorphia, and related
‣ Chronic pain
‣ Substance use disorders
‣ Eating disorders and body image issues
‣ Relationship issues
‣ Self-esteem and perfectionism
‣ Work-related stress and burnout
‣ Self-harm
‣ Insomnia
Pelissolo, A., Abou Kassm, S., & Delhay, L. (2019). Therapeutic strategies for social anxiety disorder: where are we now?. Expert review of neurotherapeutics, 19(12), 1179–1189.
Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., Huesing, J., Joraschky, P., Nolting, B., Poehlmann, K., Ritter, V., Stangier, U., Strauss, B., Stuhldreher, N., Tefikow, S., Teismann, T., Willutzki, U., Wiltink, J., & Leibing, E. (2013). Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: a multicenter randomized controlled trial. The American journal of psychiatry, 170(7), 759–767.
Clarke, G. N., Rohde, P., Lewinsohn, P. M., Hops, H., & Seeley, J. R. (1999). Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. Journal of the American Academy of Child and Adolescent Psychiatry, 38(3), 272–279.
Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2000). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. JAMA, 283(19), 2529–2536.
Fairburn, C. G., Norman, P. A., Welch, S. L., O’Connor, M. E., Doll, H. A., & Peveler, R. C. (1995). A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Archives of general psychiatry, 52(4), 304–312.
Grilo, C. M., Masheb, R. M., & Wilson, G. T. (2005). Efficacy of cognitive behavioral therapy and fluoxetine for the treatment of binge eating disorder: a randomized double-blind placebo-controlled comparison. Biological psychiatry, 57(3), 301–309.
Anand, N., Sudhir, P. M., Math, S. B., Thennarasu, K., & Janardhan Reddy, Y. C. (2011). Cognitive behavior therapy in medication non-responders with obsessive–compulsive disorder: A prospective 1-year follow-up study. Journal of Anxiety Disorders, 25(7), 939–945.
Harrison, A., Fernández de la Cruz, L., Enander, J., Radua, J., & Mataix-Cols, D. (2016). Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials. Clinical psychology review, 48, 43–51.
Barrett, K., & Stewart, I. (2021). A preliminary comparison of the efficacy of online Acceptance and Commitment Therapy (ACT) and Cognitive Behavioural Therapy (CBT) stress management interventions for social and healthcare workers. Health & social care in the community, 29(1), 113–126. https://doi.org/10.1111/hsc.13074
The Edinburgh Therapy Service is a psychotherapy and counseling practice based in Edinburgh, Scotland (United Kingdom). We offer therapy both in-person in Edinburgh and online, available in English and Spanish.
Contact us for more information or to book your first appointment: [email protected]