Healthy Mind features

“We can't solve problems by using the same kind of thinking we used when we created them,” said Einstein. But can changing the way we think make it easier for us to cope with our problems? The answer for many is yes – with the help of cognitive behaviour therapy (CBT).

Persistent negative or self-critical thoughts can be overwhelming and can aggravate a problem that you’re already struggling to deal with, such as anxiety or depression. That voice in your head telling you “you’re not good enough”, “you’ll make a fool of yourself”, “this is all your own fault” holds you back from taking actions that challenge these irrational thoughts. You’re so convinced things will go wrong that you don’t even attempt them – and this perceived ‘bottling out’ reinforces your sense of failure.

So how do you break out of this vicious circle? One way is by using a ‘talking’ therapy known as CBT. It works by helping you break down an overwhelming problem into smaller parts, which makes it easier to understand how your thoughts, feelings and behaviour are connected and how they affect each other.

Psychological or talking therapies like CBT, counselling and family therapy have become much more widely used in recent years to treat a growing number of conditions, including depression, anxiety, eating disorders, sleep problems, and relationship and family problems. Talking therapies are used both as a stand-alone treatment and, for those with more a severe psychological disorder, as an adjunct to another form of treatment, such as medication.

The success of talking therapies in treating conditions such as anxiety and depression has been demonstrated in a large number of scientific studies, and demand within the NHS has grown significantly, leading to long waiting times for some patients. As a result, the government has announced a big increase in funding for talking therapies over the next few years. The money will be used to improve access to talking therapies at GP surgeries, train more therapists and reduce waiting times.

CBT is a practical, ‘solution-based’ treatment that helps you to identify irrational thoughts, assumptions and beliefs and learn how to replace them with more reasonable ones. The treatment is highly structured and focuses on specific problems and goals. It therefore works best for people who can identify the main problem they want help with. “It may be less suitable for someone who feels vaguely unhappy or unfulfilled, but doesn't have troubling symptoms or a particular aspect of their life they want to work on,” notes the mental health charity Mind.

The Royal College of Psychiatrists explains that, unlike some of the other talking therapies, CBT focuses on ‘here and now’ problems and situations. “Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now,” it says.

CBT also tends to be of shorter duration than some other talking therapies, involving between five and 20 weekly sessions of an hour or so each. It should not be seen as a quick-fix, however; to be successful, it requires a lot of motivation, commitment and work. You’ll be expected to participate actively both during and in between sessions, practising techniques you’ve learned and working on set tasks at home, for example.

“The overall aim is for the individual to attribute improvement in their problems to their own efforts, in collaboration with the psychotherapist,” says the British Association for Behavioural and Cognitive Psychotherapies (BABCP), the profession’s accrediting body.

The first step is to discuss the problem that’s concerning you with your GP, who can refer you for CBT, if appropriate. Some CBT practitioners work on a self-employed basis or through private clinics – you can search for an accredited psychotherapist on the BABCP’s website. You may be able to self-refer, although some practitioners will require a referral from your GP or another health professional.

If the problem you want to work on is not too severe, you could also investigate the wide range of self-help CBT materials available. “A recent development is using interactive CD-Rom programmes, which can be accessed via your GP or other service-providers. Some of these are very high quality,” says Mind.

The BABCP cautions, however, that self-help materials are not appropriate for everyone and that the quality can be variable. It recommends that you have a professional assessment first if there’s any doubt about your current ability to use the materials to their full potential.

“Choosing Talking Therapies?”

“Making sense of cognitive behaviour therapy”

British Association for Behavioural and Cognitive Psychotherapies

Royal College of Psychiatrists

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