Cognitive Behaviour Therapy

Cognitive therapy, often referred to as Cognitive Behaviour Therapy or CBT, is a strand of psychotherapy. Cognitive therapy's roots can be traced back to the late 19th century work of Sigmund Freud and the 20th century methods of psychotherapists such as Carl Rogers. Cognitive therapy methods used today however can be traced back to the 1950s and the work of psychotherapist Albert Ellis.

Ellis developed 'Rational Emotive Behaviour Therapy' (REBT) as a way to understand and overcome emotional disturbance. Ellis proposed that people not only get upset by problems, but also form strong views about reality in relation to their perceived beliefs of that problem. If these beliefs are irrational or self-defeating, the result can be unhealthy to their emotional and behavioural function.

Ellis' work was developed further in the 1960s by American psychiatrist Aaron Beck who coined the term 'Cognitive Behaviour Therapy' (CBT). Beck concluded that patients suffering with depression magnified negative thoughts and minimised positive ones. His therapy aimed to alter this distorted way of thinking to change their emotional and behavioural state.

Cognitive Behaviour Therapy is a combination of psychotherapy and behavioural therapy. The cognitive therapist focuses on thoughts, beliefs and images (cognitive processes). How a person perceives these cognitive processes reflects their behaviour and how they deal with emotions.

CBT looks to change how people think (the cognitive) and react (the behaviour). By breaking down problems to manageable parts, cognitive therapy makes it easier to understand how those parts are connected and how they affect a person both physically and emotionally.

Cognitive therapy sessions are structured as opposed to other psychotherapy treatments that allow the patient to talk openly about anything. Homework is also an important part of the therapy to identify incidents that provoke a problem and also to monitor progress in dealing with it.

Be prepared - It is advisable to choose a cognitive therapist who is a member of, or is accredited by, an association or professional body. This ensures your therapy session is carried out in a suitable environment and by someone who has received formal training and ongoing development. Members are also bound to a code of ethics and practice. The main cognitive therapy organisations are listed at the foot of this article.

Before your first appointment, you may be asked to complete a short questionnaire, this is optional but it may help you think about the problems you want to discuss. Consider writing down any questions or concerns you have about the therapy as you may forget to ask them during the session. If you are taking prescription drugs, take them with you or make a note of what they are.

Your session will be confidential and take place in a quiet environment. CBT can take place in a group but is usually done on an individual basis. Although cognitive therapy is about the present, expect to spend time in your first session and subsequent sessions examining your past.

The cognitive therapist will begin by asking questions about your problem in order to define it. They may ask how long it's been going on and what steps you have previously made to prevent it. The therapist will try and learn more about you, any personal relationships you have and your work or interests. Be prepared to answer questions about your mental health and any previous problems or family history.

Working with the cognitive therapist, you will work out a treatment plan that lays out the direction of your therapy and what you are expected to do during your treatment. They will then begin discussing your problem breaking it down into manageable parts. This will help with understanding your thoughts, feelings and behaviour and how best to change them.

After discussing how to make changes, your cognitive therapist will set 'homework' for you to put into practise what's been discussed. This may be through writing a diary or a trying out a coping exercise for a specific situation. This is an important part of the process and the results will be analysed at your follow-up appointments.

Should they be needed, your therapist may recommend medication or referral to another specialist. They will discuss this with you at your first appointment and throughout your therapy. Although confidential, there are certain legal exceptions that your therapist will discuss with you and you may also be required to sign an agreement for conducting your sessions.

Cognitive therapy appointments typically last an hour but your first session may last a little longer as your therapist assesses your problem. Expect follow-up appointments to be 45 - 60 minutes long. Your appointment will be structured and time is used efficiently as the therapy looks toward overcoming your problem rather than dwelling on it.

Cognitive therapy costs vary but as a guide expect to pay £30 - £80 for a session depending on your location and practitioner's overheads. It is advisable to check these costs before making an appointment.

Cognitive therapy can last from six weeks to six months and the number of sessions you will need depends upon the issues you have. 6-15 sessions are normal and you will usually attend on a weekly basis. Your cognitive therapist will discuss this with you during your first session.

Cognitive behaviour therapy is one of the most effective therapies for conditions where anxiety or depression is the main cause. Cognitive therapy is most beneficial to people who have a specific problem and are looking toward a practical way to solve it.

CBT does not claim to cure physical problems, but it can help provide ways of coping while living with an injury, disease or disorder. Consult with your GP and cognitive therapist about any medical problems or concerns you have as they are trained to recognise what can and cannot be treated with the therapy.