CBT helps understand the relationship between thoughts, feelings and behaviours. Individuals get a personalised treatment plan, which therapists call a formulation, which shows the key factors that maintain the problem and informs treatment, including what techniques could be utilised. The therapist and client then collaboratively agree on a way forward.
CBT therapists use a variety of techniques to help people feel better and achieve their goals. These include cognitive restructuring, behavioural activation, behaviour experiments, exposure with response prevention, relaxation techniques, problem solving and thought records. Therapists help individuals to modify unhelpful thought patterns and behaviours to help them feel better.
Some common CBT techniques:
Cognitive Restructuring:
This involves identifying negative and / or distorted thinking and then working to develop a more realistic and balanced perspective on the situation. Individuals may be asked to keep a thought diary so that they can learn to identify what they are thinking. The reason for this is you need to be aware of what you are thinking to use the techniques to change what you are thinking! The therapist helps individuals to recognise common thinking errors such as predictions (predicting what will happen in the future), mind reading (assuming we know what other people are imagining or thinking), catastrophising (believing the worst possible thing will happen), should and musts (which put pressure on us and unrealistic expectations), self critical thinking (putting yourself down, blaming yourself), black and white thinking (it’s either good or bad and there are no shades of grey) and then they work together to work out alternative ways of looking at it.
Behavioural Activation:
This technique is used to increase activity levels. It helps people to engage in meaningful activity, which improves mood and well-being. The therapist works with the individual to schedule activities, even if they feel tired and lacking motivation. By engaging in activity, individuals can experience a sense of achievement, connection with others and/ or enjoyment, which helps lift mood and helps people feel better.
Behaviour Experiments:
This technique involves the therapist and individual collaboratively designing an experiment where the individual behaves in a new way so that they can test out a thought to see how true it is. Individuals are encouraged to face a situation they would normally avoid and behave in a new way.
Exposure with Response Prevention (ERP):
This technique is most commonly used to treat OCD. It involves gradually exposing an individual to anxiety-provoking situations, thoughts or images whilst not engaging in compulsions or behaviours. By letting the thoughts occur and not putting them right with compulsions, the anxiety starts to diminish over time.
Relaxation Techniques:
Relaxation techniques such as progressive muscle relaxation and imagery are used to help manage anxiety and stress. Relaxation techniques are also used when treating other conditions such as Tics as they help calm the physical and emotional responses to anxiety and stress and this can aid in a reduction of conditions such as Tics.
Problem solving:
CBT encourages people to identify and solve problems in their lives rather than worry about them. Individuals are encouraged to understand the problem, explore solutions and implement the best approach.
Thought Records:
A thought record is a structured sheet which helps the individual identify a specific situation, the negative thoughts that arise, how the thoughts make them feel, and then analyse the thoughts by considering the evidence for and against those thoughts, as if you were in a court of law! and then gaining a more balanced objective perspective. By examining the accuracy of their thoughts, individuals can assess how accurate and valid they are. The aim is to generate a new way objective way of looking at a situation. By looking at things more objectively, individuals can experience changes in emotion. This sheet can be used to challenge common thinking errors such as catastrophising, making predictions and black and white thinking as described above.
Are there other techniques?
There are many other techniques besides these. A High Intensity CBT therapist will work with you to get a personalised treatment plan which informs treatment. Just like a road map it guides which treatment and techniques can be used to help people feel better.
Kate and Alex practice High Intensity CBT, providing evidence-based interventions. There is no waiting list, meaning individuals can get the High Intensity CBT help they need immediately. If you would like information on how they can support, click the link below.