Cognitive Behaviour Therapy (CBT) was developed by Aaron Beck in the 1960s. CBT is a form of psychotherapy which focuses on the here-and-now and is characterised by its structured sessions and short-term nature, typically limited to six to fourteen sessions. The purpose is to achieve symptom relief, resolve disturbing issues, and learn skills to prevent relapse and deal with future problems. CBT sessions explore the meaning of client experiences, identify recurring themes, and connect present and past experiences. The behavioural element of CBT involves aspects such as goal setting, homework assignment and behavioural experiments, with the therapist having an active role in sessions.
Originally developed to treat depression, many therapists and clinicians have since adapted this approach for many psychological issues. CBT has also been adapted for clients of different ages, cultures, and levels of education, as well as in different formats including one-to-one, couple, family, and group settings. The cognitive model forms the basis of this approach, what this means is when a situation triggers a psychological disturbance, the associated inaccurate and/or unhelpful thoughts about the situation will influence emotional, behavioural, and physiological responses. It is the way in which a person interprets a situation that causes distress rather than the situation itself, with allowances made for some situations being universally accepted as being distressing. Through CBT, the therapist will provide education on aspects of the cognitive model as well as the cognitive triad: how the presenting issue distorts the view of themselves, others, and the world. CBT teaches people to evaluate and respond to their unhelpful thoughts and beliefs, to problem solve, and to modify their behaviour to reach a more balanced perspective and undergo lasting change.
CBT is goal-oriented and solution-focused and follows a beginning, middle and end structure. At the level of individual sessions, beginnings involve a mood check, agenda setting, obtaining an overview, and reviewing previous homework. Middles focus on working on a specific issue through psychoeducation and intervention use. Endings consist of session summary, homework setting, and eliciting feedback.
In the beginning of therapy, questions are asked to understand the client’s presenting issue(s), how they have arrived at therapy, and expectations. Agenda setting is introduced in the beginning of therapy to provide a structure for the session and set expectations for future sessions. An assessment is completed so that the therapist can obtain a measurable interpretation of the client’s presenting issue(s). The client is also asked to identify SMART (specific, measurable, achievable, realistic and time limited) goals which will form the focus of the therapy. Beginnings have a strong focus on psychoeducation and bringing awareness to the client. The middle sessions of therapy focus on the treatment of presenting problem(s). The purpose of endings is to work on relapse prevention which involves solidifying learning, identifying possible areas of concern, and client becoming their own therapist.
Therapy with Kirsty 