Cognitive Behaviour Therapy & etherapies

What is Cognitive Behaviour Therapy?

CBT is an evidence-based therapeutic intervention which is based on the fact that the way we think directly affects how we feel, and in order to enhance well being it is necessary to identify and modify faulty thinking. This faulty thinking is invariably automatic, containing flows of consciousness, and is informed by the specific core belief system held by the individual.

CBT is concerned with the here-and-now, rather than the causes of the problem behaviours.

It is absolutely necessary that the client plays an active role in thinking modification in terms of identifying the problem areas, setting goals and engaging in the treatment regarding the goals by completing set homework between sessions. In this way then, CBT is very much an educational model and the aim is to empower the individual to better manage their cognitive processes for the benefit of their well being. One of the advantages of CBT is that as well as being evidenced based, the intervention is very much problem and solution focussed within a framework involving clear goals and pathways to achieve change in the individual’s life through thought management. Unlike some other interventions, CBT is time limited and change is quantifiable.

There is no doubt that psychologically based treatments aka the talking therapies  are effective in terms of helping you to manage your thoughts and patterns of thought or “schemas” so that you are able to better manage your anxiety and depression by reducing the irrational worries and concerns. A growing number of online programs, or e-therapies, are also available and the rise in these programs is related to the need for versatility in general in terms of service delivery, as well as the sophistication and ease of use of our online technology.

In fact, the evidence is that the e-therapies, or computer-aided psychological therapy, are just as effective as face-to-face services for people with mild to moderate anxiety and depression. Most e-therapies follow the same principles as CBT or behaviour therapy, and the structured nature of these treatments means they’re well suited to being delivered online.

The e-therapies help you to identify irrational patterns of thinking and behaviour that may be underlying your anxiety and depression and teach you to replace these erroneous approaches with more positive, realistic frameworks and thought processes, and change patterns of thinking and behaviour that might be preventing you from overcoming your anxiety and depression. Typically, you work through the program by yourself, with some online support, and although it is certainly possible to manage anxiety and depression through the e-therapies, it is also the case that there is no doubt that you would benefit from a face-to-face session at some stage and in this way then the e-therapy would be excellent complimentary program as an introduction to the more individually focussed one on one intervention. As well as face-to-face, support from a therapist can be via telephone, email, text, instant messaging, Skype or Face-Time.

Online programs have several advantages, including, the fact that they are easy to access; can be undertaken from the comfort and privacy of your home; particular benefit for people in rural and remote areas and can be provided in many cases without having to visit a doctor for a referral.

If you are interested, the Australian Government’s Head to Health website has an extensive library of online programs, and check out the following links for self help therapy online

CBT in action

Cognitive Distortions

When a person experiences an unhelpful emotion (eg, depression or anxiety), it is usually preceded by a number of unhelpful self-statements and thoughts. Often there is a pattern to such thoughts and we call these, “unhelpful thinking styles”. One of the things that have noticed is that people use unhelpful thinking styles as an automatic habit. It is something that happens out of our awareness. However, when a person consistently and constantly uses some of these styles of thinking, they can often cause themselves a great deal of emotional distress. The following information includes a number of “unhelpful thinking styles”. As you read through them, you might notice some thinking patterns and styles that you use consistently. Some of these styles might sound similar to one another. They are not meant to be distinct categories but to help you see if there is a kind of pattern to your thoughts.

Mental Filter

This thinking styles involves a “filtering in” and “filtering out” process – a sort of “tunnel vision,” focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.

Jumping to Conclusions

We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going tohappen in the future (predictive thinking).

Personalisation

This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events.

Catastrophising

Catastrophising occurs when we “blow things out of proportion“., and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small.

Black & White Thinking

This thinking style involves seeing only one extreme or the other. You are either wrong or right, good or bad and so on. There are no in- betweens or shades of gray.

Shoulding and Musting

Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (eg “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.

Overgeneralisation

When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.

Labelling

We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that aren’t consistent with that label.

Emotional Reasoning

This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen.

Magnification and Minimisation

In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. It’s as though you’re explaining away your own positive characteristics.