Anxiety Can Take many different forms
What Is CBT
Cognitive Behavioural Therapy or CBT, is a highly effective therapy used in the treatment of many mental health difficulties, including anxiety disorders. CBT is an evidence-based therapy recommended by the National Institute of Clinical Excellence (NICE) as a first line treatment for most anxiety disorders. NICE guidelines are the standards set out by the UK government for the treatment of all illnesses.
In CBT, we’re particularly interested in how what you think and believe (cognitions,) and what you do or avoid (behaviours), affects how you feel (e.g. anxious, fearful, worried).
Often when we feel anxious, we can get stuck in a cycle of thinking negatively or even catastrophically. We may also use compulsions or unhelpful “safety-seeking” behaviours, which unintentionally reinforce the negative/catastrophic/unhelpful thoughts. This then results in you feeling stuck in an anxious cycle.
CBT focuses on reversing this vicious cycle by helping you to understand what cognitions and behaviours are keeping you stuck, and giving you practical tools, techniques and coping mechanisms to get you unstuck and feeling better.
What is the difference between counselling and CBT?
CBT
CBT is an active, goal-orientated and changed-based therapy. This means that most of the time in CBT, we will be focusing on what is keeping you stuck in the “here and now” and how to get you unstuck, using practical tools to help you think and behave differently. This means we’re not just talking, we’re doing, and making change happen.
Whatever we practice in session together, you’ll also usually be practicing during the week yourself to ensure that change happens relatively quickly, and we get you feeling better as soon as possible.
Where some beliefs are particularly “sticky”, we may spend some time exploring past experiences which may have contributed towards these beliefs. Once we understand where they have come from, we can start applying our tools and techniques to these beliefs too. We can start making changes in the here and now to let go of old beliefs that no longer serve you and hold you back.
CBT is designed to be a relatively short-term therapy and generally, people start to feel much better within 3 months or so.
Counselling
Counselling, however, is a different style of talking therapy. Counselling is generally a slower and more exploratory therapy. Where CBT focusses more on the here and now, counselling generally focusses on past experiences and exploring these to make sense of how the person is currently feeling.
The idea is that gradually over time, and through this exploration of past experiences, the patient will start to understand more about themselves and adjust beliefs and behaviours accordingly. However, this change is generally more intuitive to the patient and the counsellor is unlikely to focus on giving practical tools and techniques.
Counselling is generally not recommended as a first line treatment for anxiety disorders. This is because anxiety disorders in part, are maintained by rumination about thoughts and worries. With an exploratory therapy like counselling, sessions may turn into a “ruminating or worrying out-loud” experience, which often just maintains the anxiety.
A change-based therapy like CBT is often needed to show the patient how to stop rumination and worry, and what to practically do about unhelpful behaviors.
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