Cognitive Behaviour Therapy in the Real World: Back to Basics

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Demonstrating the far-reaching influence of counselling, the book will show you how its concepts have been applied beyond the consulting room and examine the recent place of counselling in the NHS and wider mental health care.

In-Depth: Cognitive Behavioral Therapy

The book explains the training process from beginning to end, covering topics including: entry requirements, course curriculum and terms and conditions of training; the training relationship and group process; the challenges of training; the outcomes of counselling and psychotherapy training. Comprising all the main theory and competencies covered in training, this book takes your students right back to basics, equipping them with the essential nuts and bolts to practice CBT effectively.

Evidence-based practice of cognitive-behavioral therapy by Deborah Dobson; Keith S. Dobson Call Number: ebook. Synthesizing the evidence base for cognitive-behavioral therapy CBT and translating it into practical clinical guidelines, this book is designed to enhance the knowledge and skills of therapists and students. This is a practical guide to using CBT for treating adults with psychological and psychiatric disorders. Hardy Editor Call Number: eBook. Drawing on forty years of research, teaching and practice, its expert authors guide you through the conversational model's theory, skills and implications for practice.

Around the same time, the Swedish press reported a finding from government auditors there : that a multimillion pound scheme to reorient mental healthcare towards CBT had proved completely ineffective in meeting its goals. The impact of such a re-evaluation could be profound; eventually, it might even change how millions of people around the world are treated for psychological problems. One big part of the problem for psychoanalysis has been the evidence that its founder was something of a charlatan, prone to distorting his findings, or worse.

But all this makes the whole thing unfalsifiable. Behaviourists such as BF Skinner had already shown that human behaviour could be predictably manipulated, much like that of pigeons or rats, by means of punishment and reward. And since the s, there had been a pressing need to do so: thousands of soldiers returning from the second world war exhibited emotional disturbances that cried out for rapid, cost-effective treatment, not years of conversation on the couch. Before laying the groundwork for CBT, Albert Ellis had in fact originally trained as a psychoanalyst.

Along with other like-minded therapists, he turned instead to the ancient philosophy of Stoicism, teaching clients that it was their beliefs about the world, not events themselves, that distressed them. Getting passed over for a promotion might induce unhappiness, but depression came from the irrational tendency to generalise from that single setback to an image of oneself as an all-round failure. CBT flips that on its head. Emotions that might appear rational — such as feeling depressed about what a catastrophe your life is — stand exposed as the result of irrational thinking.

Cognitive Behaviour Therapy in the Real World: Back to Basics

If this second approach is right, change is clearly far simpler: you need only identify and correct various thought-glitches, rather than decoding the secret reasons for your suffering. In analysis, the relationship between therapist and patient serves as a kind of petri dish, in which the patient re-enacts her habitual ways of relating with others, enabling them to be better understood.

The sweary, freewheeling Ellis was destined to remain an outsider, but the approach he pioneered soon attained respectability thanks to Aaron Beck, a sober-minded psychiatrist at the University of Pennsylvania. Objections from analysts were dismissed, with some justification, as the complaints of people trying to protect their lucrative turf.

They found themselves compared to 19th-century medical doctors — bungling improvisers, threatened and offended by the notion that their mystical art could be reduced to a sequence of evidence-based steps.

Role Play: Cognitive Behaviour Therapy

Many more studies followed, demonstrating the benefits of CBT in treating everything from depression to obsessive-compulsive disorder to post-traumatic stress. By , more than a million people had received free therapy as a result of the initiative Layard helped push through, working with the Oxford psychologist David Clark. After all, we experience our own inner lives, and our relationships with others, as bewilderingly complex. Arguably the entire history of both religion and literature is an attempt to grapple with what it all means; neuroscience daily reveals new subtleties in the workings of the brain.


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Could therapy really be so straightforward that you could receive it not from a human but from a book, or a computer? Jonathan Shedler remembers where he was when he first realised there might be something to the psychoanalytic idea of the mind as a realm far more complex, and peculiar, than most of us imagine.

He was an undergraduate, at college in Massachusetts, when a psychology lecturer astonished him by interpreting a dream Shedler had related — about driving on bridges over lakes, and trying on hats in a shop — as an expression of the fear of pregnancy. But the lecturer knew none of this context; he was apparently just an expert interpreter of the symbolism of dreams. Yet academic psychology, the field Shedler next entered, meant having that kind of enthusiasm for the mysteries of the mind drummed out of you; researchers, he concluded, were committed to quantification and measurement, but not to the inner lives of real people.

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Exposure therapy, as the name suggests, exposes you to the situations or objects you fear. The exposure is done in one of two ways: Your therapist may ask you to imagine the scary situation, or you may confront it in real life. Exposure therapy may be used alone, or it may be conducted as part of cognitive behavioral therapy. This step-by-step approach is called systematic desensitization. Systematic desensitization allows you to gradually challenge your fears, build confidence, and master skills for controlling panic.

Learning relaxation skills. First, your therapist will teach you a relaxation technique, such as progressive muscle relaxation or deep breathing. Creating a step-by-step list. For example, if your final goal is to overcome your fear of flying, you might start by looking at photos of planes and end with taking an actual flight. Each step should be as specific as possible, with a clear, measurable objective. Working through the steps.

The goal is to stay in each scary situation until your fears subside. Every time the anxiety gets too intense, you will switch to the relaxation technique you learned. As you explore your anxiety disorder in therapy, you may also want to experiment with complementary therapies designed to bring your overall stress levels down and help you achieve emotional balance. Exercise is a natural stress buster and anxiety reliever.

Therapy wars: the revenge of Freud

Research shows that as little as 30 minutes of exercise three to five times a week can provide significant anxiety relief. To achieve the maximum benefit, aim for at least an hour of aerobic exercise on most days. Relaxation techniques such as mindfulness meditation and progressive muscle relaxation, when practiced regularly, can reduce anxiety and increase feelings of emotional well-being.


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  • Hypnosis is sometimes used in combination with CBT for anxiety. There is no quick fix for anxiety. Overcoming an anxiety disorder takes time and commitment. You can also support your own anxiety therapy by making positive choices. Everything from your activity level to your social life affects anxiety. Set the stage for success by making a conscious decision to promote relaxation, vitality, and a positive mental outlook in your everyday life. Learn about anxiety. Cultivate your connections with other people.

    Loneliness and isolation set the stage for anxiety. Decrease your vulnerability by reaching out to others. Make it a point to see friends; join a self-help or support group; share your worries and concerns with a trusted loved one. Adopt healthy lifestyle habits. Physical activity relieves tension and anxiety, so make time for regular exercise. Reduce stress in your life. Examine your life for stress, and look for ways to minimize it. Avoid people who make you anxious, say no to extra responsibilities, and make time for fun and relaxation in your daily schedule.