CBT
CBT sounds like quite a simple therapy, but it takes a skillful therapist to be effective.
Dr Elaine Ryan is highly trained and experienced in the delivery of cognitive behavioural therapy (CBT). She has previously supervised doctoral level trainees during their CBT training.
Psychologists are one of the few professions who have expert training in CBT. Counsellor and psychotherapists are not normally trained in CBT. For more information please see Why choose a psychologist.
Other therapeutic approaches such as counselling, don’t seek to actively help an individual change but rather offer support and an opportunity to talk about feelings. In general, scientific evidence suggests that these approaches tend not achieve very significant results even after many sessions.
Contemporary research suggests that CBT is the most effective treatment for the most common psychological problems such as depression, anxiety, panic, stress, insomnia, relationship difficulties and coping with chronic illness (such as pain). CBT is a relatively short-term, scientifically based therapeutic approach that is effective in achieving desired and meaningful changes.
CBT involves the use of practical self-help strategies, which are designed to bring about positive and immediate changes in the person’s quality of life.
The core philosophy of CBT is that thoughts, feelings and behaviours combine to influence a person’s quality of life.
For example, severe shyness in social situations (social phobia) may stem from the person thinking that other people will always find them boring or stupid. This automatic belief causes the person to feel extremely anxious at social gatherings.
Their behaviour may include stammering, sweating and other uncomfortable symptoms. The person then feels overwhelmed with negative emotions (such as shame) and negative self-talk (‘I’m such an idiot’). Their fear of social situations may become worse with every bad experience.
CBT aims to teach people that it is possible to have control over one’s thoughts, feelings and behaviours. CBT helps the person to challenge and overcome automatic beliefs, and use practical strategies to change or modify their behaviour. The result is more positive feelings, which in turn lead to more positive thoughts and behaviours.
CBT focuses mostly on the way people think about things (including their attitudes and beliefs) and the way they behave. CBT helps people identify where their thoughts and actions are self-defeating, and then to replace these “bad habits” with more helpful thoughts and responses.
CBT comprises both cognitive therapy and behaviour therapy. Cognitive therapy involves identifying and systematically evaluating the unhelpful thoughts (or cognitions) that lead to intense or frequent negative feelings (e.g. depression, anxiety) and result in unhelpful behaviours (e.g. avoiding friends). The treatment focuses on questioning thoughts and coming up with new more helpful ways to think about difficult situations.
Behaviour therapy is goal-oriented and aims to help people change unhealthy or unhelpful behaviours that cause them to suffer or lower their quality and enjoyment of life. For example, people who are depressed often enjoy fewer pleasurable activities and so your Psychologist would work with you to identify pleasurable activities and develop a plan to increase your participation in them.
Finally, CBT is focused on helping people like you to achieve your goals and to get more out of life. As well as helping you to change your unhelpful thinking and behaviour, CBT involves teaching you a range of useful and practical strategies to overcome the hurdles and obstacles in your life and to be happier and more productive.
What happens at the initial assessment session?
The two main aims of the initial assessment session are to: discuss the issues that have brought you to the session, and to outline how we think we can help you. Each assessment session is individually tailored to suit your needs. Generally though, your Counselling Psychologist or CBT Therapist will ask you questions about your feelings, associated physical symptoms, thoughts that may have been bothering you, your family and medical history, your relationships, your activity level, and your goals and expectations for the program. At the end of the session there will be a brief discussion of the session plan and a chance for you to ask any questions of your Counselling Psychologist or CBT Therapist.
What do I do between sessions?
CBT is an active skills-based approach, so you will have to put work into learning new strategies and ways of dealing with difficult life issues. To get the most out of the sessions you will need to commit some time outside the sessions to working on tasks that you and your Counselling Psychologist agree upon. Tasks you may be asked to complete between sessions may include: keeping a thoughts diary, practising relaxation techniques, completing an activity that you were working on in a session, or reading some relevant chapters from a book.
How often will I attend sessions?
Ideally you will attend on either a weekly or fortnightly basis initially. At the start of treatment sessions tend to be more frequent so that you can quickly make some positive changes and start to feel better. As you progress through the session plan, you might discuss meeting less frequently so that you have more time to put in place longer term changes and work towards your goals. Average duration of therapy is 6 sessions.
What will the sessions involve?
The sessions are structured so that you get the most out of them. A typical agenda for a 50 minute session follows:
Brief review of progress since last session (discuss how you have been feeling and any major events)
5 minutes
Review of tasks assigned during the last session (troubleshooting any difficulties in applying the strategies)
10 minutes
Skills component (e.g. learn how to question thoughts or practice relaxation techniques)
25 minutes
Set tasks and goals to be completed for review next session and arrange next appointment
10 minutes
As you can see, most of the time in sessions is devoted to learning and practising new skills and there is limited time for just “chatting”. We believe that clients get the most benefit out of sessions when they are active and learning a new skill, so just talking or ‘ventilating’ isn’t likely to be as beneficial. After all, if you want to just talk you can always talk to a friend or family member. Other therapeutic approaches such as counselling, don’t seek to actively help an individual change but rather offer support and an opportunity to talk about feelings. In general, scientific evidence suggests that these approaches tend not achieve very significant results even after many sessions.
What to expect from therapy
The specifics of treatment vary according to the person’s problem. However, CBT typically includes the following:
Assessment – this may include filling out various questionnaires to help you describe your particular problem and pinpoint distressing symptoms. You will be asked to complete forms from time to time so that you and the therapist can plot your progress and identify problems or symptoms that need extra attention.
Person education – the therapist provides written materials (such as brochures or books) to help you learn more about your particular problem. The adage ‘knowledge is power’ is a cornerstone of CBT. A good understanding of your particular psychological problem will help you to dismiss unfounded fears, which will help to ease your anxiety and other negative feelings.
Goal setting – the therapist helps you to draw up a list of goals you wish to achieve from therapy; for example, you may want to overcome your shyness in social settings. You and the therapist brainstorm practical strategies to help fulfil these goals.
Practise of strategies – you practise your new strategies with the therapist. For example, you may role-play difficult social situations or come up with realistic self-talk (how you talk to yourself in your head) to replace unhealthy or negative self-talk.
Homework – you will be expected to actively participate in your own therapy – for example, the therapist may ask you to keep a diary – and you are encouraged to use the practical strategies during the course of your daily life and report the results to the therapist.
If you would like to arrange an appointment please do so here
Counsellor Dublin | Life Coach | Psychologist Dublin
Counsellor Dublin | Psychologist Dublin | Life Coach Dublin | 20 Lower Baggot Street, Dublin 2 Ireland
