CBT as a model of therapy works well with online therapy and self-help as the model is highly structured.
The whole idea of CBT is you teach you how to manage yourself, without having to rely on your therapist.
The goal is to make your therapist redundant and become your own therapist.
A client has asked me ‘can I do CBT for myself’ and the answer is yes, we call it self-directed Cognitive Behavioural Therapy or guided CBT.
Self-help therapies are psychological therapies that you complete yourself at your own pace and in your time. My online courses are examples of self-help CBT, where I show you through pre-recorded lessons how to apply the techniques of the model, yourself.
Stepped care approach to therapy.
I previously worked in the NHS in England, where I first came across a stepped care approach to therapy. The idea behind this model is that you first get an effective treatment that uses fewer resources, such as not meeting with a therapist (if deemed suitable) before the person gets ‘stepped up’ to a more specialist service. Most times the first step is self-help.
Becoming your own therapist
One of the key ideas behind CBT is that you become your own therapist.
I would always say in session with clients, that the whole idea is to make me redundant. There will come a stage in face-to-face therapy where I am not needed, as the client has all the knowledge and skills to continue, and then I know that I have been successful in what I started out to do.
Cognitive Behavioural Therapy works well without a therapist, as it is psychoeducational and highly structured. When I talk about psychoeducation in therapy, this means I give you information about what is troubling you and information about the model of therapy and then teach what you need to do to recover in order that you can apply this yourself.
In traditional face-to-face CBT, each session follows roughly the same format.
- Review of previous session’s homework
- Explanation of what we will cover today
- Instruction on how to do this
- Homework explained and assigned.
We can replicate this without meeting with a CBT therapist in person, either through self-help books or online courses where you receive the information and materials through pre-recorded spoken word or print.
Will CBT at home be personal to my own problems?
If you saw me in person for face-to-face CBT, we would discover your underlying thoughts, feelings and behaviours that need changing through the homework sheets you complete between sessions.
There will be many things you are probably not aware of, that have resulted in your current difficulty. These include;
These things, of course, are personal to you, but do not need teasing out sitting in the room with a therapist. I do not collect this information in session, I would explain the importance of it, and tell you what I need you to do, where I need you to make changes, based on your own lifestyle. You collect the information and make the changes between sessions on your own.
The idea is to teach you to become your own expert and Retrain Your Brain®
This again works well in an online format. Hopefully, you see that regardless of whether you choose face to face or online; you collect all of this information (to personalise the process to your own specific needs) between sessions.
How do you do CBT by yourself?
There are several options open to you, including
- self help CBT books, and
- online cbt courses
Both options will use the same teaching, and I shall talk about this now in terms of online CBT.
You are taught to be your own therapist through the following steps
How to use CBT self help
- Model of therapy explained
When you are undertaking CBT by yourself, I explain this the same way I would in session, only in self help you are viewing pre-recorded animated lessons
- Recognise unhelpful thinking patterns.
Each time you notice a change in your mood, you will complete a homework sheet, detailing what was happening, what you were feeling, and noting the thoughts in your head.
- Alternative thinking patterns
You will be taught how to police your thoughts, like a mini scientist in your head, looking for evidence for your thought processes, and change them if you cannot prove that they are accurate.
- Behavioural experiments
You will be introduced to behavioural experiments and asked to do things differently if you found out that your behaviours were not helpful to you in the long run
You will be taught guided relaxation if appropriate to your problem. This is much easier to teach I find using online CBT as I can use animated videos to help with relaxation.
Learning new beliefs systems and changing how you operate in the world is about practice. All skills have to be practiced until they become part of you.
How effective is self-help CBT?
In a 2017 study Kumar et al1 concluded that online CBT was both useful and cost effective. Luo et. al (2020)2 found that eCBT was more effective than face-to-face CBT at reducing the severity of depression.
You can look at what past users of my own courses thought after completing the course and as you see below, the feedback is favourable.
Feedback from my online courses.
Please note the figures below come from live dynamic feedback form and can change but are correct as I write this.
- Kumar V, Sattar Y, Bseiso A, Khan S, Rutkofsky IH. The Effectiveness of Internet-Based Cognitive Behavioral Therapy in Treatment of Psychiatric Disorders. Cureus. 2017;9(8):e1626. Published 2017 Aug 29. doi:10.7759/cureus.1626
- Luo, C., Sanger, N., Singhal, N., Pattrick, K., Shams, I., Shahid, H., … & Puckering, M. (2020). A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. EClinicalMedicine, 100442.