Online CBT

Table of Contents

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, which uses 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.

woman doing CBT at home

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 sessions 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 though pre-recorded spoken word or print.

Will CBT at home be personal to my own unique 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;

  • how your brain works
  • habits that you have
  • how you speak to yourself inside your head ,
  • how you typically react to daily stress
  • what you eat, the amount of exercise you undertake
  • how you go about your day, how many hours you work, whether you take adequate breaks
  • the quality of your sleep

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.

Online CBT

You are taught to be your own therapist through the following steps

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. Relaxation

    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.

  6. Practice

    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.

Please note the figures below come from live dynamic feedback form and can change but are correct as I write this.

Image showing Dr Elaine Ryan teaching anxiety self help course

Retrain Your Brain® for anxiety

92% stated that the course helped with anxiety and 97% would recommend the course to others


image showing online therapy session for health anxiety

Health Anxiety

90% stated that the course helped with health anxiety and 97% would recommend the course to others


image showing teaching of panic disorder self help course

Overcoming Panic Attacks

80% stated that the course helped with panic disorder and 96% would recommend the course to others

References
  1. 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
  2. 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.