Thursday, 27 October 2016

CBT Process

While theory without practice is pointless, if you have no understanding of why something works then all the practice in the world will not get you to where you want to go.  Cognitive Behavioural Therapy is rooted in the scientific method as follows:
1. Create a question you want the answer to, called a formulation.
2. Come up with an explanation, called a hypothesis.
3. What does your hypothesis predict?
4. Do an experiment to see whether the hypothesis is true, or not?
5. Discuss and analyse the results of the experiment, do they support the hypothesis or not?
Some terms and conditions apply to the above.  The first is that one has to scrupulous in accepting that the  null-hypothesis, or opposite, is actually true, which means you have to be open to being wrong.  You have to also pare down the hypothesis to make it as simple as they need to be as  Occam's Razor applies, and also:
6. You must be able to replicate the experiment, do it more than once.
7. You must be open to criticism of your methods and re-do experiments.
8. You must record and share the results, even if what happens refutes your hypothesis.
9. You must rate the certainty that your results are right.
I would observe that one of the reasons that people find Cognitive Behavioural Therapy difficult to engage with is because it's rooted so deeply in the scientific method, but however imperfect it may be the therapy is based on evidence that can be measured.  Any therapy that isn't conducive to being measured and tested is asking for a person to trust it on faith.

Friday, 21 October 2016

Cognitive Behavioural Therapy 101

I like to tell my clients that Cognitive Behavioural Therapy is like that Ronseal advert on TV that tells you the product does what it says on the tin.  Three words that describe what it is:
  • Cognitions are thoughts that you have in your head
  • Behaviours are things that you do
  • Therapy is healing, which for therapists means change.  

Cognitive Behavioural Therapy is often described as a talking therapy, in that one can expect a lot of talking to occur in a session with one's therapist.

I would also argue that talking is like theory, and that changing cognitions and behaviours is like practice.  For me the foundations of Cognitive Behavioural Therapy are based on the principle that theory should always follow practice; because sessions will talk about what you have done, or the problems you have from not being able to change the things you want to do.

However, before you can even begin to address the problems you have to have some basic things in place, and these can be condensed down into seven short pithy statements as follows:
  1. Breathe 
  2. Drink 
  3. Eat 
  4. Sleep 
  5. Exercise 
  6. Family & Friends 
  7. Work & Hobbies
All of the above are required to maintain you physical and mental well-being through a process called homeostasis.

Friday, 14 October 2016

A Belated Update

It has been three years since I last posted here.

This was down to pursuing a career in writing, which is progressing slowly, so it seems remiss of me not to write about my passion for cognitive behavioural therapy.

For example I had the privilege of presenting a talk on cognitive behavioural therapy at Carshalton High School for Girls for the students in A2 psychology in December of 2014, which went down very well – tweets were sent out by the school too, and I received a lovely box of chocolates and a gift card from the students.  So I was well chuffed, and I later learnt that one of the students has decided to change her degree option to psychology after hearing me speak.

Since then I've started work back in the NHS and last week did another presentation I called CBT 101: Anxiety & Depression.  The feedback from which has spurred me to restart this blog.

Saturday, 12 October 2013

World Mental Health Day 2013

It was World Mental Health Day on Thursday and at Imperial College they were running a Tea & Talk 2013, link here, drop in where staff could come and talk about mental health whilst having a cup of tea or coffee and a cake.  My partner who works for Imperial College decided that rather than take food they would bring me as a Mental Health professional.  So I found myself invited to talk informally to a group of Imperial college staff ranging from administration personnel to lecturers and professors and even one of the Pro-Rector's about cognitive behavioural therapy.

I took the opportunity to introduce myself, explain that my core profession was a mental health nurse before I trained to become a cognitive behavioural therapist, and that I have worked within the NHS and private sector.  After this I invited people to just ask me questions about anything they wanted.

The questions ranged from what is cognitive behavioural therapy and how to access services, and then moved onto other areas like treatment outcomes, number of sessions and anecdote about therapy some of the attendees had received.  So my answers covered how we got to where we are today in terms of national provision, treatment guidelines and what I would ask of a therapist I met; namely what is required of me and how long is it going to take?  Other topics discussed included computerized therapy, the therapeutic relationship and what makes people vulnerable to being overcome by life's stresses?  All in all an awful lot of ground was covered.

I had only expected to talk for about ten to twenty minutes, but ended up answering questions for about an hour.  I received a lot of positive verbal feedback and may be invited back on a more formal basis in the future.  What I took from this event was the lack of knowledge and fear that still surrounds having mental health issues; something that up to one in four people are likely to have to face during their lifetime.

Wednesday, 6 March 2013


As it says welcome to my blog that will tell you more about me and how I work, and what I do as a cognitive behavioural therapist.  More to come, as they say, later.