Cognitive Behaviour Therapies for Depression and Anxiety Disorders

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    Cognitive Behaviour Therapies (CBT) for depression and anxiety disorders

    “At first I didn't see how the CBT would help me, now I feel I've come a very long way in a short period of time”

    Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.  It is most commonly used to treat anxiety disorders and depression.

    CBT cannot remove your problems, but it can help you deal with them in a more positive way. It is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.

    CBT aims to help you crack this cycle by breaking down overwhelming problems into smaller parts and showing you how to change these negative patterns to improve the way you feel. Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

    I have learnt so much about myself and CBT has enabled me to continue with everyday life (work, going out).  I would strongly recommend CBT and First Step.

    What happens during CBT sessions?

    During the sessions, you will work with your therapist to break down your problems into their separate parts – such as your thoughts, physical feelings and actions.

    You and your therapist will analyse these areas to work out if they are unrealistic or unhelpful and to determine the effect they have on each other and on you. Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.

    After working out what you can change, your therapist will ask you to practice these changes in your daily life and you will discuss how you got on during the next session.

    The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life. This should help you manage your problems and stop them having a negative impact on your life – even after your course of treatment finishes.

    CBT has been an excellent therapy and helped me move forward.  I have a future now and have the skills to take my life forward.

    The clips below show examples of what might happen in a session, in the case for a patient with Obsessive Compulsive Disorder. The therapist and patient work together to understand the problem, what is keeping it going and how they might work together to make changes.

    How many sessions will I need?

    It varies greatly between patients but you and your therapist would usually agree a small number of sessions at the start to see if CBT is likely to be helpful to you.

    How long will the sessions take?

    Approximately 50 minutes.

    How often will I be seen?

    This varies on patients and also the stage of therapy but usually once every one or two weeks

    Counselling for depression

    The aim of counselling for depression is to help patients access underlying feelings, make sense of them, and draw on the new meanings which emerge to make positive changes in their lives. It has a particular focus on ‘self-discrepancy’ – differences between how a person feels they actually are and how they feel they should be – which has been shown to be associated with depression.

    Self-discrepancy can emerge from, and lead to, a variety of difficult and distressing emotional processes, such as internal self-conflict, excessive self-criticism, unresolved loss or trauma, and the distortion or interruption of emotional experiencing. The identification of such processes provides opportunities for focused work with clients, aimed at reducing the intensity of the focal processes and, in turn, the degree of self-discrepancy. The net result of this is a reduction in emotional distress and depressed mood.

    Eye Movement Desensitisation and Reprocessing (EMDR)

    EMDR is a psychological therapy designed for working with distressing traumatic memories. The theory behind EMDR is that distress and psychological difficulties caused by traumatic experiences have not been stored in the memory properly and are unprocessed or blocked. These traumatic memories may need to become processed or unblocked, and EMDR is one psychological therapy used to do.

    There is good evidence that EMDR is an effective treatment for post-traumatic stress disorder (PTSD) and is recommended by the National Institute for Health and Care Excellence (NICE) for PTSD but not for military veterans when the trauma is consequent to their military service.  Within First Step we only use EMDR as one of the treatment choices for PTSD in addition to Trauma focussed Cognitive Behavioural Therapy.