CBT currently has the largest amount of research carried out on its effectiveness. CBT focuses on what people think, how those thoughts affect them emotionally and how they ultimately behave. When someone is distressed or anxious, the way they see and evaluate themselves can become negative. CBT therapists work alongside the person to help them begin to see the link between negative thoughts and mood. This empowers people to assert control over negative emotions and to change the way they behave. CBT has grown in popularity following recommendations from the National Institute of Health and Clinical Excellence (NICE) for the treatment of anxiety disorders.
CBT can be delivered at a number of levels of intensity, meaning it can be usful to those who have only just started feeling anxious as well as those with longstanding anxiety problems. In the lower levels of the stepped care model “soft” techniques, such as guided self help, are used, placing the onus on you to complete diary sheets and other interventions with the support and guidance of a trained worker. Self help resources are often CBT based and suitable for a range of conditions. Mental health workers may use these resources with you to provide an awareness of techniques that may empower you to overcome your problem. Soft CBT can be carried out over the phone or face to face.
Further up the stepped care model is pure CBT, usually offered at step 3 or above for problems of a more complex and longstanding nature. CBT is delivered by a trained therapist, usually in a clinical setting. This form of therapy focuses on the “here and now” and is not overly concerned with finding the initial cause of anxiety. During CBT, the therapist will first assist you to identify your problem (along with the behaviours, thoughts and feelings that may be linked in with the problem). Once the problem has been explored, the therapist will help you examine your thought and behaviour patterns and help you to work on ways of changing these. If you access this type of therapy you will often be given a set number of sessions that typically last 50 minutes per session.
Therapists will usually set you “homework tasks” which are completed between sessions. Homework tasks may include carrying out activities such as thought monitoring and entering these into a thought diary, or practicing specific behaviours through what is known as “behavioural exposure’.
In the unlikely event that Anxiety UK is unable to help you we would recommend accessing therapy through referral to an NHS service via your GP. Most CBT therapists are registered with the BABCP (British Association of Behavioural and Cognitive Psychotherapies), the governing body for CBT. Their website contains lists of private therapists (www.babcp.com).
Find out how CBT can help people cope and how it can treat anxiety on the NHS Choices website.