Photo by Steven Arenas from Pexels

Cognitive Behavioural Therapy (CBT) Techniques

CBT is a directive approach and requires a particular kind of client motivation and willingness to participate to be effective, which may not suit everybody.

There are numerous research studies supporting CBT techniques as an effective way of modifying maladaptive behaviours improving a person’s everyday life. This approach is carefully formulated in direct response to each client’s unique issues and their capacity to engage.

CBT interventions revolve around the client. Taking a step-by-step method, with both short and long-term goals, helps make the process less intimidating and more realisable. Each problem is investigated in a collaborative way. These interactions are evaluated during assessment and formulated by the therapist working closely with the client. The process analyses thoughts, emotions, bodily reactions and actions (behaviours) in relation to the client’s social, cultural, economic and family systems.

How do CBT techniques work?

CBT techniques use a process of guided discovery through ‘Socratic’ questioning, one question/answer leads to the next. This methodology offers new perspectives through lateral thought (day-to-day) and vertical thinking (relating events to a timeline). Crucially, the therapist’s questions respond to disconnects between what the client says/thinks/feels and actually does - identifying these discrepancies is core to CBT and informs an interventions toolbox. Importantly, the client needs to understand how the tools will help them achieve their goal. Then, through a process of analysis of the data gleaned, the therapist uses theory to ascertain which of the issues effect the core problem, and establishes how these patterns might be maintaining the problems. 

For example: each person will take away different (multiple) meanings from an event. Our thoughts, memories, observations are selective. Simons-Chabris’ ‘Gorilla at the basketball game’ experiment demonstrates this: three black shirted and six white shirted people passed a basketball to each other and viewers were asked to count the passes, half the viewers completely missed the gorilla. The experiment helps demonstrate how selectively we see and don't see events (Chablis, Simons 2010). This is particularly relevant in relation to memories of a traumatic events - what the person saw and how those thoughts are remembered, and then re-remembered.

So CBT addresses perception issues using tasks that might involve word replacement techniques, diarising triggers both good and bad or practical exercises, even surveys to challenge assumptions: testing beliefs. Using evidence and examples allows the client to understand and relate the research to their issue. The use of surveys/real life experiments helps break a maintaining cycle. For example, Kennerley et al. (2017 p218) demonstrates two behavioural experiments in relation to an anxiety scenario in a supermarket. The first approach supports the client’s problem directly by going on actual shopping trips together, this exposure/habituation lessens the effects of the anxiety, while the second aims to test the problem by establishing what the cognitive fears are and intervening in situ: “Did your fear actually happen?”. The objective is to dispel the negative thoughts, the root of the anxiety.

Therapist client relationship

According to Cooper (2008) approximately 30% of the effectiveness of a client receiving counselling is down to the relationship built up: the working alliance between counsellor and client, while the other 70% is down to the client’s willingness to engage with the process. Client motivation is even more crucial when applying CBT techniques.

The implementation of CBT requires the therapist to determine the suitability of the client; are they willing and able to commit to the process? Are they ready to change? Did they arrive at therapy of their own volition or were they pushed? CBT is an evidenced based methodology. Medalia & Saperstein’s (2011) recognised the importance of motivation on the success of the therapy in their study ‘The Role of Motivation for Treatment Success’.

As a counsellor I can offer person-centered therapy, CBT techniques or a combination of approaches, the methodology will be carefully designed in response to each client’s unique issues.

If you require immediate psychological support contact the Samaritans free from any phone 116 123. Otherwise please contact me to book an appointment or for further details.