Why I chose Cognitive Behavioural Therapy (CBT)
By Paul Mallott BA (Hons) Counselling Dip CBTPaul Mallott offers Counselling, Psychotherapy | Securely Book Online | Contact Me
Having trained as a Counsellor using a person-centred approach, I used many techniques and various models, which I learned in training and then put into practice in my counselling.
Although I found myself to be an effective counsellor, the approaches I used although proven were seemingly slow in the relation to the client’s recovery.
I also tended receive a lot of phone calls from registered occupational health companies requesting my services as a CBT Counsellor. Unfortunately I had to turn them down, as I was not qualified in this area and knew little about its impact in counselling.
To this end I bought many books on the CBT approach and one such book being Cognitive Therapy “The Basics and Beyond” (Judith S Beck). In which was stated, “A structured short-term, present-orientated psychotherapy for depression, directed toward solving current problems and modifying dysfunctional thinking and behaviour”.
I was intrigued by this statement, as a lot of previous approaches, rather than deal with the “here and now” tended to rely heavily on how a person's childhood experiences both reflected and had an impact in the their adult lives and the way they behave and function in present day life.
I also found these models to be less interactive between the client and counsellor - once a session was finished the client would go away for another week until the next session only having his or her thoughts to deal with and what was said in the counselling session.
Further to this, I also always had the feeling that my hands were tied. Being empathic, understanding, non-judgemental and a good listener, qualities to which a counsellor relies upon, I always had the feeling that, I wish I could do more, or be more interactive with my clients, ideally have a more hands on approach.
The CBT approach seemed to answer my questions and appealed to me greatly, especially when dealing with clients whom suffered from anxiety and its related depression.
This approach was everything I previously wanted to do but was unable to do so using a person centred approach. I have found CBT to be more interactive and I structure my counselling sessions in the way shown in “Cognitive Behavioural Therapy in Mental Health” (Grant et al), as shown below;
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Working from a list of goals
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Working from an agenda in sessions
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Using measurement and evaluation regularly
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Having key tasks that are repeated during each session, such as weekly measures of mood levels
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Following a planned programme
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Following a self-help resource, such as books or computer packages
By structuring sessions in this manner, it is also easier to help the client, and to back up what is accomplished in counselling sessions.
Giving the client an opportunity to complete homework, and read literature, is a great form of self-help, and the clients also feel they are achieving more by completing the homework tasks.
Further to this clients suffering from anxiety and depression are reluctant to keep themselves busy, get out of bed, etc, they concentrate on their negative thoughts, emotions and anxiety, so by having this homework to complete it takes the clients “mind” off these issues.
I have also found that clients enjoy completing such Forms as the “ABC” chart or dysfunctional thought record, as it is also referred. This chart enables the client to recognize:
Not all clients are able to identify these “triggers” to which they were previously “Blind” too, or their associated patterns of behaviour related to their anxiety, so such forms as above are extremely helpful to these clients. However there are still clients whom have difficulty recognising “triggers” or their “automatic thoughts” from the use of such forms, so another area of CBT I have found to be effective is “Imagery”.
Imagery being that with most dysfunctional thoughts there are related images “Cognitive Therapy for Dummies” (Rob Wilson), so the counsellor can help the client further to identify their negative thoughts by recreating a key situation vividly enough by identifying the images that coincide with the thoughts.
I have found CBT to be very effective and so effective to the point that many of my clients recovery time is a lot quicker than the person-centred approach I previously relied upon.
It is also an excellent way for clients to see how they are progressing, in the form of homework and visual feedback from charts such as “depression checklists” and “mood charts” give a constant ongoing assessment.
The final element of every CBT session is the feedback.
At the end of the first session, most patients I have found feel positively about the session and therapy.
Asking the client for feedback further strengthens rapport, providing my client the message “I care about what they think”.
It also gives my client a chance to express and resolve any misunderstandings or to ask about anything they were and are unsure about.
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This article was written by RSCPP Therapist Paul Mallott:
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