Whenever we’re recommended therapy, we may question if it’s actually going to work. Is CBT effective? Long story short: everyone is different. For me, it’s given me a practical toolkit for tackling my distorted thought patterns and liberated me from previous spiralling. But what may work for me might not work for you – it’s completely different for everyone involved.
Read more to find out the answers to some common questions around CBT.
In 2019, I referred myself for some counselling. I first spoke with my GP, who signposted me to a local service called Talking Change. It’s a self-referral process, so you don’t need to go through a GP to get it.
2019 was a really challenging year for me. I knew that counselling would help me get back on track. When I self-referred to the Talking Change team, I had a primary assessment to talk through the problems I struggled with most.
They told me about a CBT course they ran, specifically catered to people with long term health conditions such as vasculitis. I’d been waiting years for this kind of counselling, so I jumped at the chance to enrol on the course.
I was really excited about the counselling and hoped it would be effective for my specific problems.
Before I get into it, it’s important to say that this is only my experience. CBT is effective for me, but I can’t speak about anyone else’s experience. Counselling helps different people in different ways and in varying levels.
The sessions took place in a group setting. I won’t discuss any identifying details (obviously) but I will say that it was liberating to hear the experiences of others. It made me feel less isolated.
As it wasn’t group therapy, there was absolutely no pressure to talk or contribute to these sessions. However, I always felt comfortable enough to speak about my own experience.
Of course, not all CBT is like this. There are loads of options out there.
These all depend on where you live and what services are on offer to you. But based on my own experience, I know that you may have the option to have face-to-face CBT with a counsellor in a one-to-one setting. Alternatively, there could be options for you to do it over the phone, or in a group like I did.
There are even online services such as Silvercloud, which enable you to complete a CBT course in your own time and on your own terms. This is usually offered to you through a GP, but my university (the University of Exeter) actually offer it to all students with no sign-up or referral necessary.
Depending on the format you go for, CBT can work in all different ways. In fact, there are tons of different CBT techniques.
But the fundamental idea is that CBT is a proactive approach to improving mental health by looking at the cycle of your thought processes, feelings, and thoughts.
In my course, we probably all wondered, ‘is this going to work? Is CBT effective? What’s going to happen here?’
In response, we were told that the more work we put into our counselling, the more effective it would be. Essentially, we were training ourselves to become our own counsellors. As someone who likes to do everything in their power to overcome poor mental health, it’s been life-changing to learn proactive skills. This is exactly why CBT is effective for me!
Throughout the weeks, we were encouraged to fill in an activity diary. 7 days a week were split into 2-hour sections, and we had to write what we did and rate our mood out of 10.
It was initially overwhelming. I don’t have the discipline to write a normal diary, let alone track my activities and mood every 2 hours!
Unsurprisingly, I didn’t manage to do it the first week. But when I remembered that “you only get what you put in”, I cracked down and managed to complete it. It may sound obvious, but this activity helped me to identify what I was doing when my moods dipped. This, in turn, helped me to think about whether these activities were the cause or the result of the problem.
I’ve now installed Daylio, a really cool app which allows me to do the same activity recording but on a daily rather than a 2-hour basis. You can read another blog of mine about wellbeing apps here if you fancy!
In this course, I learned about processes such as deconditioning, graded exposure, and pacing (via the boom and bust model).
Here are some quick definitions of each from external sources (to prevent me from reinventing the wheel):
(Disclaimer: this is aimed for the elderly but is frequently seen in those with chronic illness).
‘Deconditioning Syndrome’ occurs when older people lose their abilities to do everyday activities over a period of time, and is often caused by inactivity. This can lead to reduced mobility, falls, functional incontinence, low self-esteem and functional abilities, and can result in longer term functional and psychological dependence.
Regaining the lost abilities (re-conditioning) can often take twice as long as deconditioning. Deconditioning can affect older people in a very short time frame and in any environment especially in acute hospitals and care homes.
It can be prevented by helping, encouraging and assisting people (where required) in performing activities of daily living. One does not need to go to a gym to do exercises. Performing routine day to day activities can be as good as exercises for many frail older people and helps them remain less dependent for longer.
Graded Exposure is a way of treating a range of anxiety problems. It works best with simple phobias or other anxiety problems where you can identify what it is that you are anxious about.
The basic idea is to gradually expose yourself to the feared situation in a way that allows you to control your fear at each step. If you get the steps right – in terms of how difficult each one is – you should be able to master your anxiety at each stage and conquer your fear.
Chronic pain can make it difficult to remain active. Many people with chronic pain do as much as they can on good days. This can cause an increase in pain, so that they need to reduce their activity for a few days. This is sometimes called a ‘boom and bust’ pattern. It can lead to reduced activity over time.
Pacing is a key skill in pain management. It involves taking a break before you need to so you have a consistent pattern of activity and rest. Over time, this is associated with being able to do more.
Often people tell us they are surprised how much they can get done by sticking to this approach.
By clicking on the hyperlinks, you can find out more about each technique in further detail. I’ll probably touch on each one in more depth in separate blogs, but for now, I’ll say that learning about each condition exposed me to a new way of living.
I’m so grateful to have been invited to learn more about my chronic ‘life blocks’ through this CBT course. I sincerely appreciate the NHS for acknowledging people like me who often feel unseen due to their invisible conditions.
Now that I have tried and tested CBT methods, I can challenge my anxiety, maintain my energy levels, and build up my stamina. Overall, I can empower myself and take control of my debilitating conditions.
Let me know your thoughts down below! Have you had CBT, and did it work for you? Is CBT effective, or can it be effective for everyone?