9 assumptions about CBT

When we talk to people about CBT, we often find there are things they’ve heard or believe about the treatment that don’t reflect reality. Here are some of the most common assumptions we come across – and the facts.

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1. I can expect to feel better after the first session.

‍CBT can achieve positive results quickly, but you might not feel you’ve made much movement forward after your first appointment. This session will focus on assessment, with the therapist aiming to find out about the difficulties you’re experiencing and how they affect you, as well as what you hope to gain from therapy. They’ll also explain how CBT works, and give you information about the treatment process.

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You might well feel relieved, lighter or hopeful afterwards, especially if you’ve got some things off your chest. It’s possible you’ll feel a bit worse, if you’ve talked about upsetting and challenging topics. You might feel indifferent, exhausted or deflated.

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Whatever you feel, remember that this initial appointment is geared towards building solid foundations for your treatment. From there, you’ll spend each session gaining a clearer understanding of your problems, and learning techniques for managing them.

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2. I’ll only have to tell my story once.

‍The route into CBT often involves a screening process to check it’s the right treatment pathway for the patient, so the person you speak to first may not be the therapist who gets assigned to you. This means you may have to explain your situation twice: the therapist will have notes, but they’ll want to hear things first-hand too, to better understand your difficulties.

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3. CBT is just a bunch of techniques!

‍It’s true that CBT is a very action-based therapy, which equips people with practical tools, techniques and strategies to achieve specific goals. This differs from some other talking therapies, such as counselling, which are mainly about the relationship between the patient and therapist, and the process that happens in the room.

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CBT believes the two go hand in hand: techniques are important, but so is the patient/therapist relationship. In fact, the treatment process is highly collaborative, with you and the therapist working as a team. And this leads us on to…

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4. My therapist will tell me what to do.

‍You’ll undertake the process very much hand-in-hand. Your therapist will continually elicit ideas and suggestions from you, and you’ll agree things like goals and homework together.

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5. If I don’t get on with my therapist, that’s tough.

‍You need to have a trusting partnership if the treatment is going to work, so you can ask to be assigned a different therapist if you feel things aren’t going well.

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6. CBT is only about the ‘here and now’.

‍Exploring the past to get to the root cause of a problem is a key part of many types of therapy, but with CBT it’s not essential to do that in order to make progress. The main focus will be on the present: the issues you’re currently experiencing, and the changes you can make now to your behaviour and thinking to improve how you feel.

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However, your therapist will take past experiences into account if they’re relevant, for instance examining your childhood to understand how certain beliefs and coping strategies may have formed.

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7. If I work hard in every session, that’s ‘job done’.

‍The homework you do in between appointments is a really important part of CBT. This is because you need to practice the skills and techniques you learn out in the real world to embed them and make them second nature. We know that the more work people do outside their appointments, the greater the impact this has on their recovery.

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8. My treatment will stop after a certain number of sessions, even if I’m not better.

‍CBT is a short-term treatment, that works towards a set of goals you agree with your therapist. Rather than working towards a certain number of sessions, you’ll have regular reviews to measure your progress, and if it becomes clear you need more appointments then you will continue.

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9. I’ll feel completely cured by the end.

‍The plan with CBT is that you learn the tools and skills you need to become your own therapist in the long-term, so the work should be ongoing. People often don’t resolve all their difficulties during treatment, but the idea is that you’ll end the process knowing exactly how to address them.

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You can find out what to expect from the online CBT ieso offers here.