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CBT and
ACT
What is Cognitive Behavioural Therapy?
Cognitive Behavioural Therapy (CBT) is a scientifically proven talking therapy that can help people with a wide range of difficulties. It is structured and time limited. The qualities of compassion, curiosity, courage and openness are integral to therapy and central to the relationship between Therapist, Client and the difficulties being explored. CBT focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviours and vice versa! It involves slowing down and tuning into your day-to-day experience so you can identify what is helpful and healthy and what is fuelling emotional difficulties or unhelpful patterns of behaviour.
CBT is a proactive approach, ensuring that by the end of Therapy you will have developed new skills and knowledge to enable you to respond wisely to life’s ups and downs. CBT tends to be more focused on the present but can refer to the past to better understand how it impacts on the here and now. CBT is recommended in the NICE Guidelines (National Institute for Clinical Excellence) as an effective treatment for Anxiety based problems (Health Anxiety, OCD, Panic, Phobias, PTSD, Social Anxiety) and Depression. It has also been found to be effective for stress management, relationship difficulties and self-confidence.
Ways of Working
At the beginning of the therapy, you and your Therapist will take time to explore your current difficulties in order to develop a shared understanding of your problem. Together you will consider what patterns of thoughts, feelings and behaviours might be causing or maintaining your distress and consider alternative ways of handling your experience. In the early sessions you will establish your hopes for therapy and build these into identifiable goals which relate to behavioural change. This will take account of your ‘bigger picture’ or what is important in you.
All sessions are different but can involve: Experiential or Mindfulness-based exercises, Visualisation exercises, Perspective taking exercises, Behavioural experiments, mapping out cycles or exploring metaphors, watching brief You-Tube Videos, Guided discovery, Behavioural Activation, Graded Exposure, Psycho-education and more. Skills and strategies learned in sessions will be reinforced through tasks between sessions, ready for further reflection and fine tuning when you return.
CBT is all about coaching people to become their own therapist, so towards the end of therapy you may develop a Wellbeing Plan, to include handling setbacks and promoting emotional resilience.
Growing in popularity due to its effectiveness and adaptability are what is called ‘3rd Wave CBT’ which includes ACT and Compassion Focused Therapy
What Is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy (pronounced like the word not A.C.T!) ACT is a Third Wave form of CBT sharing many of the above principles but adds some extra dimensions, backed by scientific evidence.
With its roots in Behavioural Science and Learning Theory, ACT highlights how our problematic ‘survival wiring’, means we can put a lot of effort into avoiding difficult thoughts, feelings and physical sensations. We might avoid situations that are anxiety provoking, put off doing things that matter or just keep busy. We try and ‘fix’ our thinking by being ‘rational’, having ‘positive’ thoughts or just overthinking everything. Sometimes ‘escape’ may be through food, alcohol or modern world distractions. These self-defeating patterns of behaviour can drain our resources, leave us living on ‘auto-pilot’ or make us feel like we are just existing. At times the frustration of it all can leave us feeling hopeless and overwhelmed.
ACT teaches mindfulness and acceptance skills to target difficult thoughts and feelings so they have much less impact and influence. This enables us to Commit (the ‘C’ in ACT) to doing more of the things that give life meaning and purpose, which generally increases a sense of wellbeing and resilience. This is called ‘Psychological Flexibility’. If you are unsure of your values, ACT includes helpful ways to clarify or reconnect with your ‘bigger picture’. ACT is unique in distinguishing between ‘you’ and your ‘mind’. This trainable skill enables you to access your ‘on board companion’ or the part of you that can notice your experience. This can be an empowering skill.
ACT can be a helpful for: depression, anxiety, stress, emotional regulation skills, managing long term health conditions, relationship difficulties, building self-acceptance to boost self-esteem, adjusting to loss, binge eating, coming to terms with change.
What is Compassion Focused Therapy?
Compassion-focused therapy (CFT) aims to help promote mental and emotional healing by encouraging people in treatment to be compassionate toward themselves and other people. It is another member of the wider family of Cognitive Behavioural Therapies and was founded by Professor Paul Gilbert.
Like ACT, CFT emphasises the inherent difficulty of our evolved ‘Tricky Brains’ which can make us our own worst critic. Compassion Focused Therapy is particularly relevant to those who experience feelings of shame or guilt and self-critical thinking. Many people feel able to respond in a kindly and supportive fashion to others but struggle to motivate themselves in this way. Although the word Compassion makes us think of qualities like kindness and warmth, this approach also places great emphasis on the strength and courage it takes to engage with our suffering and do something about it. CFT presents Compassion as a skill that can be developed and nurtured through Compassionate Focused Exercises and Practice.
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