Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is a psychotherapeutic approach to talking therapy.

CBT looks at how our thoughts, feelings, behaviours and physical reactions all interact to impact our environment. By exploring these things, CBT can help to change unhelpful ways of thinking (‘cognitive’) and unhelpful ways of acting (‘behaviour’), which can help one feel better about life.

CBT’s focus is on present problems and difficulties as opposed to issues from the past. It looks for practical ways to improve state of mind on a regular basis.
There is empirical evidence that CBT is effective in improving problems such as anxiety, depression, post-traumatic stress disorder, eating disorders and chronic pain.

In the United Kingdom, the National Institute for Health and Clinical Excellence  (NICE) recommends CBT as the treatment of choice for a number of mental health difficulties, including post-traumatic stress disorder, OCD, bulimia nervosa, and clinical depression.

In 2009, NICE issued guidelines about what treatments should be provided to people with chronic back pain

NICE recommended that chronic back pain can be treated using painkilling medication and one of the following treatment options:

  • acupuncture – fine needles are inserted into your skin at certain points on the body
  • exercise classes – aerobic exercise, muscle strengthening and stretching
  • manual therapy – your back is massaged or manipulated

If the treatments listed prove to be ineffective, a combined programme of exercise and psychological treatment is advised.

Cognitive behavioural treatment (CBT) for pain management is based upon a cognitive-behavioural model of pain (Turk, Meichenbaum, & Genest, 1983). The basis of this model is the idea that pain is an intricate experience that is not only influenced by its underlying pathophysiology, but also by an individuals' cognitions, affect, and behaviour (Keefe & Gil, 1986).

The particular therapeutic techniques of CBT frequently include keeping a diary of important events and associated feelings, thoughts and behaviours; probing and testing cognitions, assumptions, evaluations and beliefs that might be unhelpful and/or unrealistic; progressively facing activities which may have been avoided; and trying out alternative ways  of  behaving and reacting.

Relaxation, mindfulness and distraction techniques are also a very important part of the therapeutic process.
 
All in all, cognitive behavioural approaches aim to improve the way that an individual manages and copes with their pain, rather than finding a biological solution to the existing pathology. The approach is very much related to problem solving and returning control to the sufferer.

CBT usually involves weekly or fortnightly sessions with a therapist. The number of sessions required varies greatly depending on your problems and objectives, with treatment usually lasting from six weeks to six months.

For further information on our CBT and Physiotherapy service please click here