Is Cognitive Behavioural Therapy always the best option?
At The Hope Street Centre we receive many enquiries from people seeking help, a large number of whom ask for Cognitive Behavioural Therapy (CBT). In recent years there has been much promotion about the effectiveness of CBT in treating a wide variety of emotional issues; however we feel it is important to provide further information which may help individuals make a more informed decision, as CBT is not always the best option for everyone.
In this article, we discuss the types of problems that CBT is most helpful for, whilst also discussing other therapies which might be better suited to the wide range of problems that bring people to us.CBT therapy is usually of slightly shorter duration than other counselling options, often lasting for between six and 12 sessions. This can make it an attractive option for those seeking a quick resolution, however if the problem is rooted in childhood or has been a long standing issue, then other forms of therapy may offer more permanent change.
CBT therapists work with their clients to identify unhelpful thought patterns (the cognitive part of CBT) and also to change unhelpful behaviours.
It can be particularly useful when supporting people with:
• Anxiety issues - Anxiety is a condition which can affect us all at any time. A modest amount of it does no harm; in fact it can serve to keep us out of trouble. But too much anxiety can lead to symptoms such as panic, phobias such as agoraphobia and claustrophobia, stage fright, and so on. In extreme forms it can become paralysing, making it impossible to carry on the normal activities of living, working and relating to people.
• Phobias - When phobias become intense they can lead to strong fear reactions such as panic attacks, and become extremely limiting. For example, someone who is extremely fearful of spiders will start to avoid any situation where a spider might be encountered - since spiders can turn up almost anywhere this could mean avoiding going out, avoiding friends’ houses, shops, going in the garden, certain rooms in the house, and so on. Left untreated phobias tend to get worse rather than improve. CBT can help people to understand their phobia and to develop better coping strategies when faced with their fears.
However other therapies may be more useful in situations such as bereavement where feelings need to be worked through and resolved, or as mentioned previously if the issue is deep seated.
Below we have listed other therapies which are available for individuals to consider when making a decision.
• Counselling - Counselling is a personal encounter between two people, the client and the counsellor. This is achieved mainly through talking, although other techniques such as drawing and working with objects can be used. It is based on confidentiality (allowing the client to talk freely and in confidence), boundaries (providing the element of safety), empathy (enabling the client to feel understood), acceptance and honesty. When these conditions are met, counsellors believe that the innate potential of the individual can operate, allowing them to heal themselves and discover their own creative solutions to their problems.
• Psychotherapy - Whereas most people have an idea what counselling means, many are much less clear about psychotherapy. There is considerable overlap between counselling and psychotherapy, both in the issues that can be addressed and the methods used. In general psychotherapy tends to address more deep-seated problems which may have roots in very early childhood experiences. Psychotherapy tends to take longer, and a commitment to regular sessions becomes important. The training of a psychotherapist can be longer than that of a counsellor, and a psychotherapist will normally have been to therapy themselves for several years.
• Alcohol and Addiction Counselling - People drink for many reasons, to be more sociable, to reduce stress or anxiety, underlying depression, to cope with difficult feelings, or sometimes just out of habit. If alcohol is acting as a support in this way it is important to tackle these issues as part of the process of bringing your drinking under control. Merely giving up alcohol without addressing why is likely to lead to relapse.
• EMDR - EMDR is an integrative psychotherapy practice based upon Adaptive Information Processing. It was originally developed by Francine Shapiro (1995, 2001) to treat PTSD (Post Traumatic Stress Disorder) and other trauma responses but has also been successful in treating anxieties, phobias, and complex grief.
• Transactional Analysis - Therapists who utilise Transactional Analysis work contractually on solving "here and now" problems. Counselling work focuses on creating productive problem solving behaviours. Using transactional analysis, counsellors establish an egalitarian, safe and mutually respectful working relationship with their clients. This working relationship provides tools clients can utilise in their day-to-day functions to improve the quality of their lives.
• Family and Relationship Counselling - In relationship counselling both partners work with a counsellor to deal with problems that are affecting the relationship. These can include issues such as work, finances, children, family and emotional problems. Any type of relationship can benefit from relationship counselling, irrespective of marital status, age, sexual orientation or race. Sessions last an hour and normally take place once a week. There is no limit to the number of sessions - some couples only require a few weeks while others may stay for much longer
• Trauma Therapy - Because of the wide variety of symptoms that can arise from trauma, there is no one particular model of therapy that can claim to have all the answers. Among the psychological therapies there can be a place for counselling, cognitive behaviour therapy (CBT), psychotherapy and techniques such as EMDR. When there are strong somatic effects, some form of bodywork may be helpful, such as therapeutic massage, Bowen technique, and reflexology.
It is worth noting that Therapists often offer a combination of therapies, and will make use of them within the session according to what they feel will be of most benefit to the client. For instance a Psychotherapist may have had training in Transactional Analysis and CBT, despite being listed as a Psychotherapist. This can make the process of choosing a counsellor less confusing, as an integrated approach is more likely to meet a variety of different needs, and create the opportunity for change.
If you are currently considering seeking counselling support and would like to discuss your options, the please call The Hope Street Centre on 01270 764003.