I often use cognitive behaviour therapy (CBT) in my work with children and young people. The therapeutic approach offers a useful framework for tackling a range of issues, from social anxiety, to depression, to obsessive-compulsive disorder (OCD). CBT aims to help a client become aware of distortions to their thoughts which may be causing psychological distress. CBT also aims to help a client become more aware of behavioural patterns which are reinforcing their thinking, and to change them.
The aim is not to correct all thinking errors a client makes. After all, virtually everyone distorts reality in some ways. The therapist attempts to understand experiences from the client’s point of view, and the client and therapist will work collaboratively with with a scientific approach, exploring the client’s thoughts, assumptions and beliefs. The therapist helps the client develop ways to test these thoughts and beliefs by checking them against reality and against other assumptions.
Often this process will continue outside the therapeutic session with ‘behavioural homework’ activities where the client takes some of the ideas explored in therapy and tests them out in real life situations. Often the client will be asked to record their thoughts, feelings and emotions in different situations for discussion at future meetings with the therapist. CBT interventions are grounded in the notion that thoughts, feelings, and behaviour are all interrelated and all influence each other.
Due to the interrelationship between thoughts, feelings and behaviours, interventions will often involve working on the client’s behaviour. For example, a client with a strong fear that pigeons will land on their head if they walk under trees may go to great lengths to avoid walking under trees. This behaviour will prevent the client from experiencing occasions that contradict their thought that “if I walk under a tree, a pigeon will land on my head”, or even their mental image of a pigeon landing on their head the moment they step under a tree. The therapist may help the client to overcome this avoidance of walking under trees as part of the process of correcting the distorted thought that walking under trees will lead to pigeons landing on the client’s head.
Throughout the therapeutic process of learning, exploring and hypothesis testing, the client develops coping strategies as well as improving their awareness, introspection and evaluation skills. This enables them to challenge their thoughts on their own in the future, reducing their reliance on the therapist, and reducing the likelihood of experiencing a relapse.