Is Cognitive Behavioural Therapy Right For Me?

Chances are that if you went to the doctor and asked for therapy, your doctor recommended you to do Cognitive Behavioural Therapy (CBT). There is a good reason why doctors love CBT. It is evidence-based, meaning that it is proven in clinical trials that it has a high chance of success (50-75% for depression and anxiety). It is also well known because it has been out there for a long time. However, therapy is outside their scope of practice, and many other therapies exist. Or you tried CBT, and you did not like it. Let's briefly look at what CBT is and some of the reasons why it did not work for you.

What Is CBT?

CBT is based on the idea that how you think affects how you feel and behave. It is cognitive, so it focuses on your perceptions and interpretations of what happens around you. In a CBT session, we identify distressful thoughts and unhelpful ways of thinking; we evaluate them with the objective of restructuring them, a fancy word that means that we change them for more realistic ones. People learn how to recognize unhelpful thoughts that make them suffer. It is important to know that sessions are structured and include homework. CBT is used to treat depression and anxiety, but it can be used for other issues. I, for example, like to use CBT principles to organize the mind and feelings, which can be beneficial.

Why Did It Not Work For You?

CBT has high rates of success, but let's see a few reasons why it did not work for you:

Your provider's skills and training: Did you really have CBT? This might seem obvious, but what CBT training did your provider use? This is an essential part. In my case, I got the training from the Beck Institute, founded by Aaron Beck, who developed and is considered the father of CBT. Don't get me wrong; some other good programs are out there, it can be different from the same one I have. Still, you would be surprised how many therapists provide CBT without formal training. CBT needs to be adapted to you.

Another thing is that CBT may not be the right therapy for you. I have been intensively trained and supervised in CBT and other modalities. As good as therapy is, it will not fit everybody's needs. We all are different and might need different approaches. You may not like a highly structured CBT session or doing homework, or your emotions are too intense to focus on your cognitions, and you need some emotion regulation first. Other modalities developed from CBT might be a better fit, like Acceptance and Commitment Therapy (ACT) or Mentalization-Based treatment (MBT), or you might benefit from a more holistic approach that focuses on your feelings and body sensations. But there are different modalities depending on your style, goals and needs.

In conclusion, CBT has high success rates and might be a good start. However, I highly recommend discussing it with your therapist in the intake session. In that first session, your therapist will ask you what your goals are and offer some suggestions for treatment. It is important that you feel comfortable and hopeful about your future sessions.