Cognitive Therapy works. It helps at least 80% of clients. It has limited benefit only for those who don't put in the effort to give it a fair go, or who are too distressed at the moment to concentrate on their thought processes.
Depending on what strengths and resources
the client already has, and on the nature and severity of the problem,
Cognitive Therapy takes between 4 and 50 sessions to enable the client
to:
Therapy is a matter of cooperation
between client and therapist. Sessions are highly structured to ensure
rapid improvement, and good value for time and money invested. In the first
session client and therapist together:
Cognitive Therapy was devised over
30 years ago, to help people who are plagued by Depression. It has since
been adapted to fight many other kinds of problems: Anxiety, Guilt, Anger,
Interpersonal Problems, to name a few. Its effectiveness is supported by
a great deal of research.
* deal with the distressing problems that led to the need for
therapy;
*
live a happier and more fulfilling life;
*
effectively deal with future problems which arise after the client has
decided to terminate therapy.
* Set
an agenda (decide how to use the session to the client's best advantage).
This includes the problems that need to be attacked.
* As
at the start of every session, the client reports on the current level
of distress, and on the past week. This is put as a point on a scale, and
records are kept so progress can be monitored.
*
Current problems are explored, and used to generate a goal list: what the
client wants to achieve in order to solve these problems. This is written
down in duplicate (one copy for each of client and therapist), and is an
important tool for improving the client's situation.
* Cognitive
Therapy is based on the fact that emotions, thoughts and behavior are intertwined.
How you feel, what you think, and what you do (or don't do) are all the
one thing. Much of your current distress is the result of certain thoughts
that 'pop into your head'. Most problems can be solved or at least reduced
by paying attention to these thoughts. This is true for everybody, but
is particularly important for those who have trouble coping, or are in
a crisis situation. At times like that, our 'automatic thoughts' can be
biased and inaccurate. In Cognitive Therapy, we look for these thoughts,
and check them out to see how accurate they are. Part of the therapist's
agenda is to explore how such thoughts may have contributed to the client's
problems.
*
Another part is to examine the typical thought patterns that
your particular distressing emotions suggest to you. For example,
Depression usually
whispers to you that 1. 'I am no good';
2. 'The world is a cruel place and everything is unfair';
and 3. 'The future is hopeless'.
These thoughts are not part of you, but the suggestions of Depression.
They can be examined and tested for truth. Similarly, people who function
less well than usual in certain situations may have Anxiety
put
thoughts in their head of one of these kinds: 1.
'I am powerless against these people';
or 2. 'I must achieve perfectly or I am
a failure'; or 3.
'If I open my mouth they will see my incompetence'.
* Throughout
the session, therapist and client agree on home assignments for the following
week. These 'homework tasks' are designed to give immediate relief for
the most distressing of your current problems, and to start you on the
road to reaching your long term goals, including being able to do self-therapy
when new problems arise after you no longer need the therapist. These self-help
tasks are the most important part of therapy. One hour is a very small
proportion of a week. Long term habits can only be changed by sustained,
every day application. Fortunately, some of this work will immediately
make you feel better.
* Finally,
at every session, the therapist will ask you for feedback on how s/he can
do the job of helping you better. This is important because it can improve
the therapist's approach, and also it is a power-levelling act. Instead
of the therapist being the powerful expert, s/he gives power to the client,
who becomes a judge.