Making CBT workSatwant SinghNurse Consultant in CBT & MH

Aims for todayUnderstanding

What is CBT What does it involve Maximising engagement in CBT Working with your therapist Identifying difficulties and finding solutions Role of homework Issues surrounding homework and dealing

obstacles Being creative in therapy to maximise therapy

impact

Why have therapy?Group exercise- spend a few moments as to why would you or someone want to have therapy and what is about?

ChangeIndividual work- what does change mean to you and

what does it involve?

CBTCognitive Behavioural Therapy is a evidence based psychotherapy that address our beliefs systems, thoughts, emotions and behaviours.

The cognitive hypotheses that the way we interpret or give meaning to a situation affects us emotionally and the way we behave or react

The interpretations we make are based on our beliefs and assumptions that we hold e.g. If I am don’t check then something bad will happen

CBTIt is:

Empirically based

Short term

Collaborative

Formulation driven

The patient is not a passive recipient

Involves in between session work tasks (homework)

Aim of therapy to make patient their own therapist- skills acquisition

What does it involve?Assessment and use of measures

A collaborative formulation of the presenting problems

Uncovering beliefs, behaviours that maintain the problems (coping strategies)

Testing out those beliefs through behavioural experiments

Undertaking home between sessions

Blue print and relapse prevention

Maximising your engagementBe open in therapy and work collaboratively

with your therapist

Develop an attitude of curiosity it is a process of discovery e.g. like a cat

Be willing to try things e.g. testing out behavioural experiments

If there are difficulties develop a hierarchy to work the easier to the more difficult

Working with your therapistYour therapist is there to work with you and

help you

If there are difficulties be honest and open about the difficulties e.g. style of therapy, pace of session

Explore together how to over come some of the difficulties- it may be related to your problems

Give feedback at the end of each session what was helpful and not helpful

Identifying difficulties and finding solutionsTherapy is not smooth sailing it is sailing a boat

there are moments it is smooth and at times it rough

Identify what are the difficulties and what are the steps to over come the problem

Identify what is the role of the difficulty e.g. is it avoidance? It is a presentation of my problem?

Remember every problem has a function and a solution

Role of homeworkCrucial for developing skills and becoming

adapt in dealing with your problem (own therapist)

Practice makes perfect e.g. cooking

Helps to test out assumptions and beliefs

Helps identification of obstacles and areas of difficulties

Allows you to take responsibility in your treatment and achieving your goals

Issues surrounding homework and dealing with obstacles

Obstacles are normal in therapy

Identify the obstacle and ask yourself what is happening here- what is the difficulty

Check on the function of the obstacle e.g. avoidance and develop an understanding how avoidance keeps the problem going

Discuss with your therapist about the obstacle and identify patterns of what happens and look at ways of dealing with the patterns

Being creative in therapy to maximise therapy impact

Sometimes it may be difficult to carry out the homework

Be flexible and creative

Work at different area that may be easier and go back to the difficult part

Develop steps to get there working consistently

Widen the band width of area that you are working on

Self help If you have no therapist there a range of self

help material available

Can be used whilst waiting for therapy or in conjunction

Helpful to provide an understanding about therapy and what it involves

Has exercises that can aid understanding and aid starting to deal with the difficulties

ConclusionYour participation in therapy is crucial and

therapy is not a passive process

The therapy is your therapy- take responsibility for your therapy

Identify the change you want to take place to help with motivation and goals of where you would like to get to

Deal with obstacles as they arise

Be flexible and creative