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Site updated: 15thMarch 2008 |
What is the difference between CBT and other therapies? There are numerous forms of therapy available, and it isn't easy to know which is the best one to choose. The differences between therapies are not always clear-cut as they all have something to offer, and there can be a lot of overlap between them. However it is possible to highlight some key areas where CBT is distinctive. If after reading this you are still unsure, don't despair! I personally use a range of different therapeutic approaches, and I have colleagues at The Hope Street Centre who can offer still further options. This means that if a problem is of a type that can be dealt with by psychological methods there is a very good chance that I or one of my colleagues can help. Short term vs Long term Most CBT is delivered as short-term therapy, and in that sense it is similar to counselling and differs from psychotherapy which is usually long-term. It does not have to be short-term, and there are case reports in the literature of CBT treatments lasting months or years in complex cases, but these tend to be exceptional. Homework One of the key factors that makes CBT a short-term approach is homework. Between sessions clients carry out homework exercises that have been agreed with the therapist, and which, for example, may consist of making records about the impact of a problem, practising specific techniques or trying out new ways of handling a situation. If homework is done diligently it extends the time spent doing therapy from the single hour normally spent with the therapist to possibly several hours each week. This can greatly reduce the number of appointments needed with the therapist. Other therapy styles also use homework tasks on an occasional basis, but with CBT it is the norm. Goals and Targets In one of the early sessions of Cognitive Behavioural Therapy the client and therapist will agree a set of clear goals or treatment targets. These provide the basis around which the treatment is designed, and enable progress to be monitored as the therapy progresses. In this regard CBT is similar to life coaching, which is strongly goal-orientated. The goals that you agree with the therapist will not necessarily be the ones that first spring to mind, as the therapist will want to make sure they are achievable. A useful acronym for goal-setting is SMART - goals should be specific, measurable, achievable, relevant/realistic and timed. Directive vs Non-Directive If you have had experience of person-centred counselling you are probably familiar with the non-directive style. A non-directive therapist or counsellor does not put forward their own ideas or solutions to problems, but helps you to discover your own. CBT is more directive - it has a collection of techniques that have been tested and are known to work well for specific problems, and a CBT therapist will teach you how to apply these techniques as effectively as possible. This doesn't mean that you have no say in the process! CBT is collaborative, and the therapist will not ask you to do anything you disagree with, but neither does it leave you to find the answers! Neither approach is right or wrong, it is a matter of finding the style of therapy that suits you best. Measurement CBT differs from most other forms of therapy in that it uses measuring and recording to assist the treatment process. This is due to the fact that CBT is rooted in the scientific method, psychological science in particular, and most of the research that has been done to prove it's efficacy has been done through measurement. This process of recording carries over into treatment, as CBT therapists believe that the only way to ensure that a treatment is working is by monitoring it. Various methods are used - questionnaires, tick lists and diary sheets for example. Childhood experiences Some clients who come for CBT are surprised that there is very little emphasis on childhood experiences - this is different to other forms of counselling and psychotherapy, especially the psychodynamic approach where childhood experiences are a key part of the therapy. Many problems that CBT is particularly effective at treating can be resolved without reference to the past - for example specific phobias, agoraphobia, social phobia, panic attacks, obsessive-compulsive disorder and generalised anxiety disorder. For some problems such as post-traumatic stress disorder (PTSD) it is necessary to address the specific traumatic memories, but even in this case it is usually not necessary to explore more general childhood experiences. Summary The above paragraphs have described some of the ways in which CBT differs from other therapies, including length of treatment, homework, goal/targets, directive style, measurement and lack of emphasis on the past. In other ways CBT shares much with other forms of psychotherapy. All therapies rely on a relationship of trust, respect and confidentiality between client and therapist. All therapies address feelings, thinking processes and behaviour. And all professional therapists are guided by codes of ethics which are designed to protect the welfare of the client.
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