What is cognitive behavioural therapy and how does it work?

Dr Aaron Beck, who was dubbed the father of cognitive behavioural therapy (CBT), has died at the age of 100.

The American psychiatrist’s work is considered highly influential. His daughter, Dr Judith S. Beck, described him as having “transformed the field of mental health” in a statement from the Beck Institute for Cognitive Behaviour Therapy, which Dr Beck and his daughter co-founded.

CBT is provided by the NHS for many mental health problems and is a recommended treatment by the National Institute for Health and Care Excellence (NICE) for anxiety disorders, depression and eating disorders among others.

But what is it and how does it help?

CBT is a type of talking therapy that focuses on changing the way a person thinks and behaves in order to deal with their problems.

According to the British Association for Behavioural and Cognitive Psychotherapies (BABCP), CBT is based on the idea that all thoughts, feelings, what we do, and how our bodies feel, are connected.

“If we change one of these we can alter the others,” says the BABCP.

Dr Beck developed the field of CBT after finding that his depressed patients frequently experienced distorted negative ideas. He discovered that patients who learn to recognise their negative thoughts, which he called “automatic thoughts”, could learn to overcome them and reduce their feelings of anxiety.

The therapy sessions are collaborative, with an individual working together with a CBT therapist on mutually agreed goals.

CBT is recommended in NICE guidelines for a number of different problems, including:

People who undergo CBT can go to individual sessions with a therapist or as part of a group, and the number of sessions needed depends on the difficulty of each person’s problem or condition.

Together, each person will set goals for with the therapist after talking things through and setting agendas for each therapy session, according to the BABCP.

People may also be given “homework assignments” to help them practice turning around self-disparaging thoughts in everyday life. Dr Beck found that the results lasted long after the therapy sessions finished as patients learned to confront their negative thoughts on their own.

CBT is available in different settings, including in schools, GP surgeries, specialist clinics and hospitals. It is also available online, over the phone or via video, as well as face-to-face appointments, which makes it more accessible.

CBT is widely available on the NHS. You can refer yourself directly to an NHS psychological therapies service without a referral from a GP, or your GP can refer you if you prefer.

Private therapists are also available, but the cost varies between £40 to £100 per session. The BABCP keeps a register of all accredited therapists in the UK.