What is Cognitive Behavioural Therapy (CBT)

We’ve written extensively on the impacts of stress, anxiety, depression and other mental health conditions to the workplace.

Not only does it affect the productivity and morale of your staff, but it also contributes to reducing your organisation’s retention rates, as well as increasing absenteeism.

In 2017/2018 the Health and Safety Executive (HSE) put the number of working days lost due to work-related stress, depression and anxiety at just over 15.4 million.

To support employees experiencing issues with their mental health, most employers now provide employee assistance programmes (EAP) that include Cognitive Behavioural Therapy (CBT) counselling.

It’s one of the more common forms of therapy and has been proven to help with a variety of mental health problems including anxiety, stress, mood disorders and depression.

In this article, as well as a definition of CBT counselling, we’ll highlight how it works, and how long it takes. The piece will also focus on its importance and benefits as a tool for supporting your workforce.

What is cognitive behavioural therapy?

It’s a form of talk therapy that combines cognitive therapy (your thoughts) with behaviour therapy (your actions) to address various mental health conditions.

It focuses on how an individual’s thought, beliefs and attitudes affect their feelings and behaviour. CBT uses communication as a tool for coping with different problems.

As well as helping to identify the emotions an individual may be experiencing at any given time, it also offers practical advice to help reduce negative feelings whenever they arise.

Within the work environment, employees and therapists can work together to identify and change negative thought patterns and behaviours. With an EAP, you can offer your staff access to face-to-face sessions and computer-based or online therapy packages.

Evidence suggests that it can be highly effective over short periods. So, this form of therapy is often used as a first step for employees dealing with stress, anxiety, depression and other similar mental health disorders.

It’s also worth knowing the difference between cognitive therapy and CBT as they’re often used interchangeably. Cognitive behavioural therapy is the umbrella term used to describe a group of talking therapies that share similar elements.

Cognitive therapy, on the other hand, is a specific form of therapy based on the model that the way individuals perceive situations influences the way they think, feel and behave.

There’re also differences between CBT and counselling. Both are forms of talking therapies used to support individuals dealing with a variety of mental health problems.

However, CBT works together with clients to identify and change their negative patterns of behaviour and thinking. Counselling helps by listening, empathising and encouraging clients to better understand themselves and to come up with their solutions to issues they face.

How does CBT work?

It’s based on the idea that problems are interconnected and broken down into five main areas. They are:

1. Thoughts
2. Physical sensations
3. Situations
4. Actions
5. Emotions

Mental health professionals believe that altering negative patterns of thinking and behaviour contribute to easing the symptoms of stress, anxiety and depression. They also believe altering negative beliefs that trigger these patterns of thinking can lead to CBT having long-lasting effects.

CBT counselling aims to examine an individual’s cognitive beliefs to help them identify the reasoning behind negative thoughts and behaviours they’re most likely to have. Effective counselling would also help to develop reasonable reactions to negative beliefs and thoughts.

But how does cognitive behavioural therapy work? It identifies practical ways individuals can improve their state of mind on a daily basis. Therapists do this by talking through issues to break them down into one of the five areas highlighted above.

Working together with the therapist, sufferers will learn how to change unhelpful thoughts and behaviours and apply them to aspects of their daily life.

What is CBT used for?

Apart from stress, anxiety and depression, regular and effective CBT counselling sessions can also treat a variety of mental health conditions, including:

• Insomnia
• Panic disorders
• Obsessive-compulsive disorder
• Menopause
• Phobias
• Schizophrenia
• Addiction
• Post-traumatic stress disorder (PTSD)

When considering anxiety counselling, treatment focuses on how sufferers can control the negative thoughts and emotions they have. The aim of Cognitive behavioural therapy for anxiety is for individuals to reach a point where they’re able to control or reduce the cycle of damaging thoughts and actions.  

Using cognitive therapy for depression provides sufferers with a medical tool kit to challenge negative thoughts. An effective CBT treatment can change the way a depressed individual sees the world.

But when is CBT used? It’s only natural to feel stress or anxiety about aspects of life including work and personal problems. However, when these feelings start to affect your ability to carry out regular day to day tasks, that’s where CBT comes in.

It’s used to help employees address overwhelming or upsetting issues more positively. And unlike other forms of therapy, it doesn’t focus on past issues, instead, it deals with current problems by offering short-term solutions.

It's worth noting at this point, while CBT can contribute to helping individuals cope with the symptoms of various mental health conditions, it shouldn’t be construed as a means of curing them.

How to get CBT

Just like other forms of talking therapies, you do not need a referral from a GP to seek CBT treatment. The NHS allows for self-referrals directly to psychological therapies services. There are also options for private counselling. Although it can be more expensive, it does offer more flexibility and range.

For employers that invest in employee assistance programmes, you’ll find that depending on the service package there might be a provision for CBT counselling.

The benefits of CBT

As well as helping to improve awareness and reducing the stigma that is attached to ill mental health, other benefits of CBT include:

• Stronger relationships between employees
• Offers strategies that can be implemented even after treatment has ended
• Better self-understanding, which leads to increased confidence and productivity
• A relatively short completion period compared to other forms of talking therapy
• Reduced work-related illness absences, including cases of anxiety, stress and depression
• CBT sessions can take various formats, including individual or group sessions, self-help books and apps

How much is CBT?

As we mentioned above, the NHS provides free options for psychological therapies to eligible individuals. There’re also other charity organisations (such as Mind, Relate and Curse) that offer talking therapies for free – or for a small fee.

The cost for private counselling sessions can vary depending on the location. It can cost anything from £10 a session to £70 a session.

Alternatively, with the right EAP package, you can have access to this service as well as others for one flat fee. The cost of your EAP will depend on the number of employees you have as well as the type of EAP package you choose.

How long does a CBT last?

While the duration varies, the NHS suggests an average course of treatment lasts between 30- to 60 minutes once or twice a week.

During this period, sufferers will discuss and breakdown issues they’re having into the five areas highlighted above (emotion, action, thought, situation and physical sensation). They’ll define the effects and explore options to help change unhelpful or unrealistic behaviours.

Again, the number of sessions will depend on the issues the individual is experiencing and the level of support they’re receiving. Generally, this course of treatment lasts anything from five to twenty sessions.

CBT techniques

While there are many CBT approaches to treatment for mental health conditions, the most popular of them take a hands-on approach to problem-solving.

Because there’s no one-size-fits-all approach, cognitive behavioural therapy techniques will depend on the sufferer as well as the circumstances surrounding their situation.

Some of the more popular techniques include:

• Exposure therapy – helps to confront fears and phobias
• Cognitive restructuring – examining the thought process to highlight negative thought patterns
• Role-playing – explores different scenarios to lessen fear and increase confidence
• Guided discovery – encourages individuals to view things from other perspectives
• Journaling – a tried and tested way to document both negative and positive thought patterns
• Mindfulness – non-judgmental focus on the present experience
• Interoceptive exposure – ideal for treating anxiety and panic attacks, it exposes suffers to feared bodily senses to prompt a response

Those that want to minimise or completely avoid contact with a therapist can also consider assessing CBT online. There are various tools available online to help individuals benefit from CBT without having to meet a therapist in-person.

The NHS offers a selection of tools in its app library. You can filter these apps by categories or price, if you filter by category, you’ll be able to see all available online CBT therapy applications.

Expert support

CBT is a wide and complicated topic and is understandable a minefield to navigate. So, for more information and additional guidance please contact Health Assured on 0844 892 2493.