This document discusses Cognitive Behavioral Therapy (CBT) and how to maximize its effectiveness. CBT aims to address beliefs, thoughts, emotions, and behaviors by challenging interpretations and assumptions. It involves assessment, formulation, identifying maladaptive behaviors and beliefs, behavioral experiments, homework, and relapse prevention. To benefit fully from CBT requires openness, curiosity, a willingness to try experiments, honesty about difficulties, feedback, identifying obstacles, flexibility, and taking responsibility for the therapy process through homework and goal-setting.

1. Making CBT work
Satwant Singh
Nurse Consultant in CBT & MH

2. Aims for today
 Understanding
 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

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

4. Change
Individual work- what does change mean to you and
what does it involve?

5. CBT
Cognitive 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

6. CBT
It 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

7. 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

8. Maximising your
engagement
 Be 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

9. Working with your therapist
 Your 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

10. Identifying difficulties and
finding solutions
 Therapy 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

11. Role of homework
 Crucial 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

12. 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

13. 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

14. 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

15. Conclusion
 Your 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