COGNITIVE BEHAVIOURAL PSYCHOTHERAPY IRELAND (CBTI)
The philosophy underpinning this approach is that a person learns to act and think in certain ways as a result of their lifetime experiences and how they perceive those experiences. This learning is a life-long process.
Usually what we learn is adaptive and functional – we learn to become active participants in our lives, our society and our culture. However, occasionally we learn ways of thinking, feeling or behaving which hinder us in our development and prevent us from achieving our potential.
Sometimes a single event such as being bitten by a dog, or a car crash, will have major repercussions or, more often, experiences which stretch over a longer period of time, e.g. being bullied or being unemployed, can affect us emotionally in the long term. Such negative experiences and our responses to them can lead us to develop low self-esteem, unhappiness, bitterness, anxiety, passivity, aggression, perfectionism and so on. These, in turn, colour the way we perceive new experiences and at worst, if unchecked, can lead to such disorders as anxiety, clinical depression, eating disorders, obsessive-compulsive disorder and panic disorder.
Clients seek help for a variety of reasons. Clients experiencing stress and anxiety with marked avoidance behaviour (i.e. behaviour that postpones an anxiety evoking event and can lead to handicaps in every day life), can change their way of behaving by becoming more outgoing and combat their fears with the help of individualised tailored cognitive behaviour therapy programme.
They may have to confront repeatedly what they fear, e.g. contamination fear where the sufferer avoids certain perceived contaminated objects, progressing from the least feared object to the most feared. Motivation to complete homework assignments is a key to success and recording their progress between sessions, facilitates the carry-over into their daily lives of the skills and insights achieved by the client during therapy.
This intervention and the willingness to explore new coping strategies are the ingredients for success.
Cognitive behaviour therapists also work with clients who have an intellectual disability. Each individual has the same rights and needs as everyone else in society. In the process they are helped to play a full part in society by extra teaching for the individual through a process of behaviour analysis. Sometimes problems can be compounded by physical disabilities, behavioural problems or communication deficits.
Within particular contexts treatment methods are used consistently, by all of those involved with the client, including the carer of the client. Carers may also have their own needs on a practical and emotional level that need addressing. This approach examines people’s behaviours in their living environment. It identifies the function of challenging behaviours, identifies how it benefits the individual, the source of the behaviour and what maintains it.
Cognitive behaviour therapists postulate that people can achieve change by working directly on their own patterns of thinking and behaviour. Due to negative lifetime experiences many individuals have learned distorted patterns of thought (patterns which hinder rather than help), so in therapy they need to learn more helpful and functional thought patterns.
How we think impacts on every aspect of our lives, from hopefulness regarding the future, to personal relationships, to how we see ourselves today. The emphasis in therapy is to loosen the hold a particular negative belief has on the client and engaging them in a re-evaluation of their perceptions and assumptions.
The progress of the therapy is interactive. The client and therapist work together developing hypotheses about the accuracy and or coping value of a variety of thoughts and behaviour. They often work together developing a healthier style of thinking, building coping skills, and reversing unproductive patterns of behaviour. Cognitive behaviour therapists are typically more active than those who practice other forms of therapy. They help structure sessions; give feedback, and coach clients on how to use CBT methods.
People who experience interpersonal difficulties can benefit from group work and some CBT therapist run:
- Anger management groups
- Assertiveness groups
- OCD groups
- Stress management
- Social skills training
Assessment is individualised for each client. It involves detailed questioning and the use of psychological questionnaires to enable the client and therapist define accurately the problem and set the goals of treatment. It focuses on the here and now, and is practical and pragmatic. The aim of therapy is to provide the client with the knowledge and techniques, which he/she can use now and in the future, and in effect, making the therapist redundant. Each client is given a detailed account of treatment options and their consent is sought before embarking on therapy. Registered practitioners adhere to a code of ethics and are committed to research and the development of theory within this sphere.
Overall, practitioners use the developing pool of knowledge in this field to resolve problems of living for any person, irrespective of intelligence or insight.
Gerry Butcher, Chair
The Capel Building