To ask for your experiences of CBT please?(43 Posts)
I've been waiting 6 months for this CBT, had my first session today and I'm so underwhelmed it is annoying me.
I honestly thought this would be amazing for my anxiety and worrying etc, but all we did today was read two pages of a booklet I have read cover to cover numerous times and taught myself stuff on my own like they said to do whilst I wait,
We didn't touch on none of my past at all, or what my fears are etc it was just outlining what cbt was and doing the book I've already done? Does it get better than this in the next sessions?. Thank You x
I've done a course of CBT in a group session - how many sessions are you booked to have ? I'd give it a fair chance, today may have just been a kind of introduction.
Having said that - it's not for everyone, my son has had it one to one - and he found it very helpful. I found it less so, but there were some useful things that I still use to help me. Hopefully you'll get some new material to work on and talk about in future sessions that you might find more helpful.
I think what you say about not going into your past or your particular feasr etc. is pretty typical - it's not really about specific problems so much as how to deal with those fears and anxieties when they arise.
In general I'd say try to stick with it - you may find it useful and if you don't then it won;t have done you any harm. But if you really feel it is no use after a few sessions talk to your counsellor and say you don't think it is for you - they may be able to support you in getting something more appropriate for your needs.
It was great, we had some classroom stuff, then went out on the bikes for an hour.
I had CBT and it changed me as a person.
It isn't counselling so it won't discuss your past in any real detail, and if you try and steer sessions that way they will stop you.
From my experience it took a few sessions before it started becoming useful which makes sense; they dont know who you are or what your issue is until they see you a few times and establish a pattern from your questionnaires.
If after a few sessions you are still 'underwhelmed' then request a change.
Is this an NHS cbt thing? I’ve never found that useful, it’s too generic and every session we’d just go through a workbook, with information that I already knew. The exercises in the workbook didn’t really fit my situation but still it was never deviated from.
Having said that, cbt can be incredibly useful for some people, and is one of the most effective treatments. I just found the nhs workbook approach completely lacking.
My experience is shite, mediocre, shite, life changing.
It really helps to find the right person for you.
Did you tell the therapist you had already worked through that leaflet?
I agree with others, give it at least another two sessions then ask to be referred onwards if not improving.
The first session is often a form filling and fact finding exercise. I'm surprised you weren't filling in forms to rate your anxiety etc. Also looking at and agreeing goals? It's good to have an idea what form the therapy will take, but reading a booklet sounds a bit lame for a first session.
CBT is very much a here and now therapy, looking at what's happening for you today as regards your thoughts, feelings and behaviours. It's looking at your cognitions, your thoughts, and often specifically your automatic negative thoughts. It doesn't delve into your past, like for example a therapist working in the psychodynamic model. It can be touched upon, but it's not the focus of the therapy.
The focus is very much goal driven, the therapist is directive, immediate and challenging, and there should be homework for you to do outside of session. CBT is often used in the treatment of depression and anxiety, it's also good for phobias.
The NHS loves CBT because it's outcomes are very measurable, it can produce verifiable results quite quickly, and can get people back on their feet quicker than other therapies. It does require real engagement from the client.
The downsides are that although it can give you tools for life, it does not address the underlying issues that brought you to it in the first place. For this reason there can be quite a high relapse rate. Depending on your presenting issue and your financial circumstances, it can be great to have CBT to put you back on track, so to speak. But if you could then follow it up with some therapy where the therapist works integratively, ie using many modalities including person-centred, psychodynamic and CBT, that could be really helpful.
Do you know what your therapists qualifications are?
Did you tell them you have read the book from cover to cover and have been using some of the techniques already? They might assume that even though they send the booklet nobody really reads it until the sessions. If you explain you have already done a lot of ground work they might get straight into helping with any sticking points in applying the technique.
I agree with a PP though, it is more about applying the techniques than talking about your fears and your past. But if the latter is what you are after explain that too and they might be able to provide that support too.
My CBT didn’t really dwell on my past or how I started getting into those negative patterns, it was more about ‘ok you think like this when this happens, let’s try and help you break out of that pattern - or give you strategies to cope better’. It was very systematic -
why do you think this? Because Stuff.
What do you think will happen if this happens? This.
Ok, if This did happen. What is the worst that would happen?
I suppose That.
And would That be so bad?
I found it very useful, I hope your sessions get better.
Just done 6 weeks by telephone. Hardly any progress, severe depression and anxiety when I started and when I finished. A lot of time looking at the theory behind CBT and very little time doing anything that helped. Waiting for 1:1 high-intensity therapy which will be for between 10 and 16 weeks. I felt like the first lot of CBT would have been far more useful if we had a 1-hour session discussing why I was there to start with.
I found it hugely useful. I liked that it didn't require me to discuss or dissect my situation or past but was just a practical approach to improving my mental health and immediate state of mind. I had severe anxiety and stress related physical symptoms which completely disappeared over the 16 weeks. At the end of it I was in a better place to consider counselling, which I am more afraid of and haven't been brave enough to start. But I am generally more happy now anyway.
DH had it and it was amazing for him, for a while, then he let some of the techniques slip. It absolutely isn't counselling though - it won't touch on your past at all. It aims to give you tools to cope with your present. Once that's under control, counselling is what you need to 'fix' any underlying issues.
My DD had CBT and it worked brilliantly for her and as I was in the room, I learned lots about myself and have made very positive changes to my life as a result.
Mine was face to face and just me, not a group or telephone session.
I had it after a car accident and I was too scared to drive again.
I thought it was absolutely shit and I just ended up having some driving lessons with my old instructor.
I'm glad it was through the perpetrators insurance company because if I'd have paid for it myself, I would have been pretty pissed off.
That's interesting MabelBee because I was so baffled about why I got so unwell I feel like I really need some understanding of why so that I don't end up in the same place. Agoraphobia and now GAD with panic attacks are very proving hard to cope with.
Did nothing for me. I spent the first half of the session having a moan, the therapist didn't stop me, and the second half giving me homework. I stuck it for 4 sessions and gave up. Couldn't see the point of it.
They won’t talk about your past necessarily OP. Not in great detail as you would with a counsellor or a psychotherapist. It’s about giveing you the tools to create coping mechanisms for yourself going forward and chnaging the way you think and react. I found it takes a lot of practice and perseverance but when you’ve got the hang of it and you’re using the tools without much thought, it’s life changing. I found it much easier to be open to it whilst taking medication too.
Thanks everyone so mixed reviews then? I wasn't expecting a miracle approach as such but I think maybe I was? I just didn't expect to do the same stuff I've already learnt my anxiety is improving by the stuff I'm doing already and changes I have made, I just thought it would be so good but I'm just shocked it's quite crap I think because I've waited so long for it and been pining for it now it's here it's like Meh.
even when the therapist was talking to me about the booklet and I told her stuff I knew she didn't seem all that fussed I'd done all this stuff, I don't know will give it another go next week and see.
TBH, having had an anxiety disorder for years, I finally did a course of CBT.
It had some small use in helping me break down the reason for some of my anxiety and 'unhelpful' thinking processes.... but, it didnt teach me anything about anxiety or how it works, it didnt teach me anything about how to handle it.
The biggest failure though? When she tried to make me unpick some very deeply ingrained issues I have around self esteem.. she didnt seem to understand that just asking me to 'write down why that belief about yourself might not be true' wouldn't work as much of my anxiety centers around how people perceive me and years of being made to feel lazy, useless and not good enough.
I KNOW its not true, I can tell you all the reasons its not true.. but believing them? Thats the issue.
So I stopped going. I clearly need more indepth therapy to pick apart that side of my anxiety.
When I had Cbt it didn’t focus on the past or things that had made me stressed (reason for cbt) but instead on how to deal with the feeling around stressed and how to manage it. I would say two main things for me:
1) you have to 100% committed to it. Practise every day and go back to practice when you think you’ve cracked it!
2) don’t expect it to be a magic fix. Either over night or right for you. Cbt doesn’t work over night (see point number 1!) it also isn’t right for everyone but before you sack it off you need to give it a good go just incase it is right for you.
Wishing you lots of luck with with it!
I found it difficult and challenging. But it's one of the best things I've ever done. I had one to one with the therapist. It has really helped my anxiety and c-ptsd. It gave me the tools to do cbt independently. I would recommend it to anyone who is looking for better mental health.
*but it didnt teach me anything about anxiety, or how it works, that I didnt already know from my own research and coping with it over the last 20 years.
I was convinced it wouldn't help me.
I can't stress just how much of a waste of time I thought it'd be. I met my CBT therapist and I really disliked her. Thought great, a shit therapist with a shit therapy.
But I knew something had to change; my symptoms were getting severe.
Week 1 was shit. Week 2 was awful. Week 3 I didn't want to go back. Week 4 I wanted to slap the therapist for being so obvious and patronising. Week 5 I was exhausted
then week 6, something clicked. I'd been doing all the 'stupid' homework, wholeheartedly, even though I 'knew' it wouldn't work.
In isolation the homework part (writing down each episode of panic, listing my anxieties, getting into the details of my thoughts) didn't help. BUT accumulatively I could see patterns. I was so happy to finally understand the bewildering negativity.
Patterns I was stuck in. Patterns of thought I could understand, and then begin to unpick and challenge.
Essentially, CBT will help if you put the effort in. The more self aware and honest you are about your thoughts and behaviour, the more likely it is to help.
It's not a cure-all, but I'm amazed how I'm improving, for my two cents' worth.
My experience of CBT was hard work but life-changing. And you have to practice it or you slip back into bad habits.
It isn't really about your past, although bits might come up, it is much more focussed on the here and now and how you might have negative thoughts and emotions completely unnecessarily.
I discovered I had a more or less constant running commentary of negative self-talk. While I have done some other counselling work about my past and why that might be, just discovering I was constantly telling myself I was shit was a bit of a light bulb and didn't really need deep analysis - I could then check-in on myself and stop it
Even doing on-line sessions I find helpful when I'm slipping a bit.
It wasn’t for me, sadly (had 3 goes at it!).
My problem with it, mainly, was that even if the rationalisation you do makes sense on paper, what do you do when you really can’t believe/feel it? I’ve recently started compassion based therapy with an NHS clinical psychologist and she has spoken to me about how this therapy is not just about what you know/think but how you actually feel and why you might be feeling that way, and I think this sounds much better for me.
I'm so disappointed for you OP. Like you say, you've waited so long and you deserve a good therapist - everybody does.
Can I make some suggestions? Ask her if she's going to assess your mood and anxiety levels, is she going to assess your GAD scores? These are done at the outset to record outcomes, demonstrate any progress or change. It's bog standard.
Ask her if you can discuss what goals you might agree to work towards. Are you going to do any type of exposure work? This is where you practically tackle a situation, very gently, for example a fear of heights, being in crowds, driving. There is work that can be done in session and outside in relation to this.
Ask her if you're going to be keeping thought records between sessions. This would be advised if you're doing exposure work outside of session, to track your thought's, feelings and beliefs.
This is deeply practical therapy. She should be filling in assessment forms, then more forms each week to assess progress. You should be talking about goals, homework, keeping thought records. I really hope this all kicks in at the next session. If it doesn't - complain. She's either qualified so getting paid in which case she's not very good at her job. Or she's a trainee, in which case she doesn't have enough experience or skills to be in placement and her supervisor and manager need to know this.
If it was clear you'd read and understood the booklet it's so bad that's all the first session was about. If this is NHS therapy you usually get about 6-12 sessions - 12 is unusual. So she really needs to crack on. That bloody booklet has made me feel annoyed!
@nicenewdusters that's actually a good point she never mentioned my scores, didn't actually tell me if I had anxiety or general anxiety didn't mention none of this to me at all, feel like quite a lot was missing and when I was speaking to her about how my anxiety presents and what triggers etc she stopped me and said we're not talking about this now but I don't know if that's normal, she even asked me at the end if it's ok to interrupt if I'm talking as it's so time limited to 30 minutes.
OP, I have to say that all sounds pretty awful.
A therapeutic hour, as it's called, is 50 minutes. I've never heard of a session only lasting 30 minutes from start to finish.
As for interrupting you. Part of the therapist's skill is to pace the session. This includes preparing for the end, so that the client can leave "zipped up", ie ready to resume their day to day life after what is usually quite a full on experience. If she is asking whether she can interrupt you that's not good.
When you spoke about how your anxiety presents and the triggers, to say we're not talking about that now. Well, that's just plain awful. Despite CBT not being overly concerned with exploring past trauma etc in detail, the therapist should still be seeking to build the therapeutic relationship. It's a collaborative, collegiate approach. To cut you down like that, at the beginning, especially when you were talking about what will be the core issues is really bad. I wonder when she was planning on exploring those issues with you?!
Although it's getting better, counselling is quite poorly regulated, and training standards differ widely. I think you'd be well advised to go in next week with a list of questions you want to ask. Show her you're well informed, ready to engage, and that you want to start the work. If there's no improvement, go over her head and say you'd like to be referred to a more experienced therapist, as this one seems unable to meet your needs.
Her supervisor will start to see a pattern of DNA, "did not attend", after a while, and action should be taken. But in the meantime people like you will be badly let down just when you most need support.
@nicenewdusters thank you for that i didn't even think it was rude at the time because she spoke so softly to me, but now thinking back I just didn't get nothing out of the session I think i was waiting for that wow amazing clock moment to explain why I do feel anxious?
Even when I said is there hope of this ever going will I always have anxiety she said some people have gotten over it but are you reassurance seeking and In our next session I won't be giving you the reassurance, however I was asking because I genuinely wanted to know if it's possible to become anxiety free etc X
Please wait and try it.
Cbt is 8-16 weeks course and if you have one to one she/he will drill down and help you challenge and change thinking and reactions. As that is what CBT is. It can be immensity powerful.
I used to do this as a student psychologist after my degrees but before PhD . Ask who is helping you (student clin psychologist or qualified clinical psychologist? )
I decided after that, despite knowing how powerful it was, that a masters in a related career/field was more for me. I still use cbt but more sparingly as it is not for everyone.
It is quite powerful though when used by an experienced practitioner and it takes at least 4 sessions to get down to deeper issues IME. So please don't give up after first session. X
I 100% won't give up just annoyed atm,
But I've realised also I seem to get so anxious at weekends I'm not entirely sure why but it's something I've learnt today I guess lol.
16-18 week course? I was told i'd get 5 session on the NHS.
There are different levels of CBT input and different levels of qualification of the practitioner. A qualified clinical psychologist (takes years of study and experience to gain that title) delivering 16 or more sessions of flexible CBT integrated perhaps with other models, will give you a more in depth approach and also pay attention to early life and core beliefs formed in childhood. A PWP (kind of entry level graduate role with minimal experience) delivering 6 sessions in an IAPt service will only offer a mnaualised, surface, strategies, here and now intervention - which might very helpful for some and especially for mild probs, but it does feel like you would find that sufficient.
Ofgh , I can only talk about about what was offered 25 years ago when I was in that field. Clinically at that time CBT was offered for 8-16 sessions at that point for serious individual issues. It was a clinical optimum but may have changed through research since.
Lower level issues at that time, got me or my colleagues, as assistant clin psychs for one of the many "3 session group courses" we ran.
I just had 10 weeks and it was life changing after suffering with anxiety and phobias for 20 years.
Weeks 1-2 we spent looking at negative thought patterns. They helped me to see what negative behaviour patterns I followed. End of each week we had homework set. It was in this week that I learned how badly I spoke to myself. I started to live by the mantra of “I would never speak to someone else this badly so why myself” this was a small step of thinking on a more conscious level and not letting my thought rule me.
Weeks 3-4 we spent looking at the patterns which lead to negatives behaviours and discussing ways in which I could break the habits. Seeing it on a board in a circle really helped me understand how something had to give
Weeks 5-6 we delved deeper into bringing the emotional response and the rational response to an even level. I had been feeling rather anxious throughout the week as I had just taken a huge step towards my career. My therapist asked me if it was anxiety or excitement as they both give the same physical feeling. I realised that I had always attempted to suppres any feelings of emotions that gave me that sensation and couldn’t remember the last time that I truly allowed myself to get excited. I realised that
Anxiety was inevitable but in a good way when not linked to negative thoughts.
Week 7-8 we went into core beliefs more. These are the beliefs that you have from a young age that can’t be changed and usually determine how we act and think. We then rationally challenged them.
Weeks 9-10 I was ready to wrap up. ( CBT should Be very client led) and so we went over the weeks and look at prevention methods.
What I learned was that the way that I speak to myself is first and foremost the most important change
That CBT has not magically made my phobias and anxiety disappear BUT I feel like I can rationalise them now.
I understand myself more as a person and therefore have an understanding of my thoughts. I accept myself more.
That everyone fights their own battle. My anxiety got out of hand a few years ago when I had some family problems
And couldn’t understand why some people were acting the way they were. I interpreted this to mean that I was unlovable and of course I would pull apart everything I had ever done in my life to back up this assumption. It’s helped me to understand others and has improved my relationship with them. The way they act is to do with them and is not a reflection on me.
I hope I have explained how helpful it is when they work this way. I don’t think I would have got the same out of it if they had handed me a booklet to go through.
To go by my own experiences, it worked incredibly well. However, that was with a private therapist who specialised in trauma, and with whom I got on well.
I have heard very mixed things about NHS CBT - some people I know have gained a lot from it, others have felt that it wasn't being done properly.
I'd stick with it and see how it pans out. I was very sceptical of the whole thing at first - I genuinely didn't see how 'reprogramming my brain' could change how I felt - but it literally changed my life. If it doesn't work, can you afford to go private?
CBT helped me overcome PTSD after about 12 sessions it helped me come 'back down to earth' when having a flashback and helped me realise that it was a flashback and wasn't real.
I found it really helpful, we re lived the situation and filed away the files in my brain that had caused the PTSD and as my counsellor explained it got worse before it got better the worst time was between sessions 3-5 but gradually got better and now rarely have flashbacks.
CBT really helped my situation, I would stick at it for the full course and hopefully will help you also.
I had it and didn't find it that much help. The therapist was great but quickly acknowledged that CBT wouldn't help me and referred me upwards. He described it as a sticking plaster that for some people would allow a wound to heal but not all things heal on their own and for those things CBT is inadequate.
CBT gives you coping strategies. If you want to address your childhood first that's more 'therapy' based. I've had both. The talking therapy helped me realise the NPD mother annihilated my self esteem & caused my depression. The CBT helped me with strategies to cope wirh a) my catastrophising every normal life up & down & b) my destructive negative thinking (which is so automatic & bloody destructive).
Hiya everyone had my second session today glad I stuck it out was really good, she said she's very happy with my progress and I feel more content and like I know what I'm doing now thanks everyone for the support x
I’ve had mixed experiences. The first time I had it it was very much like you describe, I persevered but the therapist just kept giving me handouts about fight of flight responses and telling me stuff I already knew even after I told him I already knew. It wasn’t very useful at all.
A couple of years later I self referred through my local mental health services and CBT was recommended and I was very reluctant and told them why I felt it wouldn’t help. The therapist told me that she didn’t think what I’d had previously was ‘proper’ CBT and referred me anyway.
My current therapist is awesome and I have really found it useful. She’s helping me to figure out why I always put the needs and feelings of others before my own and how this has led me to have a series of disasterous relationships and blame myself for my DS’s anxiety issues. Unfortunately I can only have 16 sessions on the NHS but we spaced them out to last longer, she got me on a mindfulness course and has now referred me to the psychotherapy service for ongoing help
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