Types of Therapy
What is Counselling?
Counselling is often referred to as a ‘talking therapy’. Counselling allows you to discuss your issues and difficult feelings in a safe, confidential environment. People often seek counselling when they have difficulties in their life that they would like to explore. By exploring and gaining a deeper understanding of your issues, counselling can help you to create change in your life.
A counsellor is not an advice giver and will not tell you what you ‘should’ do. A counsellor is skilled in being able to listen with empathy, offering challenge and guidance where appropriate to help you to explore your issues without judgment. A counsellor can facilitate Identification of the root causes of your difficulties, as well as helping to process difficult emotions that may be causing you pain.
How does counselling work?
If it is felt that counselling may be suitable for you, you will usually have sessions weekly to begin as consistency is important. This may be reviewed and decreased to fortnightly over time. Sessions last up to 50 minutes.
Counselling is generally unstructured and the approach may be slightly different for each client. There is often no set number of sessions advised at the outset of counselling, but usually a minimum of 6 sessions is advised. In most cases, less than this will not be enough adequately work through your issues. Counselling is a journey, and it can take time to work effectively.
Counselling works by offering a confidential space for you to explore how you relate to yourself and others. Often the therapeutic relationship that is developed with the counsellor is key to gaining these insights. It is through gaining these insights into your patterns of relating that can help you to have better relationships with others and yourself.
Counselling can help you understand yourself better and the way you think, which will ultimately help you develop a clearer understanding of the issues in your life. The more aware you become, the easier it can be to work your way through any difficulties you are facing so that eventually you have better coping strategies and more robust emotional resilience.
How is counselling different from CBT?
Counselling is much less structured that CBT and less directive. A counsellor will help you to explore your issues and to understand why you are the way you are, without trying to ‘fix’ anything. Counselling, whilst working predominantly on the ‘here and now’ may also explore the past and your childhood where appropriate to help you identify links between the past and your current ways of thinking and feeling.
Sessions will be mainly led by you, as counselling is about helping you to become autonomous and to arrive at your own conclusions and solutions, rather than being told what is best for you. Counselling unlike CBT is mainly based around talking and you will not be given any practical exercises or ‘homework’ to do between sessions.
What is counselling used to treat?
Counselling can be useful to explore a range of emotional issues and offers support with mental health issues. Some of these issues may include low self-esteem, sexual abuse, issues from childhood, periods of change (i.e. childbirth, redundancy), addictions, bereavement and loss, relationship issues, bullying, trauma, work related issues and stress.
Counselling can also help to alleviate the impact of mental illness (such as anxiety and depression) on different aspects of life, by offering space for the client to feel supported and less isolated.
What is CBT?
Cognitive Behavioural Therapy is an evidence-based psychological therapy that can help you manage your problems by changing the way you think and behave. CBT can help you to get a better understanding of your problems and what keeps them going, and then teaches you new skills and techniques for better managing and overcoming these difficulties.
CBT is based on the concept that our thoughts, feelings, physical sensations and behaviours are all connected. For example, our thoughts about a specific situation can affect how we feel emotionally and physically and how we behave. Sometimes our thoughts and behaviours can get into unhelpful patterns and we get caught in vicious cycles making us feel bad. CBT can help identify and change unhelpful patterns of thinking and behaviours to help improve how we feel.
How does CBT work?
If it is agreed that CBT will be suitable for you, you will usually have sessions once a week or every two weeks. A course of CBT can last from 4-20 sessions with each session lasting up to 50 minutes.
During the sessions, you will work with your therapist to break down your problems into situations or triggers, thoughts, feelings, physical sensations and behaviours. You and your therapist will then decide which areas to focus on and what changes you may need to make in order to help you feel better. Your therapist will teach you skills and techniques to apply and practise in your daily life.
It is hoped by the end of therapy you will have learnt to become your own therapist so you can practise your new CBT skills in order to better manage your difficulties or prevent them from returning.
CBT is not a quick fix miracle cure, it can be hard work. Your therapist is like a personal trainer that advises and encourages you – but they cannot ‘do’ it for you. To benefit from CBT, you need to commit yourself to the process and be prepared to be persistent, open and willing to give new things a try.
How is CBT different from other therapies?
CBT mostly focuses on the ‘here and now,’ your current day to day problems rather than issues and difficulties from the past. It is a practical therapy and in CBT you are expected to take an active role in your treatment. CBT isn’t just about talking, you may be asked to keep records or diaries, test out ideas, and apply new skills. For example, someone who is depressed may have stopped doing some of the activities they used to enjoy. The therapist and client may spend some time in the session identifying some easy activities the client may start doing again and plan when they will do these over the coming week.
In CBT, there is homework! But no long essays, don’t worry. A vital part of CBT is putting what you have learnt into practice between sessions. It has been shown that people who complete exercises between sessions benefit the most from CBT. You and your therapist will agree on a homework task for you to complete each session, for example keeping a diary or practising a new technique. Trying out these exercises and discussing the outcome with your therapist will be an important part of what happens in therapy.
CBT differs from other therapies in that sessions are structured. This helps to ensure that there is time to cover everything. At the beginning of each session you and your therapist will jointly decide on the main issues to work on. There will also be time to discuss the previous session and the homework that was set. At the end of the session, you will jointly plan homework to complete for the next session. In CBT it can also be helpful to make notes in the sessions to help you remember what you discussed and the techniques to practice.
What is CBT used to treat?
CBT has been shown to be effective for a range of difficulties including depression, anxiety, stress, panic disorder, phobias, obsessive compulsive disorder (OCD), social anxiety, post-traumatic stress disorder, sleep problems including insomnia and bulimia nervosa.
CBT is sometimes used to treat people with long-term physical health problems such as chronic pain, irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS). CBT cannot cure the physical symptoms of these conditions but can help people cope better with the symptoms.