What is Cognitive Behaviour Therapy?
Cognitive behaviour therapy (CBT) is a form of psychological therapy that helps you to recognise unhelpful thinking or negative thought patterns.
It looks at how your thoughts influence your feelings and behaviours and how this can become a vicious cycle of negative thinking.
CBT is delivered for only a short term, with between 12-20 sessions per treatment. There is a homework element to CBT, where you will put into practice what has been discussed in your therapy session. There is a lot of learning gained from your homework, so it will be an expectation for you to carry it out to meet your goals.
CBT for Generalised Anxiety Disorder
The Cognitive and Behavioural Approach to Generalised Anxiety Disorder or also known as GAD, looks at how influential your thoughts are on your feelings and behaviours. Worries can come in different forms and types, and a big part of CBT is having awareness of your worry and what the primary role of your worry means to you. Your treatment plan may include psychoeducation about worry and anxiety; problem solving training, building tolerance to uncertainty; reducing cognitive avoidance and restructuring; imaginal and behaviour exposure; exploration of your beliefs about worry and how useful it is; mindfulness and relaxation and relapse prevention plan to maintain your changes. Group therapy is the bringing together of a small group of people with similar issues, who can support each other and work together on their problems. This is beneficial as it can give you different perspectives and help to widen your cognitive flexibility.
Types of worries:
Problem worries
Problem worries: are often about a current situation that you can do something about. For example this can include things like’ “I don’t have enough time to complete my work”, ”I have a toothache” or “I need to book leave for my holiday”. It is quite normal when we are feeling anxious or overwhelmed not to act on our worries and to start putting things off. However, this often leads to our worries piling up and we can become overwhelmed and then being stuck in a vicious cycle.
Hypothetical worries
Hypothetical worries are often about the future and what might happen. These worries are about things that we do not currently have control over and therefore cannot do anything about. Hypothetical worries often come in the form of a “what if”, for example: “What if my car breaks down?”; “What if the train is late?” or “What if my dad gets lost on the way home?”. These worries are essentially a form of scenario building, but they can be very overwhelming and can lead us to worrying about worry.
CBT Therapy Sessions and Fees
Terms & Conditions
I operate a 24 hour cancellation policy, to give me enough notice to offer the session to another person in need.
Should sessions not be attended or cancelled within the 24 hour notice period, then the session will be chargeable.
I currently do not accept referrals on insurance.
If reports, or letters regarding treatment are required for third parties, please contact to discuss requirements and the additional charge.
Saturday appointments are available on request, however these will have an additional £10 charge.
Assessment
CBT Assessment & Formulation
90 minutes - £85
Prior to meeting on Zoom or Teams for your CBT Assessment, we will carry out a brief consultation via text or email. Your Assessment will be your first session, where we will develop a formulation of your problem and how it fits in with CBT. We will also discuss your goals and expectations of therapy. This first session is an assessment session, where no treatment will be given. This will give you the opportunity to discuss the difficulties you are facing at the moment, for us to develop a formulation around your thoughts, feelings, and behaviours in a CBT approach. We can also discuss some goals that you would like to achieve for the duration of your treatment, this enables the treatment to be structured, tailored to your goals and also time limited.
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What is Generalised Anxiety Disorder?The process of worry can be debilitating. It has been known that most people who suffer from Worry or GAD lead a poorer quality of life, and much of this has to do with their tendency to live ‘in the future’. This can prevent living in the here and now, and having the ability to enjoy things without constantly thinking about what will happen next. Research has shown that people who experience GAD, tend to have thoughts that are in the form of “What if…?” Some examples of this can include: “What if my child drowns at his swimming lesson?” “What if I miss my deadline at work?” “What if I am late for my dentist appointment tomorrow?” According to Diagnostic and Statistic Manual of mental disorders (American Psychiatric Association; 1994), the characteristics and clinical presentation of GAD include excessive anxiety and worry for at least 6 months about a number of events, which are difficult to stop or control. Symptoms The main symptoms that accompany the anxiety and worry are fatigue, restlessness, difficulty concentrating, feeling irritable, experiencing muscle tension and sleep difficulties. These symptoms and feelings of anxiety and worry cause significant distress which impacts on social, occupational and other areas of functioning. Typically, we all have daily things that we worry about. GAD is about excessively worrying, where you find yourself building scenarios in your mind, taking everything that is uncertain in your life and trying to think of every possible eventuality to prevent surprises or to be prepared. Worry chains GAD sufferers may have ‘worry chains’, where one worry can lead to other worries with a negative outcome. Here is an example of a worry chain. ‘What if I miss my deadline at work? What if my boss fires me? I won’t find another job and I won’t be able to pay my bills…. How would I pay my mortgage? I will lose my house… then I'll be homeless.’
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What's the 'Worry Chain' and how can the Cognitive Therapy approach help?Here are some examples: You're given a big project to work on and think, “What if I miss my deadline for the project” – They will think I am incompetent – I will get sacked – I won’t be able to pay my mortgage – I will become homeless and destitute and my children will have to go into foster care. The impact of worry also comes in the form of fear and anxiety. We can pick up positive and negative beliefs about worry, such as “If I worry, it shows I care” (positive), or “I can’t control my worrying, and I fear that it will be dangerous for my mental health” (negative). We can also worry about worrying! The result of this process leads to exhaustion and burnout. The cognitive approach that I use for GAD will look at four main features: intolerance of uncertainty, positive and negative beliefs of your worrying, negative problem orientation cognitive avoidance.
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What is group therapy?Group therapy is a form of intervention involving a small group (up to 6 people). It can help you feel less isolated, better understood and also gives you the opportunity to learn from others in the group who experience similar problems. Group Therapy can be taken on its own or blended in with individual sessions. It can also be cost effective to do group therapy instead of paying for individual sessions. The group programme that I deliver consists of 10 sessions and follows a 'metacognitive' approach which helps to break down the maintenance of GAD. The programme involves reducing avoidance, behaviour and thought changes to beliefs about worry, problem solving, intolerance of uncertainty, managing moods, relaxation and relapse prevention.
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How can you diagnose GAD/Worry?Diagnostic Summary for GAD/worry: Excessive anxiety and worry (apprehensive expectations), occurring more days than not for a period of at least six months, about a number of events and activities. The person finds it difficult to control the worry. The anxiety and worry are associated with three (or more) of the following six symptoms: Restlessness (or feeling keyed up or on edge) Being easily fatigued Difficulty concentration or mind going blank Irritability Muscle tension Disturbed sleep The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupation or other important areas of functioning. Adapted from APA, 2013.
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What if I already have a diagnosis for another mood disorder, such as depression?At your first appointment, a full and comprehensive assessment will be completed which will include your mental health history. It is important that we assess which problem is the most severe and what will improve overall functioning. It is common that GAD can coexist with other disorders, so it is important that the most severe problem is treated first. Following your assessment, we can discuss the best course of action to get you the relief you need.
Get in touch
Contact me by email or send me a message via the enquiry form to arrange a free consultation!