Cognitive Behavioral Therapy (CBT)

What is CBT? (Royal College of Psychiatrist Mental Health Information)

It is way of talking about;

  • How you think about yourself, the world and other people.
  • How and what you do affect your thoughts and feelings.

CBT can help you to change you think (“cognitive”) and what you do (“Behaviour”). These changes can help you feel better. Unlike some of the other talking treatment, it focuses on the “Here and Now” problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

It has been found to be helpful in;

  • Anxiety
  • Depression
  • Panic
  • Agoraphobia and other phobias
  • Social phobia
  • Antisocial behaviour
  • Suicidal and self harming ideations
  • Drug addiction
  • Bulimia
  • Obsessive compulsive disorder
  • Post traumatic stress disorder
  • Schizophrenia

 

How does CBT works?

CBT helps you to make sense of overwhelming problem by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These pars are;

(STEP- A) S, Stands for situation, T, stands for thought, E, stands for emotional changes, P, stands for physical changes and a stands for action taken,

STAR (Situation, task, action taken and result) because;

  • A Situation- a problem, event or difficult situation, from this can follow,
  • Thoughts
  • Emotions
  • Physical feelings
  • Action

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It cal also alter what you do about it.

An example

There are helpful and unhelpful ways of reacting to more situations, depending on how you think about the, because;

“We are what we think, the way we think (in a helpful or unhelpful way) and act”.

Situation; you have had a very bad day, feel fed up so go out shopping. As you walk down the road, someone you know walks by, and apparently, ignore you, as a result.

 

(Unhelpful ways)                                                (Helpful ways)

Thoughts                       He/she ignored me-                                He/she looks a bit

They don’t like me   –                       wrapped up in them

I wonder if something wrong

 

 

Emotional feelings;                  low, sad and rejected                   concerned for other person

 

 

 

Physical feelings;                stomach cramps, feel sick                None- feel comfortable

 

Action;                       go home and avoid them             Make insure other person is ok

The same situation had led to two very different results, depending on how you thought about the situation. How you think has affected how you felt and what you did. Because;

“We are what we think, the way we think, feel and act. Let’s think well, feel well, heal well as well as deal well” (Dr Najeeb)

Think thrice before you jump to conclusion.

In the example in the left hand columns, you’ve jumped to conclusion without very much evidence for it- and this matter, because it’s led to;

  • A number of uncomfortable of feelings
  • An unhelpful behaviour.

If you go home feeling depressed, you’ll probably brood on what has happened and feel worse. If you get in touch with the other person, there is good chance to correct any misunderstandings about what they think of you- and you will probably feel worse.

“Mind the communication gap”

The “vicious circle” can make you feel worse. It can even create new situation that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happen because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.

CBT can help you to break this vicious cycle of altered things, feelings and behaviour. When you see the parts of the sequence clearly, you can change them- and so change the way you feel. CBT aims to get you a point where you can “do it yourself”, and work out your own ways of tackling these problems.

 

“Five areas” Assessment

This is another way of connecting all the 5 areas mentioned above. It is in our relationships with other people and helps us to see how these can make us feel better or worse. Other issues such as debt, jobs, and housing difficulties are also important part of your life as well.

 

The sessions of CBT

CBT can be done individually or with a group of people. It can also be done from self-help- book of computer programme or in the voluntary sector organisations like “Health and Happiness for All” we have free ongoing CBT sessions where the members of the diverse communities are openly invited on every Saturday to come and participate in these sessions.

CBT done in many different places- GP practices, out- patient hospital departments or community mental health centres. The therapist may be a doctor, nurse, counsellor or CBT therapist.

  • You will usually meet with a therapist for between 5 and 20, weekly or fortnightly, sessions. Each session will last between 30 and 60 minutes.
  • In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.
  • The therapist will also ask you questions about your past life and background. Although CBT concentrates on “The Here and Now” at times you may need to talk about the past to understand how it is affected you now.
  • You decide what you want to deal with in the short, medium and long term.
  • You and therapist will usually start by agreeing on what to discuss that day.

The work

  • With the therapist you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, badly feelings and actions.
  • Together you will look at your thoughts, feelings and behaviours to work out;
  • If you are unrealistic or unhelpful
  • How they affect each other, and you.
  • The therapist then helps you to work out how to change unhelpful thought and behaviours.
  • It’s easily to talk about doing something, much harder to actually do it. So after you have identified what you can change, your therapist will recommend “home work”- you practice these changes in your everyday life. Depending on the situation , you might start to;
  • Question a self-critical or upsetting thoughts and replace it with more helpful ( and accurate) one that you have developed in CBT;
  • Recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.
  • At each meeting, you discuss how you have got on since the last session. Your therapist can help with the suggestions if any of the tasks seems too hard or don’t seem to be helping.
  • They will not ask you to change things too quickly – you decide the pace of the treatment and what you will and won’t try.

The strength of CBT is that you can continue to practice and develop your skills even after the sessions have finished. This make as less likely that your symptoms or problem will return.

How effective is CBT?

  • It is one of the most effective treatments for conditions where anxiety or depression is the main problem.
  • It is the most effective psychological treatment for moderate or severe depression.
  • It is as effective as anti depressants for many types of depression.
  • CBT isn’t for everyone and another type of talking treatment may work better for you.
  • CBT is as effective as antidepressants for many forms of depressions. It may be slightly more effective than anti depressant in treating anxiety.
  • For severe depression, CBT should be used with anti depressant medication. When you are very low, you may find it hard to change the way you think until antidepressants have started you to feel better.
  • Tranquillisers should not been used as a long term treatment for anxiety. CBT is a better option.

Problems with CBT

  • If you are feeling low and are having difficulty concentrating, it can be hard, at first to get the hang of CBT- or, indeed, any psychotherapy.
  • This can make you may feel disappointed pr overwhelmed. A good therapist will pace your sessions so you can cope with the work you are trying to do.
  • It can sometimes be difficult to talk about feelings of depression, anxiety, shame or anger.

How long will the treatment last?

A course may be 6 weeks to 6 months. It will depend upon the type of problem and how it is working for you. The availability of CBT varies between different areas and there may be a waiting list for treatment.

What if the symptoms come back?

There is always a risk that the anxiety or depression will return.

If they do, your CBT skill should make it easier for you to control them. So it is important to keep practicing your CBT skills, even after you are feeling better. There is some research that suggests CBT may be better than antidepressants at preventing depression coming back. If necessary, you can have a “Refresher” course.

So what impact would CBT have on my life?

Depression and anxiety are unpleasant. They can seriously affect your ability to work and enjoy life. CBT can help you to control the symptoms. It is unlikely to have a negative effect on your life, apart from the time you need to give up to do it.

What will happen if I don’t have CBT?

You can discuss alternatives with your doctor. You could also;

  • Read more about the treatment and its alternatives.
  • If you want to “Try before you buy”, get hold of a self-help book or CD-Rom and see if it makes sense to you.
  • Wait to see if you get better anyway- you can always ask for CBT later if you change your mind.

Useful CBT web links

British Association for Behavioural and Cognitive Psychotherapies (www.BABCP.com)

The role of therapist and holistic physician is important they work like a trainer and coach. For example if people go to gym, or play sports, fitness trainers don’t do the actual physical work of getting them fit. That is up to the individual. However, the coach or trainer will help devise a fitness plan, monitor a person‘s progress and keep encouraging them when the the things going gets tough. The trainer or holistic physician will act in the same way. As a coach or trainer the holistic physician have role as educator and supporter, helping motivate the service users to use evidence based preventive measures and intervention such as to lead an active, positive, constructive, creative, meaningful, purposeful helpful and valuable lifestyle in order to prevent un healthy lifestyle like unhealthy eating, smoking and drug abuse, disturb sleeping pattern and living with stressful, aggressive and negative behaviour.

In these kinds of interventions always acknowledging that the work is being under taken by the service users through an active participation in these healthy activities as they expert in their own recovery journey.

Holistic physician or trainer devise non clinical remedy according to coaching manual this idea can help differentiate between traditional therapy as delivered by high intensity therapist and low intensity i.e. prevention of disease/problem and promotion of an active, positive happy and healthy lifestyle.

In these kind of activities the main focus of the short terms and long terms intervention is on supporting the service users to use of published manual, self help guide or other CBT self help material sometime this can be computerised CBT self help and by using the technique of biblio therapy ( is an expressive therapy that uses an individual’s relationship to the content of books and poetry and other written words as well as through performing art like to perform a roll in a play or in drama in terms of identification of their own problems with intention overpower their problems on self help basis.

The basic concept behind bibliothrapy is a healing experience. Literary sources can assist with the resolution of complex problems. An active engagement in reading and performing art seemed to be good for their sense of wellbeing for a variety of reason. Today the health care workers and institution recognise the wide and varied use of bibliotherapy within the range of scenario.

 

People of all ages with medically unexplained symptoms present frequently to the health services contact with primary care clinician GP may be at least 50% more frequent per person than the general population, and they may also have up to 33% more secondary care consultation.

Medically unexplained symptoms have been estimated to cost the NHS in England £3 billion per year.

 

Few research based, scientific and clinically proven facts about Cognitive Behaviour Therapy (CBT)

NICE- Guide line (National Institute for Health and Clinical Excellence)

  • In fact, several studies funded by NICE (National Institute for Health and Clinical Excellence) and SIGN (Scottish Intercollegiate Guideline Network) have shown that the process and application of CBT is far more effective than medication as treatment alone for specific conditions such as depression and anxiety disorders.
  • Research and clinical studies, it has become very important that the majority of people undergoing CBT (Cognitive Behavioural Therapy) process for the treatment of depression and anxiety disorders tend to remain well and non-lapsing for longer than those on anxiety and anti-depressive medication alone.
  • “From these clinical trials, more intense and faster working form of CBT process have come into being for the ‘specific treatment of panic attacks, social and personal anxiety and ‘free-floating anxiousness and low level of worry’.
  • CBT has been clinically proven as an effective treatment most of the issues related to emotional, mental, social as well as physical health.
  • CBT uses psychological approaches which are based on scientific, clinically proven research, and which have been shown to be effective for the issues associated with emotional, mental, social and physical health.
  • CBT begins with assessment using diagnostic tests including questionnaires and a semi-structured interview. A client/service user is given a diagnosis or presenting issue and an individual treatment plan
  • CBT is a Positive-Though-Provoking life-saving strategy.

 

 

There are following conditions in which CBT is non-medicinal treatment of choice these include;

  • Obesity and eating disorders
  • Mental health related issues like depression, obsession, stress and anxiety disorders
  • Middle age crises
  • Emotional ,mental and social health issues among youth
  • Alcohol/Drug Abuse, currently, I in every 10 adults in the UK has a serious alcohol problem and 1 in 30 adults had or have some form of drug addiction (National Treatment Agency (NTA) figures-2007).

 

Few facts and figures about some mental health issues

  • According to the report of ‘Royal Society of Public Health’, that there are more than quarters of a million young people who believe that they have nothing to live for because of long terms unemployment. Shirley Cramer, Chief Executive of Royal Society of Public Health said that the issue had to be tackled urgently. The research proves that unemployment is a big public health issue.
  • Youngsters turn to drugs & drink, to cope with joblessness (The Times 02/01/2014) 1 in 3 long term unemployed young people has contemplated suicide and 1 in 4 has self-harmed.
  • 4 million younger in Britain are jobless. I in 5th among them experiencing mental health problems.
  • According to The Prince Trust, that 1 in 3 young women have thought about committing suicide, with 1 in 6 have been prescribed anti-depressant. In almost every area, young women were more likely to suffer issues with their wellbeing than men including feeling more stressed, more anxious are being more likely to admit to feeling like crying.
  • 1 in 4 people in the UK will experience mental health problem each year.

 

Prompt action needs to be taken as a life saving strategy

A life saving strategy is required to be implemented in order to rescue those who have been suffering from invisible pain and misery.

We have the solution to the problems, helping them back out of depression and hopelessness. So that they can build a future (Dr Najeeb Ahmad)

 

CBT is the Best (Metro -News- paper, 12/12/2014)

(Pill Popping fuelled by GPs)

The reason nearly half of us take prescription pills is because GPs tend to prescribe medication rather than undertake a detailed analysis of the patient’s problem, lifestyle and Mental attitude to find the root cause their illness. Such analysis is more time consuming and require a different kind of expertise, so most GPs will not do it especially if they have lots of patients. I think a more holistic approach to health in general is needed (Kate, Somerset)

  • I am sick of the doctors prescribing my dad so many pills, many of which have side effect. We have been begging my dad to come off the Statin Simvastatin which can cause memory loss. ( S ,Brighton)
  • I am an NHS patients and provider in mental health and pills are way overprescribed as cheaper alternatives GP and some providers are reluctant to abandon the old models and mix and match with the talking therapies or provide talking therapies on their own. This is due to huge under investment by the government and overmedication in Mental health (Anon)
  • Last year when I was 17, I was put on antidepressant after my first appointment. I thought that was fair enough because I do have depression. I now realise they could have referred me to someone who could help instead of pumping me up with pills. Also I disagree that poorer people are more likely have depression it is lot more complicated than that ( Tom, Kent)
  • I had problem sleeping and a doctor put me on 20mg of Citalopram, the same dose as friend who does been diagnosed with depression. After 3 months with no change, I asked to see a different doctor and was taken off the tablets and sent for a few sessions of CBT which sorted the problem (Rachel, London)
  • All you need to stop out pill popping nation is exercise and healthy eating.
  • I am 17 and hate that fact I am growing up in a world where people are like artificial machines- relying on drug, alcohol and unhealthy food to live (Cannon)
  • I am GP part of the reason for so many prescription for anti-depressant is patients have to wait months for counselling what’s also not been mentioned is that all patients on medications need regular GP reviews therapy affecting appointment availability for everyone else. (Anon)

 

  • The total cost of the NHS in England of prescribed drugs rose by more than £1 billion to £14.4 billion in 2013-2014 (BMJs Dec-2014)
  • GPs are being blamed for over £15 billion a year prescription drug culture

 

Important information to share

 

  • One of the first duties of the physician is to educate the masses not to take medicine. (William Osler) 1849- 1919 (Described as father of Morden Medicine)
  • A physician once said “The best Medicine for human is Love”. Someone asked “What if it does not work?” He smiled and said increase the dose.
  • “A strong positive Mind attitude will create more Miracles than any wonder drug”
  • “We are what we think, the way we think, feel and act”. Let’s think well, feel well, heal well as well as deal well (Dr Najeeb)
  • The only person that can save you……..is you!

 

CBT IN NHS

It is now possible to get CBT on the NHS in some part of the UK, and the NHS Mental Health Service is developing CBT Clinics and practitioners currently. Some counsellors and psychologists offer CBT under the NHS and also some nurses, doctors, occupational therapists and clinical psychologists work in community mental health teams can also provide CBT in specific circumstances.

However, waiting lists tend to be long and there are not many private practitioners currently, although some private hospitals employ CBT therapists.

 

 

 

Prompt action needs to be taken as life saving strategy

  • A real life saving strategy is required to be implemented on wider compassionate grounds to rescue those who may have been suffering from invisible pain, suffering and misery of isolation and loneliness.
  • Don’t let the innocent people suffer and to die in a misery of isolation and loneliness
  • Let’s save ourselves as well as others collectively as a joint venture.
  • We have positive, pragmatic and realistic solutions to these problems, helping them back out of depression, hopelessness, invisible pain of isolation and loneliness. So that they can build future in meaningful, positive, pragmatic, proactive and realistic way (Dr Najeeb Ahmad)
  • Don’t worry yours pain is our pain (Sharing and Caring Group)
  • Free Emotional Help and Support Services 24/7 Helpline; Mob;07950767099

‘Health and Happiness for All’

London

 

It is to cordially invite you to please attend the following, ongoing, weekly ‘free Holistic Body and Mind wellbeing Cognitive Behavioural Therapy’ (talking therapy) sessions, being held under the supervision of professional team of doctors and cognitive behavioural therapist with full confidentiality.

(Self-Management Holistic-Body & Mind wellbeing Cognitive Behavioural Therapy- Services)

  • Stress & drug free lifestyle and awareness sessions.
  • Weight Management, issues related to more or less eating.
  • Sleep management.
  • Management of Stress, anger/ anxiety, fear, phobia, obsessions and depression.
  • Problems related to isolation and relationships.
  • Misuse of drug and Alcohol Management.
  • Middle age crises Management.
  • Free Meditational sessions.
  • Healthy indoor as well as outdoor activities.
  • Musical, drama and poetry sessions.
  • Free healthy food (Vegan & Fruits served)
  • Just pop in to chat with the team of volunteers and therapist.
  • Free -Emotional –Help and Support services (24/7)
  • One to one service is also available on request.
  • Volunteers and referral cases are welcome to these services

Please feel free to contact if you require further information about these services.

Contact person; Dr Najeeb, M.B, B.S, M.P.H (Masters in Public Health), Diploma in Cognitive Behavioural Therapy (UK)

  • Every Saturday (2pm- 5pm) 115, Twyford Avenue,

Acton, W3 9QG

  • Every Monday (1pm-3pm), Lea Bridge Road, Library,

 

Leyton, Waltham Forest

 

(Healthy living Home)

‘Health and Happiness for All’

(Website;www.voluntaryaction.net/groups/health-and-happiness-all-hnh)

115 Twyford Avenue, Acton, London, W3 9QG

 

Team of volunteers of ‘Stress free Club’ (Health & Happiness for All)

 

  • “Our Mind is like a garden and thoughts are seeds, we can grow flowers or we can grow weeds”,
  • “Real happiness is always based on our quality of thought”.

 

 

 

 

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