People coming for counselling at my practice in Brighton often ask me for Cognitive Behavioural Therapy (CBT). Perhaps they have read about CBT in the press or it has been mentioned to them by their GP. CBT is one of many approaches to counselling, rather than a separate form. I adopt a cognitive behavioural approach to some of my work, particularly at the start of the process. For instance, if you were to come to me for help with problematic anxiety or relationship difficulties I would be interested in your core beliefs and rules for living (two central planks of CBT theory) and whether these assumptions are relevant to your current life.
As a relational counsellor and psychotherapist I would also be interested in how you respond to me when we are working together and, conversely, what it is like for me to be with you. In counselling jargon this is known as transference and countertransference. These emotional experiences (as opposed to simple cognition – i.e. what you are thinking) often prove to be a rich source of information, particularly regarding the assumptions we all make about how to be with other people, and exploring them together can in turn lead to insight, relief from emotional distress and personal growth.
I believe that it does not really matter which approach a suitably qualified and experienced counsellor or psychotherapist adopts (so long as they do adopt a recognised approach of some sort) since it is generally agreed that it is the quality of the therapeutic relationship – i.e. how well you and your therapist get along – which has the most influence on a successful outcome (Wampold, 2011). Also, the therapist’s style will undoubtedly be influenced not only by their choice of theoretical orientation but also a whole host of other factors including their age, culture, personality and life experiences.
In short, I believe that finding a professionally registered therapist with whom you feel comfortable is more important than the theoretical approach they take. All counsellors and psychotherapists will have their own individual style and you should be able to get a feel for the way they work from their website or internet profile, together with an initial consultation. There are many similarities between approaches and most therapists are familiar with more than one, allowing them to draw on a number of theories and different ways of helping people.
Wampole, B. (2011) Qualities and Actions of Effective Therapists. American Psychological Association.
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There is a bit of a myth (in my view!) around that 6 sessions of CBT is all that is needed to resolve a whole host of issues. In the UK, the National Institute for Health & Clinical Excellence – NICE – recommends CBT for a number of mental health problems including depression and anxiety. The minimum recommended number of CBT sessions for mild cases ranges from 6 to 8 with a suggested number of 20 and above for more severe cases. GP’s often consult the NICE guidelines when referring patients for NHS-funded counselling. Most private practitioners do not set limits on the number of counselling or psychotherapy sessions on offer, giving you the opportunity to proceed at a pace that suits you.
Copyright – Caroline Clarke, Counselling in Brighton and Hove