CBT Tools

Cognitive-behavioural therapy (CBT) is like a toolkit for life. This toolkit contains evidence-based strategies towards living life to the full. Most often CBT aims to improve mood, reduce irritability, optimise control of anxiety, and increase enjoyment of relationships. CBT is often referred to as a ‘talking therapy’ but this is a misnomer.

At Emerge Psychology™ we provide evidence-based CBT strategies to challenge thoughts and behaviour patterns – individualised according to your goals – over the phone – seven days per week – to rural Australians referred by their GP.

In describing CBT, Beyond Blue Ambassador Gary McDonald has used the analogy of getting a flat tyre. If you’re going along in life and you get a flat tyre, rather than focusing on how you got it, “Was it a rock, was it a nail? Was it 100km ago, or 1000km ago?”, CBT focuses on fixing the flat and moving forwards, and then using your toolkit to keep moving forwards.  We provide training in best use of your toolkit – but you’re the expert too, because you know your life better than anyone!

Tools in the CBT toolkit include:

Psych education
Psych education, like the manual for how to operate a car, covers aspects like controlling our level of tension effectively so our level of comfort, performance and ability to think with clarity is in the optimal range.

Arousal Control/Relaxation strategies
Relaxation strategies are indicated for goals of reducing anxiety or irritability because they are portable and relevant in controlling our natural Fight vs Flight response. Where considered clinically-appropriate training will be provided during sessions in the following evidence-based Arousal Control strategies: Controlled Breathing Technique, Progressive Muscle Relaxation & Mindfulness Meditation.

Positive Activity Scheduling
It is often hardest to do the things that make us feel better, when we would actually benefit from doing so the most. Positive activity Scheduling attempts to redress this by monitoring which activities give us the most “bang for the buck”, balanced according to our CBT goals.

Cognitive Challenging of our automatic thoughts
Our thoughts; whether they are right or not, helpful or not, realistic or not, cause the commensurate emotions. So if I’m worried something bad is going to happen, this thought will make me feel anxious regardless, even if everything will most-likely turn out okay. Or if I’m thinking that I am not up to scratch, I will feel the distress caused entirely by this thought. I tend to barely notice such fast and automatic thoughts, but I’ll certainly notice the negative emotions these thoughts cause, and will often modify what I do accordingly. But just because I think something, that doesn’t mean the thought is realistic, or helpful in my goal of enjoying my life to the full. Cognitive challenging, regardless of our situation, seeks to figure out the most helpful way to think, and make changes in what we do accordingly.

Often when we give a friend advice, we notice how different – how wise, rational, helpful and compassionate what we say is – in contrast to what we tend to tell ourselves! We often tell ourselves to freak out in case a problem eventuates, or generally give ourselves a hard time. By introducing cognitive challenging (that is, challenging of our thoughts), we can move towards using our wisdom to our own advantage.

Approaching our thoughts like a curious scientist enables us to test how helpful they are. Common cognitive challenges include:

What would I tell a friend in this situation?
Is there anything good about this situation?
What is the evidence for, and against my thoughts?
What’s the most likely thing that will happen?
Will this matter in five years?
Whose problem is this anyway?
Whilst I’d prefer X, Y, Z; where is it written that it must be so?

Initially Cognitive Challenging focuses on automatic thoughts, but then seeks to move to challenging underlying core beliefs, and meta cognitive processes.

Exposure therapy
CBT utilises gradual exposure to feared situations, with relaxation and cognitive challenging simultaneously, for long enough for the level of anxiety/tension to habituate. Just as traffic noise, for example, fades into the background after awhile, so too can our level of tension with Exposure Therapy where clinically indicated.

Behavioural disputing
Behavioural Disputing is when CBT moves from “talking the talk” to “walking the walk” and is generally worked through once the foundation skills of CBT are established. Group programs on Communication training may be an appropriate treatment modality towards Behavioural Disputing.

© 2018 Nicole Hayes, Emerge Psychology