Cognitive Behavioural Therapist in London
Are you looking for a therapy which is practical and gives you coping strategies?
Are you seeking a treatment which has research supporting its effectiveness?
I am a BABCP accredited CBT therapist as well as being a Chartered Clinical Psychologist. You can therefore feel assured that you are in good hands.
What is CBT Therapy?
Cognitive Behavioural Therapy (CBT) is a single term which refers to several related types of psychotherapy/talking therapies. All of these share a common feature: they are based on the philosophy that our thoughts , emotions, body sensations and behaviours are all inter-connected. A change in one domain leads to a change in another. In therapy people can often find it very helpful to deconstruct an overwhelming feeling and break this down into its relative parts. For example, your thoughts about an event will likely affect how you respond both emotionally and physically, as well as how you behave.
Is CBT effective?
In short, yes. It is arguably the talking therapy with the best evidence base at present. The National Institute for Health and Clinical Excellence (NICE) is a government body which draws upon the best research available to advise the NHS as to what treatments are most effective. The NICE guidelines recommend CBT for a range of difficulties including: Depression, Generalised Anxiety, OCD, Panic, Health Anxiety, Phobias, PTSD, and Insomnia.
What does CBT involve?
CBT usually involves an assessment followed by weekly sessions with a therapist. It is a highly structured approach with agenda setting, change techniques and weekly homework. It is a very collaborative and empowering process with the philosophy of helping the client gradually become their own therapist. The client works with their therapist on mutually agreed goals that are relevant and meaningful to them. Whilst time-limited therapy is the norm (10-20 sessions is typical) longer-term therapy may be recommended at times if I determine that a client would benefit from this.
Should I have CBT or Counselling?
Great question. It really depends on what you want to get out of the process. Counselling may be best if you simply want somewhere where you can express yourself and have a listening ear. However, if you want to see demonstrable change in how you think and feel then a targeted therapy like CBT would be far more appropriate. Nonetheless, you need to be prepared to put more effort into CBT than you would into counselling as it’s much more active than just talking and listening.
Can you tell me more about how CBT is different?
CBT often looks quite different from counselling and other types of therapy in that it is:
Short term: Time-limited rather than long term or open-ended.
Practical: you will be learning a set of skills that you can use after therapy has ended.
Active: in most sessions you will be engaged in a change technique whether that is cognitive restructuring, identifying problematic thinking styles or setting a behavioural experiment.
What techniques do you use in Private CBT?
There are many different cognitive behavioral therapy techniques, yet all are aimed at:
Changing overwhelming emotions.
Overcoming unhelpful/dysfunctional behaviours that leave you feeling bad.
Identifying and tackling self-defeating thoughts.
Transforming negative thoughts into more balanced ones.
Helping a patient move forwards into meaningful positive action.
Allowing a patient to see alternative perspectives on their situation.
Optimising their problem-solving skills even under times of stress.
Helping them move towards their goals.
Improving their self esteem and their relationships.
Helping them become their own therapist, so that they are able to manage their mood after therapy ends.
What is a typical CBT session like?
A typical structure for a session is
An update on progress since the last session
A review of last session’s homework
Agreeing an agenda (what we talk about) for the day’s session
A change technique
Setting homework building on today’s session (and in line with the treatment plan and agreed goals).
Do you talk about the past in CBT?
It is an overgeneralisation to say that CBT therapists do not take a person’s past into account when helping them to make sense of their difficulties. Many CBT therapists recognise that exploring the development of a problem and a person’s background is important for an overall understanding of the client’s difficulties. I certainly do. However it should also be said that CBT can focus purely on understanding and breaking vicious cycles in the present only and still yield effective results. So even when a client doesn't wish to talk about the past, CBT therapists can still help by focusing purely on what is going on in the here and now.
I had CBT and it didn't work. Should I try it again?
This depends on the reason it didn’t work. The first question to ask yourself is whether you had CBT or not. Sometimes therapists say they do CBT but when you look at the content of sessions they are missing key parts . If you had a course of sessions and there were components such as identifying thoughts and feelings, behavioural experiments, learning about thinking biases, learning new coping strategies, homework, thought records etc. then you had CBT.
The second question to ask yourself is whether you were in the right headspace to engage in CBT. Bear in mind that the more effort and time you put into CBT the more you can get out of it. Is it possible that you had a lot going on and were unable to give it the effort it needed for you to truly benefit from it?
The third thing to consider is whether you had a good rapport with your therapist? Therapeutic alliance is a predictor of therapy success. Some therapists apply CBT is a very “top down” kind of way. They forget that therapy is an art as well as a science and they can overlook the central importance of a strong therapeutic relationship. For instance, the treatment protocol of CBT for panic disorder is useful for guiding treatment. However, some therapists may adhere to this too strictly (in my view) insisting that specific parts of the treatment happen on specific sessions. A more flexible, responsive and client-centred therapist (which is how I describe myself) will listen to the clients’ needs, and may adjust things accordingly if other crises/priorities need temporary attention before realigning therapy to the protocol. I regard the former type of CBT as a “top down” approach and the latter type of CBT as a “bottom up” approach.
How does CBT work?
In short, CBT helps people to identify and change thinking and behavioural patterns that are unhelpful or ineffective, and replace these with thoughts/cognitions that are more accurate, and behaviours that are more helpful in terms of their goals and feelings. Cognitive restructuring, for instance, can include monitoring thoughts during stressful times, identifying cognitive distortions (ways in which thoughts are biased), and engaging in behavioral experiments to test out whether your thoughts are true.
So is CBT just about fixing my thoughts?
It is a common misperception that CBT is about fixing faulty thoughts/thinking processes and only looks at surface level issues. This is a shame as it means that people can dismiss CBT and then miss out on an approach which could have been very useful to them. The reality is that CBT has the ability to shine a light on profound aspects of our existence - how we see ourselves in relation to others and how our views of the world are shaped.
At the heart of CBT is the notion of “meaning”. That is, how people make sense of what happens to them. On a daily basis, you interpret what is happening around you and you form beliefs. These beliefs or appraisals happen automatically but they shape how you perceive and understand the world.
At times our beliefs can be upsetting to us and can lead to unhelpful ways of behaving (e.g. a person with low self worth who withdraws socially). A CBT therapist can help you examine your beliefs and transform meaning, highlighting biases that may have occurred and aspects that may have been overlooked.
CBT shows us that it is not events in themselves that upset us. It is rather the meaning attached to those events that leads to feelings.
So two different people experiencing the same situation can respond entirely differently based on two different interpretations.
Can CBT involve looking at deeper issues?
Absolutely. Let me give you a couple of illustrations:
The cognitive model refers to our deepest level of our belief systems as Core Beliefs. These might be regarded by some as linked to what psychoanalysts refer to asone’s Unconscious. These beliefs are often not spoken and not held in one’s everyday awareness. Do they influence us? Yes hugely. We hold these beliefs as global truths about ourselves, other people, and the world . Yet these are just opinions and not facts. To begin thinking about what yours might look like ask yourself “What has your life led you to believe about yourself, others around you or the world?”. Core beliefs are often phrased in the form of absolute statements
I am worthless/dumb/unloveable.
Other people are hostile/rejecting/cruel.
The world is unjust/ uncaring/ critical.
Core beliefs are closely related to the next level, which are intermediate beliefs. These are often formed of “If Then rules”.People often hold these as ways of avoiding the core beliefs e.g.
“If I work 80 hour weeks then I won’t reveal to others how stupid I really am”.
“If I always put others first in my relationships, then I will not be rejected”.
Is CBT related to the notion of unintended consequences?
Yes. If you think about it, everything we do has consequences, with some intended and some unintended. During assessment and therapy we ask questions such as “What were the consequences of doing that/acting that way”? So a patient with health anxiety might have looked up possible reasons for a body sensation in order to feel safer (intention), yet they then felt even more confused with an increase in anxiety and reassurance seeking (unintended consequence) . A key part of our training is to look for links between thoughts, feelings and behaviours that might be reinforcing a problem.
When might you recommended CBT?
If you suffer from a single condition (particularly a specific anxiety disorder) then CBT is usually what we would try first. However this would depend upon the assessment. Everyone is unique.
There are some factors that may make me more likely to consider CBT for a patient. For instance . If the patient is able to identify thoughts or beliefs in the assessment.
CBT Therapy London
If you are seeking CBT Therapy in London then drop me a line and let’s discuss your hopes and goals for treatment.
The evidence base for CBT is huge. That is to say that thousands of research trials have demonstrated that CBT is an effective treatment for depression and anxiety through to insomnia and trauma. It has been shown to be effective across the lifespan: for children/adolescents, working age adults and older adults. And CBT can be just as effective when delivered online as when delivered face to face.
Private CBT London
Here are three tips I usually give people looking for private CBT in London:
1. Check the education and training of therapist and ensure that they are fully accredited with the BABCP (this is the "gold standard").
2. Phone and speak with a few of them. Can you imagine working with them?
3. Check that they are able to offer you another type of therapy if CBT doesn't quite fit for you. For example, a patient with PTSD might not get on so well with CBT but may get on very well with EMDR.
CBT West London
Finding a CBT Therapist seems to be especially difficult in West London.
My Harley Street clinic is situated near Oxford Circus which can be reached in under 15-20 minutes from much of West London (e.g. Ealing Broadway to Oxford Circus).
Private CBT Near Me?
Many of my clients travel from the City of London to my clinic in Harley Street. It is just 4 stops on the Central Line from St Paul’s to the closest underground station, Oxford Circus. It is also 15 minutes on the Jubilee line from London Bridge to Bond Street station, which is close by.
Joel is a great therapist. His approach is kind, patient and respectful whilst still challenging enough to drive growth. Its a great combination - I'd happily recommend Joel to anyone looking to undertake CBT.
Book Private CBT London
CBT is a highly effective type of talking therapy which has been shown in research trials as an effective form of treatment for a number of different disorders such as generalised anxiety and depression. Book a free telephone consultation with me to find out more.