Frequently Asked Questions
1. How many sessions will I need?
This is probably the most frequently asked question about CBT. The answer is an honest “at this stage, I don’t know”. I will need to meet you for an assessment, and gain a better understanding of your difficulties before I can say how many sessions you will need. CBT is not a “one size fits all” approach and I will therefore want to find out more about your difficulties. CBT is time-limited; typically, it lasts between 5-20 sessions. However, if a problem is long-standing (has been around for many years) or you have multiple problems, therapy can last longer than 20 sessions. Duration of therapy depends on the nature of your problems and on your progress.
2. I've heard that CBT is short-term; how short-term is it?
This is a great question. The assumption is that CBT is shorter-term than long-term psychoanalysis, and this is most often the case. CBT can last anywhere from a handful of sessions, to 20+ sessions, depending on the nature of the problem. Certainly, the NICE Guidelines recommend between 12-15 sessions of CBT for generalised anxiety disorder (also known as “worry”) but they also acknowledge that more sessions may be necessary if clinically required.
For example, individuals with long-standing personality difficulties (affecting their relationships) may benefit from longer-term CBT.
There isn’t a one size fits all approach to CBT (the number of sessions required is based on a number of factors), i.e., the nature of your problems, engagement with therapy, pace of progress, etc.
3. How often do I need to attend for therapy?
We will meet weekly at the start of treatment. Once you start to feel better we will discuss reducing the frequency of our sessions to every fortnight, etc. When you feel ready to end therapy, we can plan some follow-up appointments to help you maintain the progress you have made, usually at 3 and 6 month intervals.
4. How soon can I expect to feel better?
Some individuals find it helpful to just come and talk to somebody about their difficulties, especially if this is the first time they are opening up, however, and contrary to popular belief, CBT is not a “quick-fix” therapy; therapy is a process, and it can take a few sessions for you to start to benefit from the therapeutic techniques that your therapist will teach you. The assessment process is the first stage of therapy, and can take up to three sessions for your therapist to gain a good understanding of your difficulties and what maintains them. Based on your therapist’s understanding of your difficulties, and a shared understanding between the two of you, of what maintains your difficulties (i.e., unhelpful behaviours like procrastinating, excessive alcohol use, setting unrealistic standards for yourself), your therapist will introduce you to a set of skills and techniques that will require practice on your part, between sessions. The practice that you put in between sessions is as important, if not more, than the actual therapy sessions-think about it: a therapy session is 50 minutes/week, but you have 6 + days between sessions to practice your new skills.
Read more about your therapy experience at CBT Canary Wharf.
5. Why can't I pay on-line?
I don’t have a “Pay Now” button because I don’t want to take your money until we’ve discussed whether CBT is the right therapy for you, and that I’m the right therapist for you.
I offer an initial free 15 minute phone consultation, so that I can find out more about you and the problems you’re experiencing, and to discuss whether CBT is the right approach for you. Once we’ve established that CBT is the right therapy for you, I will discuss my payment methods with you.
6. Who can refer for therapy?
I accept referrals from GPs, Consultant Psychiatrists, other Health Professionals, Employers, Occupational Health Departments, Insurance Companies, Solicitors.
7. Do I need a referral by my GP or can I refer myself?
You can refer yourself, however if you would like to pay for your treatment through your health insurance company, your health insurer may require you to have a referral by your GP, or by a consultant psychiatrist. I can recommend a consultant psychiatrist if you would like me to.
8. Will anyone else have to be involved in my treatment?
No, nobody else has to know that you are seeking therapy, however, in order for me to take you on as a client/patient, you will need to be registered with a GP and you will need to provide me with your GP details. If you are not already registered with a GP, you will need to do so before I agree to take you on as a client/patient. I do not provide an out of hours emergency service, and if you needed support out of hours, your GP is normally the person to contact. Also, if I am ever concerned about your mental state, and I haven’t heard from you in a while, it is your GP who I would contact to see that you are OK. Ultimately, your GP is responsible for your care.
If, after your assessment with me, we both agree that you would benefit from an antidepressant, I would normally refer you to a consultant psychiatrist who will discuss medication with you. The consultant psychiatrist is also bound by confidentiality. Some patients/clients like their GP’s to be aware that they are seeking treatment; if you would like me to write to your GP informing them that you are seeing me for therapy, I would be happy to do so.
9. Is everything we discuss confidential?
10. Will I need medication? Do you prescribe medication?
If we decide that your mood is so low that it is making it difficult for you to concentrate on the therapy, and if your low mood is also making it difficult for you to attend work, or attend to your day to day tasks at home, we can discuss the role of medication. I am not qualified to prescribe medication (most therapists are not qualified). If I think you would benefit from starting an anti-depressant, or other medication, I would recommend that you visit your GP, or a psychiatrist. They are both qualified to prescribe medication.
11. Why should I choose CBT over other therapies?
There are a lot of “talking therapies” available, with some offering longer-term therapy (traditionally, psychoanalysis lasts over one year). CBT is a relatively short-term therapy (up to 20 sessions), and is goal-focused.
NICE (The National Institute for Clinical Excellence) issues guidelines for the treatment and care of people with depression and anxiety, and sets National Standards for care for people with depression and anxiety.
NICE recommends CBT as the psychological therapy for the treatment of depression and anxiety. Clinical trials have been carried out which have demonstrated CBT’s effectiveness, compared to other talking therapies. The updated version on NICE’s guideline for the treatment of depression in adults is available to read.
Over the years, CBT has received a lot of coverage in the media because it is evidence-based and has shown to be effective in treating a number of emotional and behavioural problems. Here is an article supporting the effectiveness of CBT.
Over the last few years, the government have recommended CBT as the treatment of choice for common mental health problems. Read about the government’s announcement to provide additional funding for CBT on the NHS as a result of the therapist shortage in the UK.
12. Are there problems CBT cannot help?
CBT can help with most emotional and psychological problems, though therapists vary in their experience and skill base. I have listed below the three main problem areas that I do not specialise in. If you think you may be suffering from any of these, you can find a list of websites for each problem area on my Useful Links page.
Problems I do not specialise in :
13. Will CBT work for me?
This is largely dependent on how much time, effort and hard work you are prepared to put into your treatment. We will review your progress regularly and if you do not think you are making progress, we can discuss the possible reasons why this may be.
CBT is not for everyone; after your initial assessment, if I think you will benefit more from a different therapy approach, I will discuss this with you, and will either provide you with contact details of another therapist or Service, or I may offer to refer you to another therapist or Service, if I think it’s appropriate.
14. How can CBT help me with the past?
CBT is a here-and-now therapy. One of the main principles of CBT is that we cannot change the past; we can only change how we think about, and understand the past.
The first stage of CBT is the assessment stage, where you and your therapist will develop a good understanding of how your problems developed, and what is maintaining them.
The main focus of your CBT sessions will be on changing current behaviours, that serve to maintain your problems, in order to help you act in ways consistent with your values and goals.
In your CBT sessions, you will also learn how to pay more attention to your thoughts, and turn the more negative, unhelpful thoughts into more helpful thoughts. This will enable you to move forward in life, instead of being held back by your past experiences.
15. How does CBT differ from other forms of therapy?
One of the main differences between the various psychotherapies and counselling is in how active an approach the therapy is, and therefore how active a role you will be expected to play.
In CBT your role is as an active participant, where you and your therapist collaborate and work together to come to a shared understanding of your problems and develop strategies together for overcoming them. CBT is empowering in that you will learn how to help yourself so that if the same problems crop up in future, you will be better prepared to deal with them. You can read more about the differences between the main therapeutic approaches.