CBT: Strengths and Pitfalls
Updated: Feb 11
Cognitive Behavioural Therapy (CBT) is considered the gold standard when it comes to therapy for a range of difficulties, such as depression, panic attacks, OCD and many more. There is a plethora of research to support its effectiveness. But in reality what are its strengths and pitfalls for those seeking therapy? This blog aims to provide insight into this question.
Strengths of CBT
Easy to learn
Compared to some other therapy models, CBT is relatively easy to learn once you become familiar with its tools and concepts. It can be introduced to you in therapy in quite a structured way and for some CBT tools there are step by step guides on how to put them into practice. There are also many workbooks out there which walk you through CBT and how to apply it to your difficulties. Alternatively, if you have therapy, your CBT therapist may introduce you to handouts/workbooks to support your learning. Other therapy models may be considered more abstract and thus more challenging to learn and put into practice.
Helps us to Gain Control
When we struggle emotionally, for example, we feel depressed or anxious, this is of course unpleasant. As humans, we are driven to change/get rid of unpleasant things, including our internal emotional struggles, and the tools and concepts you learn in CBT can help you to do just that. This can be satisfying, knowing that we are taking steps to make changes to reduce our emotional struggles and this helps us to feel more in control.
There are many therapists who have CBT training. For all psychologists, this is one of the main therapy models that they have training in. Therefore, it is relatively easy to find a CBT therapist on your doorstep!
For many individuals I’ve worked with, they feel some, or all, of the CBT tools really resonate. For example, one CBT tool is ’cognitive restructuring’ or ‘thought challenging’ where you are taught to catch your troublesome thoughts (e.g. self-critical thoughts, catastrophic thoughts) and to challenge or question them to generate more balance alternatives. It’s fair to say all of us experience negative thoughts (our human brain is actually designed to have ‘negative thoughts’ for survival purposes) and we would all perhaps benefit from identifying these to stop them in their tracks to offset their negative impact upon us. CBT also encourages us to identify and analyse our behavioural patterns which can help us to see where it can be beneficial to make changes. As humans we can often be on autopilot where when we have a troublesome thought we let it, and the emotions it elicits, guide our behaviour. This can lead to behaviours that may not be the most helpful for us or our situation. Therefore, it can be helpful for many of us to identify and analyse our behavioural tendencies and make adjustments, this is a large focus of CBT.
CBT often requires individuals to be pretty motivated to be open to learn its tools and concepts as well as to put ‘homework assignments’ into practice between sessions. This suits those who generally take a proactive approach to things, but for those who do not, who perhaps have a tendency to be avoidant of their difficulties, this may be challenging. Some may feel they are letting themselves and their therapists down by not completing ‘homework assignments’ which may further fuel negative thoughts about themselves. Some, perhaps less clinically skilled CBT therapists, may let their frustrations show rather than explore the reasons why homework tasks are not completed, address such obstacles and/or take a different tact which may be required.
No Change at the Emotional Level
I have heard many individuals say (and this is my own experience too when I apply CBT to myself) that even though they can apply CBT tools well, for example, they are able to challenge their tricky thoughts well and they have made good behavioural changes yet they see little change at the emotion level. They continue to feel, for example, depressed and anxious. CBT focuses on changes we can make at the cognitive and behavioural level with the aim of this, in turn, improving things at the emotion level. Whilst some individuals do see improvements at the emotion level after undertaking CBT, some do not reap the same benefits. In my work with individuals, to address this issue, I integrate exercises from other therapy models which tap into the emotion level.
Too Present Focused
CBT places a large emphasis on the here and now struggles and how to cope. There is space in CBT to also explore past experiences and how these perhaps led to the development of troublesome underlying beliefs which are contributing to our here and now difficulties. Whilst some individuals seeking CBT are happy with focusing on the present more, others benefit from a deeper exploration of their past, to allow processing and healing. Again, when I practice CBT if I feel more emphasis on the past is required I create space for this whilst drawing upon tools and concepts from other therapy models to guide this aspect of the work.
It’s Too Structured
Some CBT therapists practice CBT in a way that is highly structured i.e. there are clear goals which are the focus of each session, an agenda is set at the beginning of each session and this is adhered to. For some individuals who like structure in other areas of their lives this can be welcomed. But for others, a more flexible approach is preferred otherwise it can sometimes feel too mechanical. Also, other issues may arise for individuals that they wish to discuss, and could be helpful to discuss, but they are not associated with their initial therapy goals. If the therapist adopts a strict agenda and is keen to solely focus on the initial therapy goals that were set, the individual may feel dissatisfied with the inflexibility of the therapy. CBT does not always need to be practiced in such a structured way. I tend to draw upon CBT in a more flexible way, tailoring the way I draw upon it to the individual I work with. For example, some prefer a more structured therapy which I will accommodate. Others prefer a more flexible approach and, in such cases, I tend to draw upon elements of CBT by interweaving them gently into our conversations which can often feel more organic.
If you would like to consider starting CBT therapy please contact me via email: firstname.lastname@example.org or complete the webform and we can discuss the next steps. I have Doctoral level training in CBT. I offer therapy in-person in St Albans/Hertfordshire and online.