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Andy Garland Therapies - Counselling Cardiff - Mental Health Services Cardiff - Cardiff Therapists - cognitive and dialectical behavioural therapy (CBT/DBT)

Cognitive and Dialectical Behavioural Therapy (CBT and DBT) are types of psychotherapeutic treatment that helps a person understand the thoughts and feelings that influence behaviours. CBT and DBT is commonly used to treat a wide range of disorders, including phobias, addiction, depression and anxiety.

CBT and DBT is generally short-term and focused on helping patients deal with a very specific problem. During the course of treatment, people learn how to identify and change destructive or disturbing thought patterns that have negative influences on behaviour.

The therapy may focus on what is going on in the present rather than the past. However, CBT and more specifically DBT will also look at your past, and how your past experiences impact on how you interpret the world now.

how effective is CBT and DBT?

Clinical trials have shown that CBT and DBT can reduce the symptoms of many emotional disorders. For some people it can work just as well as drug therapies at treating depression and anxiety disorders. The National Institute for Health and Clinical Excellence (NIHCE) recommends CBT and DBT for common mental disorders, such as depression and anxiety.

The goal of DBT is to help you learn to manage your difficult emotions by letting yourself experience, recognise and accept them. Then as you learn to accept and regulate your emotions, you also become more able to change your harmful behaviour. To help you achieve this, your therapist uses a balance of acceptance and change techniques.

Dialectics means trying to balance opposite positions and look at how they go together. For example, in DBT, you will work with your therapist to find a good balance between accepting yourself as you are, and making positive changes in your life.

You might eventually come to feel that these goals are not as conflicting as they first seem. For example, coming to understand and accept yourself, your experiences and your emotions, can then help you learn to deal with your feelings in a different way. Patients undergoing DBT are taught how to effectively change their behaviour using strategies and coping techniques. Researchers have also found that DBT is effective regardless of age, sex, sexual orientation, and race/ethnicity. Ultimately in DBT, the patient and therapist are working to resolve the seeming contradiction between self-acceptance and change in order to bring about positive changes in the patient.

Andy Garland Therapies - Counselling Cardiff - Mental Health Services Cardiff - Cardiff Therapists - dialectical behavioural therapy - DBT

You and your therapist will discuss your specific difficulties and set goals for you to achieve. CBT and DBT is not a quick fix - it involves hard work during and between sessions e.g. keeping track of what you are thinking, feeling and doing, or trying out new ways of thinking or acting.

Your therapist will not make decisions for you. They will help you decide what difficulties you want to work on in order to help you improve your situation. Your therapist will be able to advise you on how to continue using CBT/DBT techniques in your daily life after your treatment ends.

CBT and DBT has a good evidence base for a wide range of mental health problems in adults, older adults, children and young people.

This research has been carefully reviewed by the National Institute for Health and Clinical Excellence (NICE), who provide independent, evidence-based guidance for the NHS on the most effective ways to treat disease and ill health.

pros and cons of CBT and DBT

Cognitive behavioural therapy (CBT) and Dialectical behavioural therapy (DBT) can be as effective as medicine in treating some mental health problems, but it may not be successful or suitable for everyone.

some of the advantages of CBT/DBT include:
- it may be helpful in cases where medicine alone has not worked
- it can be completed in a relatively short period of time compared with other talking therapies
- the highly structured nature of CBT (there is less structure within DBT theory) means it can be provided in different formats, including in groups, self-help books and apps (you can find mental health apps and tools in the NHS apps library)
- it teaches you useful and practical strategies that can be used in everyday life, even after the treatment has finished

Andy Garland Therapies - Counselling Cardiff - Mental Health Services Cardiff - Cardiff Therapists - cognitive behavioual therapy - CBT

some of the disadvantages of CBT and DBT to consider include:
- you need to commit yourself to the process to get the most from it - a therapist can help and advise you, but they need your co-operation
- attending regular CBT/DBT sessions and carrying out any extra work between sessions can take up some of your time
- it may not be suitable for people with more complex mental health needs or learning difficulties, as it requires structured sessions (less so with DBT)
- it involves confronting your emotions and anxieties - you may experience initial periods where you're anxious or emotionally uncomfortable
- it focuses on the person's capacity to change themselves (their thoughts, feelings and behaviours) - this does not address any wider problems in systems or families that often have a significant impact on someone's health and wellbeing

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