I have been working as a counsellor for over 15 years providing effective
counselling solutions for many different issues including:
Self confidence and self esteem
Post traumatic reactions
The main approach that I use in my counselling work is Cognitive Behavioural
Therapy or CBT. CBT is the therapeutic approach most widely used in the NHS
and it is a method which provides clients with a range of strategies that they can
use in order to overcome their difficulties.
Although CBT is at the core of what I do, I am trained in several other approaches
including psychodynamic counselling and Eye Movement Desensitzation
Reprocessing or EMDR. I will use these approaches with some clients when I feel
that they are the methods most likely to bring about positive results.
How does CBT work?
The starting point for CBT is helping the client to understand what is causing
their difficulties. CBT theory suggests that there are a number of different factors
that lie behind problems like stress, anxiety, low confidence or depression.
Firstly there are the things pressures and triggers that we have to face –
problems like having a huge workload or not being successful in a job interview.
How we think is the second key factor. CBT counsellors argue that excessively
negative thinking lies at the heart of psychological problems and a fundamental
idea here is that how we feel is actually driven by the thoughts that go through
our minds. People often have recurrent negative thought patterns that have been
with them for many years, and another aspect of CBT is to look for the
experiences earlier in our lives that put these negative thought patterns into
The third factor looks at the way in which our behaviour might be contributing
to how we feel. People who are stressed, for example, often isolate themselves
and stop seeing their friends. But socializing with friends is actually something
that might help to alleviate stress. CBT counsellors help their clients to recognize
how what they are doing is affecting how they are feeling, showing them that
often their behaviour patterns are actually making their core problems worse.
A fourth area, and one that is often neglected, is how psychological problems
affect us physically. Stress and depression mess up your sleep and leave you
feeling exhausted. Headaches, digestive problems, colds, flu and a range of other
physical issues can also be problems. Feeling physically run down only serves to
reduce your ability to deal with your problems and is the fourth important area
to look at when trying to understand a mental health problem.
CBT argues, then, that there are four key areas that drive our mental health
The pressures that we have to deal
Our negative thought patterns
Unhelpful behaviour patterns
Our physical reactions
CBT then looks for solutions to their clients’ problems by proposing a series of
strategies that will bring improvements in each of the four areas. Basic to CBT is
the idea of giving the client a toolkit of strategies in order to overcome their
When it comes to the pressures, the counsellor will look at the changes clients
can make to ease the pressures they face. People often assume that there is little
that they can do to change their situations, but usually there is much more
potential for change than we realize. CBT counsellors help their clients to see
what can be changed, and to better come to terms with the things that can’t be
Working with thoughts is the second vital strategy in CBT technique. Clients with
mental health issues usually have constantly recurring negative thoughts, and
these thoughts are also usually unrealistic and excessive in their negativity. CBT
counsellors show clients how to block the constant thoughts so that they are less
intrusive, and they show clients how to challenge their excessively negative
thoughts, and to replace them with thinking that is more realistic and more
With behaviour the key question is to look at how what the client is doing is
affecting how they are feeling. CBT counsellors are skilled at spotting the
behaviour patterns that are fuelling clients’ problems and helping them to
replace them with more helpful ways of living your life.
Finally CBT counsellors will help clients tackle the physical impact of mental
health difficulties, for example by showing them effective relaxation techniques
or looking at ways of improving health, diet and physical resilience.
By working with these four key dimensions, CBT counsellors provide their
clients with a personalized set of strategies which help them to tackle their
difficulties. These strategies will usually take some practice, but the aim is that
the client becomes able to resolve their problems on their own so that after a
while they no longer depend on their counsellor. Because of this, CBT counselling
is typically a short term kind of therapy and most CBT work will not exceed 20