What CBT is

1. CBT is a talking treatment, so it works on what a person thinks and does rather than on their brain chemistry.
2. It rests on the idea that thoughts determine feelings, so changing what a person thinks changes how they feel and what they do.
3. The version built on Beck's cognitive triad is the one usually called CBT, while the version built on Ellis's irrational beliefs is called rational emotive behaviour therapy, or REBT.
4. CBT is present-focused, meaning the therapist works on the thinking and the habits you have now rather than searching your past for a cause.
5. Sessions are structured and time-limited, with a goal agreed for each session and tasks to try between sessions.

The techniques used in a CBT session

1. The first step is to notice the negative automatic thoughts that arrive without being chosen.
2. Patients are taught to monitor their thoughts and to identify the ones that trigger faulty, irrational feelings.
3. Each thought is then treated as a claim to be tested against real evidence rather than as a fact.
4. A more balanced thought is put in its place, and this replacing of one thought with another is the cognitive half of the therapy.
5. Homework tasks make up the behavioural half, because between sessions you practise using the new, more rational ways of thinking and then see what actually happens.

CBT for depression

1. The cognitive explanation says that low mood is kept going by negative, unrealistic thinking, and CBT targets exactly that thinking.
2. You and the therapist identify the negative views you hold about yourself, about the world around you and about your future.
3. Those views are challenged with evidence, so a thought such as 'I always fail' is checked against the things that actually went well.
4. Cognitive restructuring then puts a fairer thought in its place, such as 'some things went badly this week and some went well'.
5. You also learn new coping skills and ways to prevent a relapse, so the change is more likely to hold once the sessions end.

CBT for addiction

1. Learning theory explains addiction as behaviour that has been learned and reinforced, so CBT works on what triggers the behaviour and on what the person believes about it.
2. The first task is to identify the triggers and high-risk situations that reliably lead to the behaviour.
3. The beliefs attached to the behaviour are then challenged, such as 'I cannot cope without it' or 'one more time will not matter'.
4. Cognitive restructuring replaces those beliefs with more accurate ones that make the behaviour easier to resist.
5. You then learn and rehearse coping responses to use in place of the behaviour when a trigger appears.
6. A relapse prevention plan is agreed, which is an agreed set of steps for what to do when the urge returns so that one lapse does not become a full return to the behaviour.

Young (2007) as the evidence for CBT

1. Young studied 114 clients at the Center for Online Addiction to find out how effective CBT is for internet addiction.
2. Clients were screened with the Internet Addiction Test, and high-risk cases were excluded.
3. The problem clients reported most often was time, at 96%, followed by relationship problems at 85%.
4. Most clients had improved by session 3, were managing their symptoms effectively by sessions 8 and 12, and still held those gains at the 6-month follow-up.
5. Young concluded that CBT reduced compulsive thoughts and behaviours around use and supported relapse prevention.

Strengths and weaknesses of CBT for depression

1. A strength is that it treats the negative thinking the cognitive explanation blames for the depression, rather than only easing the symptoms.
2. A second strength is that it has no physical side effects, unlike drug treatment.
3. A weakness is that it asks for weeks of effort, and the low energy and hopelessness that are themselves symptoms of depression make attending and completing tasks genuinely hard.
4. A second weakness is that it works slowly, so it is a poor fit for someone who needs relief quickly.

Strengths and weaknesses of CBT for addiction

1. A strength is that it targets the learned triggers and the reinforcement that learning theory says keep the addiction going.
2. A second strength is the evidence from Young (2007), where the gains were still there six months after treatment.
3. A weakness is that Young used no control group, so the improvement could have come from time, motivation or the attention of a therapist rather than from CBT itself.
4. A second weakness is generalisability, because all 114 clients came to a single centre for help with one kind of addiction, so the findings may not transfer to other people or other addictions.

Setting CBT against drug treatment

1. The two treatments come at the same problem from opposite ends, because CBT changes the thinking and the behaviour while drugs change the brain chemistry.
2. That makes CBT the more holistic treatment, since it takes in the person's thoughts and circumstances rather than their biology alone.
3. Drugs act faster, which is one reason the two are often used together, with medication easing symptoms enough for the person to engage with therapy.
4. The trade-off is speed against durability, since drugs work sooner but CBT leaves behind skills that outlast the treatment.

Turning this into marks

1. For a describe item give one technique plus a developed detail rather than two bare names.
2. An explain item needs the point, the reason it counts and the link back to depression or addiction.
3. The mark most often lost is retelling Young's procedure without stating the point it proves.