Cognitive Behavioural Therapy: Information for Clients

VINCENT SQUARE EATING DISORDER SERVICE

Cognitive Behavioural Therapy (CBT): Information for Clients

Here is a basic introduction to Cognitive Behavioural Therapy (CBT). It outlines key elements of CBT, why CBT is the chosen therapy for you, and what CBT involves.

What is CBT? CBT focuses on forming a shared understanding of what is Thoughts (e.g., "I am going to keep keeping your eating disorder going. It explores the links gaining weight "; “I have between how you think, what you feel, your physical state and broken my rules”) what you do (see diagram). Highlighting these links helps to identify what thoughts and behaviours might need to change to help you feel better. CBT is time-limited. The number of Physical state Feelings sessions will be decided with your clinician but each session (e.g., starvation) (e.g., anxiety) will last 50 minutes. CBT is generally a ‘here’ and ‘now’ approach, focusing on reducing your current eating disorder symptoms. Sometimes, you and your therapist may look in Behaviour more detail at earlier experiences that might have laid (e.g., avoid food; overeat; foundations for your current difficulties, but this would only be over-exercise) if there is a good rationale and would be decided together.

Why choose CBT in your case? The National Institute for Clinical Excellence (NICE - a government body that reviews research evidence and consults with experts in the field) recommends CBT as the current treatment of choice for bulimia nervosa and other related eating disorders. It also suggests that CBT can be considered as a treatment option for anorexia nervosa. (See the NICE leaflet for more information – available from the service.)

What does CBT involve? The aim is for your working relationship with your therapist to be a collaborative one. The therapist is an active participant, but you are ultimately responsible for change. Initially, the therapist is likely to guide you in developing the necessary skills and strategies. However, the ultimate goal is for you to become your own therapist.

There are some aspects of CBT that are essential parts of the treatment of your eating disorder. These are:  Commitment to regular attendance and being punctual  Being weighed weekly in each session  Medical investigations if recommended (e.g. blood tests)  Homework (including food diaries)  Behavioural experiments – trying out changes to see what happens, but in a structured way

What can I expect of my therapist? Your therapist works as part of a team, and will discuss your case with members of the team from time to time in a confidential and respectful manner. Your therapist will respect your position as a patient. This means that they will try to be punctual, not cancel at short notice, and give you as much information as possible. In addition, they will not meet with you outside agreed times or outside the clinic, and any physical contact will be limited to that which is courteous (such a handshake). Your therapist will put your interests first. If you are uncertain or uncomfortable, it is important to discuss this with your therapist. If you are still experiencing difficulty, you are very welcome to approach Tanya Paxton (Service Director), Dr Frances Connan (Consultant Psychiatrist), or Dr Sue Harris (Clinical Psychologist).

An advocacy service is available if you feel that you are not being listened too, or would like help to get your views across. You can also access help through the Patient Advice and Liaison Service (PALS). Your PALS representative at Vincent Square is Pam Taft, our receptionist.

Updated April 2013