Nothing pisses me off more in my job than finding out someone wasted years of their
life in bad cognitive behavioral therapy.
Hey welcome back to the psych show.
I'm Dr. Ali Mattu clinical psychologist and cognitive behavioral therapist.
I want to talk to you about that today.
CBT what it is and how to know if you're getting bad CBT CBT is one of the most effective treatments
for things like anxiety depression bipolar depression A.D.H.D and a whole number of other
problems.
It's about understanding yourself your strengths and weaknesses learning how to get unstuck
with your thoughts developing skills to help yourself manage difficult emotions and also
learn how to be in the kind of situations that you want to be in.
While there are a lot of great CBT treatments out there and available with decades of research
behind them and there's a lot of people who know how to do these treatments as a patient
as a client who's trying to navigate the mess of the mental health system it's really hard
to know if you're getting real good CBT.
So in this video I'm going to outline the top Signs That You're Getting Bad CBT number
one therapy is mysterious in CBT the process is all supposed to be very transparent what
you're doing why you're doing it how the treatment works.
It's kind of like a car you can open up the hood and see all the parts and you know how
this thing is working.
If your therapy is mysterious if you don't know why you're doing something if the rationale
hasn't been provided.
If it doesn't make sense how the techniques being used are going to lead to the goals
that you want it might not be CBT speaking of goals that gets to my number two which
is your treatment has no goals.
CBT is a very goal oriented treatment.
You have specific observable measurable goals and you're able to know how your symptoms
are doing where you are in relation to the goal you're working on and when you get to
that goal you kind of know that OK maybe it's time for us to start ramping down to treatment
it's well no not ramping down tapering off tapering off when it's time to start tapering
off treatment.
If your therapy doesn't really have any specific goals if you don't know if you're making progress
towards the thing that you came into treatment for you might now be getting CBT and it's
OK to go into treatment and not necessarily have a goal sometimes that's what we do in
CBT is we try to help develop goals.
That's totally cool.
But you kind of need to know what you're working on and getting back to my first point.
You kind of need to know how you're going to get there.
The third way to know you're getting bad CBT is you're not developing new skills.
This is one of the central things in all cognitive behavioral therapies is whether it's cognitive
therapy or exposure therapy Acceptance and Commitment Therapy Dialectical Behavior Therapy.
There's so many different types of cognitive behavioral therapies out there.
But one thing they all have in common is developing new skills new ways of dealing with your thoughts
new ways of dealing with your emotions new ways to be in a situation.
Number four is no homework.
One of the things CBT might be infamous for is having homework things that you have to
do outside of your session with your therapist.
The thing about therapy is it's great but it's only for a small chunk of your week maybe
it's 45 minute therapy maybe 50 minute therapy sometimes less than that and it's not enough
to help you take the gains you're making in your therapist's office and extend them to
your life.
There's nothing we do in life that we can just like practice for a little bit once a
week and then we're done like whether it's learning a new instrument playing a sport
or any other skill you develop in life you have to practice it.
You have to do it over and over again you have to do it outside in your real life and
that's where Homework comes in and CBT a CBT therapist will often help you to learn something
in session and then give you a specific homework assignment to practice that outside of the
office.
It's not to say you are going to have homework every single week but CBT extends its reach
outside of the office and it usually does that through homework.
The number five way to know you're not getting good CBT is you never get out of your chair
or sofa or chaise lounge.
Many CBT treatments will at some point get you moving in some way.
They'll get you to practice something they'll get you to act in some way with a lot of my
patients when we work on anxiety.
We leave my office and we go into the kind of situations that are difficult for them
or maybe if I'm working with someone who has depression we might practice a skill in my
office we might not leave the office but we might kind of get up and do something.
I should say with some people I work with we might do the whole treatment in the chair
like for example if I'm working with someone who has generalized anxiety disorder and they
struggle with worries and uncertainty we might do all of that stuff in the chair like help
them develop skills right there in my office.
So there are some exceptions here but CBT is an active treatment.
It gets you to do stuff and if you're not doing stuff you're not doing CBT.
Have you been in CBT.
Have you been a good CBT or bad CBT what's your experience been.
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