Cbt in counselling
Cognitive behavioral therapy - Mayo Clinic
Overview
Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.
CBT can be a very helpful tool ― either alone or in combination with other therapies ― in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. CBT can be an effective tool to help anyone learn how to better manage stressful life situations.
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Why it's done
Cognitive behavioral therapy is used to treat a wide range of issues. It's often the preferred type of psychotherapy because it can quickly help you identify and cope with specific challenges. It generally requires fewer sessions than other types of therapy and is done in a structured way.
CBT is a useful tool to address emotional challenges. For example, it may help you:
- Manage symptoms of mental illness
- Prevent a relapse of mental illness symptoms
- Treat a mental illness when medications aren't a good option
- Learn techniques for coping with stressful life situations
- Identify ways to manage emotions
- Resolve relationship conflicts and learn better ways to communicate
- Cope with grief or loss
- Overcome emotional trauma related to abuse or violence
- Cope with a medical illness
- Manage chronic physical symptoms
Mental health disorders that may improve with CBT include:
- Depression
- Anxiety disorders
- Phobias
- PTSD
- Sleep disorders
- Eating disorders
- Obsessive-compulsive disorder (OCD)
- Substance use disorders
- Bipolar disorders
- Schizophrenia
- Sexual disorders
In some cases, CBT is most effective when it's combined with other treatments, such as antidepressants or other medications.
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Risks
In general, there's little risk in getting cognitive behavioral therapy. But you may feel emotionally uncomfortable at times. This is because CBT can cause you to explore painful feelings, emotions and experiences. You may cry, get upset or feel angry during a challenging session. You may also feel physically drained.
Some forms of CBT, such as exposure therapy, may require you to confront situations you'd rather avoid — such as airplanes if you have a fear of flying. This can lead to temporary stress or anxiety.
However, working with a skilled therapist will minimize any risks. The coping skills you learn can help you manage and conquer negative feelings and fears.
How you prepare
You might decide on your own that you want to try cognitive behavioral therapy. Or a doctor or someone else may suggest therapy to you.
Here's how to get started:
- Find a therapist. You can get a referral from a doctor, health insurance plan, friend or other trusted source. Many employers offer counseling services or referrals through employee assistance programs (EAPs). Or you can find a therapist on your own — for instance, through a local or state psychological association or by searching the internet.
- Understand the costs. If you have health insurance, find out what coverage it offers for psychotherapy. Some health plans cover only a certain number of therapy sessions a year. Also, talk to your therapist about fees and payment options.
- Review your concerns. Before your first appointment, think about what issues you'd like to work on. While you can also sort this out with your therapist, having some sense in advance may provide a starting point.
Check qualifications
Psychotherapist is a general term, rather than a job title or indication of education, training or licensure.
Examples of psychotherapists include psychiatrists, psychologists, licensed professional counselors, licensed social workers, licensed marriage and family therapists, psychiatric nurses, or other licensed professionals with mental health training.
Before seeing a psychotherapist, check his or her:
- Background and education. Trained psychotherapists can have a number of different job titles, depending on their education and role. Most have a master's or doctoral degree with specific training in psychological counseling. Medical doctors who specialize in mental health (psychiatrists) can prescribe medications as well as provide psychotherapy.
- Certification and licensing. Make sure that the therapist you choose meets state certification and licensing requirements for his or her particular discipline.
- Area of expertise. Ask whether the therapist has expertise and experience treating your symptoms or your area of concern, such as eating disorders or PTSD.
The key is to find a skilled therapist who can match the type and intensity of therapy with your needs.
What you can expect
Cognitive behavioral therapy may be done one-on-one or in groups with family members or with people who have similar issues. Online resources are available that may make participating in CBT possible, especially if you live in an area with few local mental health resources.
CBT often includes:
- Learning about your mental health condition
- Learning and practicing techniques such as relaxation, coping, resilience, stress management and assertiveness
Your first therapy session
At your first session, your therapist will typically gather information about you and ask what concerns you'd like to work on. The therapist will likely ask you about your current and past physical and emotional health to gain a deeper understanding of your situation. Your therapist may discuss whether you might benefit from other treatment as well, such as medications.
The first session is also an opportunity for you to interview your therapist to see if he or she will be a good match for you. Make sure you understand:
- His or her approach
- What type of therapy is appropriate for you
- The goals of your treatment
- The length of each session
- How many therapy sessions you may need
It might take a few sessions for your therapist to fully understand your situation and concerns, and to determine the best course of action. If you don't feel comfortable with the first therapist you see, try someone else. Having a good "fit" with your therapist can help you get the most benefit from CBT.
During CBT
Your therapist will encourage you to talk about your thoughts and feelings and what's troubling you. Don't worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort.
CBT generally focuses on specific problems, using a goal-oriented approach.
As you go through the therapy process, your therapist may ask you to do homework — activities, reading or practices that build on what you learn during your regular therapy sessions — and encourage you to apply what you're learning in your daily life.
Your therapist's approach will depend on your particular situation and preferences. Your therapist may combine CBT with another therapeutic approach — for example, interpersonal therapy, which focuses on your relationships with other people.
Steps in CBT
CBT typically includes these steps:
- Identify troubling situations or conditions in your life. These may include such issues as a medical condition, divorce, grief, anger or symptoms of a mental health disorder. You and your therapist may spend some time deciding what problems and goals you want to focus on.
- Become aware of your thoughts, emotions and beliefs about these problems. Once you've identified the problems to work on, your therapist will encourage you to share your thoughts about them.
This may include observing what you tell yourself about an experience (self-talk), your interpretation of the meaning of a situation, and your beliefs about yourself, other people and events. Your therapist may suggest that you keep a journal of your thoughts. - Identify negative or inaccurate thinking. To help you recognize patterns of thinking and behavior that may be contributing to your problem, your therapist may ask you to pay attention to your physical, emotional and behavioral responses in different situations.
- Reshape negative or inaccurate thinking. Your therapist will likely encourage you to ask yourself whether your view of a situation is based on fact or on an inaccurate perception of what's going on. This step can be difficult. You may have long-standing ways of thinking about your life and yourself. With practice, helpful thinking and behavior patterns will become a habit and won't take as much effort.
Length of therapy
CBT is generally considered short-term therapy — ranging from about five to 20 sessions.
You and your therapist can discuss how many sessions may be right for you. Factors to consider include:
- Type of disorder or situation
- Severity of your symptoms
- How long you've had your symptoms or have been dealing with your situation
- How quickly you make progress
- How much stress you're experiencing
- How much support you receive from family members and other people
Confidentiality
Except in very specific circumstances, conversations with your therapist are confidential. However, a therapist may break confidentiality if there is an immediate threat to safety or when required by state or federal law to report concerns to authorities. These situations include:
- Threatening to immediately or soon (imminently) harm yourself or take your own life
- Threatening to imminently harm or take the life of another person
- Abusing a child or a vulnerable adult ― someone over age 18 who is hospitalized or made vulnerable by a disability
- Being unable to safely care for yourself
Results
Cognitive behavioral therapy may not cure your condition or make an unpleasant situation go away.
But it can give you the power to cope with your situation in a healthy way and to feel better about yourself and your life.
Getting the most out of CBT
CBT isn't effective for everyone. But you can take steps to get the most out of your therapy and help make it a success.
- Approach therapy as a partnership. Therapy is most effective when you're an active participant and share in decision-making. Make sure you and your therapist agree about the major issues and how to tackle them. Together, you can set goals and assess progress over time.
- Be open and honest. Success with therapy depends on your willingness to share your thoughts, feelings and experiences, and on being open to new insights and ways of doing things. If you're reluctant to talk about certain things because of painful emotions, embarrassment or fears about your therapist's reaction, let your therapist know about your reservations.
- Stick to your treatment plan.
If you feel down or lack motivation, it may be tempting to skip therapy sessions. Doing so can disrupt your progress. Attend all sessions and give some thought to what you want to discuss. - Don't expect instant results. Working on emotional issues can be painful and often requires hard work. It's not uncommon to feel worse during the initial part of therapy as you begin to confront past and current conflicts. You may need several sessions before you begin to see improvement.
- Do your homework between sessions. If your therapist asks you to read, keep a journal or do other activities outside of your regular therapy sessions, follow through. Doing these homework assignments will help you apply what you've learned in the therapy sessions.
- If therapy isn't helping, talk to your therapist. If you don't feel that you're benefiting from CBT after several sessions, talk to your therapist about it. You and your therapist may decide to make some changes or try a different approach.
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Overview - Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.
It's most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.
How CBT works
CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a negative cycle.
CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts.
You're shown how to change these negative patterns to improve the way you feel.
Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past.
It looks for practical ways to improve your state of mind on a daily basis.
Uses for CBT
CBT has been shown to be an effective way of treating a number of different mental health conditions.
In addition to depression or anxiety disorders, CBT can also help people with:
- bipolar disorder
- borderline personality disorder
- eating disorders – such as anorexia and bulimia
- obsessive compulsive disorder (OCD)
- panic disorder
- phobias
- post-traumatic stress disorder (PTSD)
- psychosis
- schizophrenia
- sleep problems – such as insomnia
- problems related to alcohol misuse
CBT is also sometimes used to treat people with long-term health conditions, such as:
- irritable bowel syndrome (IBS)
- chronic fatigue syndrome (CFS)
- fibromyalgia
- chronic pain
Although CBT cannot cure the physical symptoms of these conditions, it can help people cope better with their symptoms.
What happens during CBT sessions
If CBT is recommended, you'll usually have a session with a therapist once a week or once every 2 weeks.
The course of treatment usually lasts for between 6 and 20 sessions, with each session lasting 30 to 60 minutes.
During the sessions, you'll work with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings and actions.
You and your therapist will analyse these areas to work out if they're unrealistic or unhelpful, and to determine the effect they have on each other and on you.
Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.
After working out what you can change, your therapist will ask you to practise these changes in your daily life and you'll discuss how you got on during the next session.
The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life.
This should help you manage your problems and stop them having a negative impact on your life, even after your course of treatment finishes.
Pros and cons of CBT
Cognitive behavioural therapy (CBT) is effective in treating some mental health problems, but it may not be successful or suitable for everyone.
Some of the advantages of CBT include:
- it can be completed in a relatively short period of time compared with other talking therapies
- the highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books and online
- it teaches you useful and practical strategies that can be used in everyday life, even after the treatment has finished
- it focuses on the person's capacity to change themselves (their thoughts, feelings and behaviours)
- it can be as effective as medicine in treating some mental health problems and may be helpful in cases where medicine alone has not worked
Some of the disadvantages of CBT 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 sessions and carrying out any extra work between sessions can take up a lot of your time
- it may not be suitable for people with more complex mental health needs or learning difficulties
- it involves confronting your emotions and anxieties – you may experience initial periods where you're anxious or emotionally uncomfortable
- it does not address any wider problems in systems or families that may have a significant impact on someone's health and wellbeing
Some critics also argue that while CBT addresses current problems and focuses on specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood.
How to find a CBT therapist
You can get psychological therapies, including CBT, on the NHS.
You can refer yourself directly to an NHS psychological therapies service (IAPT) without a referral from a GP.
Or your GP can refer you if you prefer.
If you can afford it, you can choose to pay for your therapy privately. The cost of private therapy sessions varies. It usually costs £60 to £100 per session, but lower rates may be available to those on lower incomes.
There is a register of all accredited therapists in the UK on the British Association for Behavioural and Cognitive Psychotherapies (BABCP) website.
There's also a directory of chartered psychologists on the British Psychological Society (BPS) website, some of whom specialise in CBT.
Video: psychological therapies for stress, anxiety and depression
Animated video explaining self-referral to psychological therapies services for stress, anxiety or depression.
Media last reviewed: 14 March 2022
Media review due: 14 March 2025
TOC Thinking Process Tools for Development and Implementation of Management Decisions (Article) - Natalia Anisimova
Our whole life is a series of decisions: enter new markets or focus on old ones; to execute the order of the management or to do otherwise due to an unforeseen event; have a child or continue a career path ... When none of the decisions suits you completely, when it “breaks” between decisions, a conflict arises: personal internal dilemmas or disagreements with others. It takes energy, time, money.
The Theory of Constraints (TOC) is based on three premises:
• people do not resist change
• contradictions can be resolved without compromise through mutually beneficial solutions
• everything is connected by cause and effect relationships
For those who hear these premises for the first time, they cause a smirk: “Yeah, of course, no matter how.
Decisions are mutually beneficial and people are ready to change?! And what about Sergei Petrovich - such a stubborn one! And Masha? What are the cause-and-effect relationships in her head?
However, in the theory of constraints there is a powerful set of logical tools that allow you to live a conscious, conflict-free life. This toolkit is wide and helps with tasks ranging from solving personal dilemmas to developing a company's long-term strategy. I will describe a few of them.
Cloud
CBT Conflict Cloud
CBT Cloud is a tool for visualizing and resolving an internal dilemma, conflict or disagreement with another person. With the help of the Cloud you can:
analyze the current situation and understand what the conflict is,
logically, without emotions, understand what premises led to the conflict,
develop a solution based on the analysis of the premises that suits both parties or suits you when working with an internal dilemma.
This is a powerful tool. Those who have mastered it are able to hear and understand other people, develop win-win solutions. But despite its apparent simplicity, the tool requires skills.
Cloud - for understanding the conflict and developing a solution.
Negative branch “We wanted the best, but it turned out as always” - to prevent this from happening, the negative branch is used. The tool allows you to visualize the possible development of events and shows where you need to take additional measures.
Negative branch
Negative branch - to assess the risks of implementing a new solution and eliminate them.
Adverse Event Chart (AEE) It is human nature to look for solutions to conflicts that lie "on the surface". And it seems that the conflict is resolved, but time passes, and it arises again - all because of hidden deep conflicts and strong cause-and-effect relationships.
The Adverse Events chart helps to analyze these relationships within the system.
Adverse Events Map (UAE)
Adverse Events Map — for system analysis and finding the causes of conflicts in the system.
Adverse Event Clouds
If the dilemma and conflict cloud helps to find a solution to a particular problem, then UDE clouds are used to develop solutions to improve the performance of the system as a whole. As a rule, there is always a "common" cloud that underlies most or all conflicts in the analyzed area. You can find it by consolidating UDE clouds.
UDE cloud — for a deeper analysis of UDE and development of a solution to improve the performance of the system
And these are not all TOC logical tools.
***
In my opinion, the tools of thought processes are the gem of the theory of constraints. TOC has developed complexes of working solutions for different areas of activity: production, distribution, retail, projects, marketing, B2B sales… TOC thought process tools help to implement these solutions and develop new ones, communicate with people, overcome resistance.
These tools are useful in both work and personal life.
But in the article, I did not consider the details of how to use these tools, because. it takes practice to master them. The first clouds are not easy. It takes practice, practice and more practice. Come to TocPro master classes or order corporate projects in the feedback form. We have experience in training new companies with companies that already use these tools. Here I have described this experience. Can conduct training in this format for you.
What can you read about the tools of the thought processes of the theory of constraints?
- the main books to start with:
- Elena Fedurko. TYPICAL ERRORS when working with logical tools TOC
The book discusses the main mistakes that are made when building a cloud and a tree of existing reality - H. William Dettemer. Goldratt's Theory of Constraints
The book covers all the main tools of the thought processes of the theory of constraints - Jelena Fedurko.
Through Clouds to Solutions
If English is not a problem for you, I highly recommend this book. It describes in detail how to work with clouds of undesirable phenomena - Physics - an article on the use of clouds
Natalya Anisimova
Candidate of Economics 9000 we hear others, and our own voice of reason too
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Introduction | Stock-M Consulting - TOC Inventory Management
| TEAM StockM Consulting - develops and implements computer software for inventory and assortment management - StockM. The team has 7 years of product development, several dozen significant implementation projects for large supply chains, as well as many years of experience in managing and consulting on Theory of Constraints (TOC). The StockM Consulting team includes a certified Theory of Constraints (TOC) trainer and consultant - Natalia Anisimova. |
IMPLEMENTATION PROCESS
Practicing TOC experts study the company's business processes, based on the implementation experience, give recommendations for their improvement, configure the software package in accordance with the specifics of the enterprise, train your employees.
Typical stages
- Diagnostics of business processes of the company
- Consulting top management
- Personnel training
- Installation
- after-project support
In the process of diagnostics, we consider the entire supply chain: from the formation of an order to the receipt of goods on store shelves.
Recommendations for improvement include:
- delivery schemes
- frequency of delivery
- product matrices of stores and warehouses
- assortment management procedures volume of purchases, management of illiquid products, etc.
TOC consulting is remarkable in that we identify weaknesses in processes: outdated procedures, conflicts between departments, blocking factors. Also, one of the main advantages of TOC consulting is the focus of management on recommendations that can give a quick tangible result.
RESULT OF IMPLEMENTATION OF RECOMMENDATIONS: TURNOVER INCREASE, PROFIT GROWTH, INVENTORY REDUCTION.
TRAINING
Training takes place in two main areas:
- Working with the software package
- New approaches to inventory and assortment management in the supply chain according to the TOC methodology
and correct the illogicality of individual processes and procedures existing in the enterprise.
Top management and key employees
The purpose of training for managers is to move from local thinking (“concern” about the performance of individual departments) to systems thinking (growing profits for the entire company / supply chain).
We analyze the limitations of the system in detail and discuss the overall direction of the company. We show what will change after the introduction of Stock-M, and how to make the reaction to changes in market conditions more flexible.
EXECUTIVES REMARK THAT STRATEGY DEVELOPMENT IS MORE CONSCIOUSLY AFTER EXPOSURE TO THE THEORY OF CONSTRAINTS.
Project team and responsible users Stock-M
The project team is responsible for the success of the inventory and assortment management changes. Therefore, we apply a special approach to training the project team.
- Group training in the skills of working with the software package, with mandatory additional adjustment of the software during training to the specifics of the client.
- Virtually one-to-one training for each project team member in new decision-making skills in inventory and assortment management
- Training in the analysis of reports generated by Stock-M and development of decision-making skills based on them.
We show what can be done by changing processes and procedures or by changing settings in the software.
During the training process, we identify and dispel possible fears and disagreements of employees in order to avoid resistance during the implementation stage.
INSTALLATION, SETUP AND LAUNCH OF THE SOFTWARE COMPLEX
Our team has repeatedly commissioned Stock-M, so there are no surprises in the process, the whole procedure is verified to the smallest detail.
Preparation
- Discussing with the client the terms of delivery, the chain, the established procedures for managing stocks and assortment, the information available in the customer's ERP system
- Setting up the upload from the accounting system (ERP)
- Testing the upload
Launch 90602
3 Uploading the history of the movement of goods (for calculating the initial values of the buffer and seasonal adjustments)
) - Setting up delivery schemes and periodicity
- Automatic generation of stock buffers for the assortment of the supplier
- Creation of the first orders
- Testing the correctness of generated regular orders for automatic addition (DTA) customers (DTO) to the system
“Improvement stage”
At this stage, the generation of analytical reports that help reduce lost sales and excess inventory, training their analytics
- Inventory management
- Connecting all suppliers
- Seasonality adjustment
- Combining alternative products into groups
Implementation progress
To control the progress of the plan, we use a "diagonal buffer" for project management (Theory of Constraints tool - CCPM).
Thanks to the diagonal buffer:
- project progress is transparent
- the motivation of employees involved in the project is increased
- management receives information in advance about possible risks of project delay
CCPM (Critical Chain Project Management) - project management using the critical chain method
POST-PROJECT SERVICE
SUPPORT SERVICE
Customer assistance is carried out in any convenient way: skype, phone, e-mail, field consultations.
Technical support
Technical support staff answer any questions from the client's employees, help to master the program, tell about new features in updated versions.
TOC Consulting
After completing the main stages of implementation, we continue to advise on supplier and customer relationships, assortment management, changes in supply chains and other inventory management issues.
Collaboration is often not limited to stock issues. For example, we help to change the motivational policy of personnel, develop a “mafia offer”, set up management accounting for TOC, etc.
SOFTWARE UPDATES
Each new client is an experience for Stock-M, which is made available to other clients in the form of software package updates.
For customers accessing the cloud version of Stock-M, updates are automatic. For clients with fixed server placement - according to the contractual agreement.
IMPLEMENTATION TERMS
On average, the main stages of implementation take from 3 to 6 months.
As a result, you get:
- a fully functioning software package with the ability to automatically send orders to suppliers
- an analytical report module for assortment management
- employees trained in new approaches to inventory and assortment management using the software package
In addition, we provide active consulting support throughout the full year - to check the adjustment of seasonal demand fluctuations, help in clarifying the range of warehouses and stores, and ensuring that employees strictly adhere to the developed procedures.
