CBT is a Counselling and Psychotherapy Model

When people are thinking about becoming a counsellor or therapist, there can sometimes be some confusion as to what counselling model to study, and at times even ask should I study CBT or Counselling?

With so many different types of therapy being practiced, all of which ultimately aim to help the client overcome a range of emotional problems, it’s not surprising the waters can become muddied.

This blog hopes to provide clarity and reassure those thinking of training in Cognitive Behavioural Therapy (and specifically Rational Emotive Behavioural Therapy, or REBT), that it is most definitely a counselling and psychotherapy model.

It is important for clients, employers or placement providers for trainee counsellors to have accurate information to make informed decisions. The ideas that underpin each counselling model have a profound effect on the techniques we develop and the way we ‘do’ our work or the way we counsel. The model a counsellor uses, their ‘therapeutic bias or preference’, will even affect what is considered important or relevant during sessions. But just because there are different types, it does not mean one is more ‘authentically’ counselling than the other.

Many models of counselling

There are many different theories of counselling available to choose from, whether as a practitioner or a client. Some of the most well-known include:

  • Psychodynamic therapy, which includes Psychoanalysis (Freud), Analytical Psychotherapy (Jung), Individual Psychology (Adler), Object-Relations (Fairbairn, Winnicott and Guntrip)

  • Learning Theory Approaches which includes Reinforcement and Psychoanalytic therapy (Dollard and Miller), Behavioural (Wolpe)

  • Perceptual – Phenomenological Approaches which includes Personal Constructs and Psychotherapy (Kelly), Transactional Analysis (Berne), Gestalt (Perls), Client Centred (Rogers)

  • Existential which includes Logotherapy (Frankl)

  • Cognitive and Behaviour Therapy which includes REBT (Ellis), CT (Beck), and Cognitive Behavioural Modification (Meichenbaum)

All of these are counselling theories. ‘Cognitive Behavioural Therapy (CBT)’ is an umbrella term for several different theories that share common principles, just as ‘Psychodynamic Therapy’ is an umbrella term for a different set of theories that share common principles.

In addition, there are some approaches that combine Psychodynamic and CBT models such as Schema Therapy, as well as therapies that are developed for Personality Disorders such as Schema and Dialectical Behaviour Therapy that combine CBT and other approaches, and so on.

Informed choice is key

When deciding on what counselling to train in or take, it is important to make an informed choice. We don’t have room in a single blog to explain what each of the different types of counselling mentioned above entail, and how they differ. Prospective counsellors must do their research and choose the model that they think best suits them, their strengths, experiences and ways of working.

But equally important is questioning received ideas or misconceptions about different models. So, some non-CBT counsellors think that CBT counsellors don’t pay any attention to the therapeutic relationship (the working relationship between the client and the counsellor), which is completely untrue. Of course, a CBT-counsellor will work hard to develop an open, trusting and relaxed working relationship. We are, after all, encouraging our clients to be frank and honest with their experiences and beliefs. How could we expect them to share these things if they did not trust us?

In Psychodynamic counselling, for example, the therapeutic alliance is viewed as the ‘the most significant condition or the central vehicle through which change occurs. In contrast, A CBT counsellor sees the therapeutic alliance as significant and very important, whilst viewing that change happens from a client changing their mindset and their behaviour, and that is a process that starts from understanding emotional responsibility, emotions, facing our past, present and future and developing skills of critical thinking and healthy behaviours. Without a therapeutic alliance effective change would be limited regardless of the counselling model used.

Even under the CBT ‘umbrella’ there can be differences. REBT, for example, can be described as philosophical and existential in nature, whilst others are less so. And even Albert Ellis himself, the founder of REBT, acknowledged that sometimes it can appear more guided or didactic than other methods, focused as it is on identifying and achieving tangible emotional and behavioural goals.

Essentially, we at CCBT believe that understanding the range of different psychotherapy models currently practiced, their differences and individual benefits or drawbacks, is key to becoming a well-rounded and helpful counsellor. We even include a overview of the many different schools and how you can include them in your REBT practice on our Advanced Diploma in Integrative CBT/REBT I and Advanced Diploma in Integrative CBT/REBT II. It might even be useful, when talking about such matters, to start using terms such as term CBT Counselling, Psychodynamic Counselling etc. Clarity in word will often lead to clarity in thought, after all!

If you have questions about CBT, REBT, or training to become a counsellor, please do get in touch at admin@cbttherapies.org.uk , and we’d be happy to answer your questions.

Avy Joseph and Nick Jones

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My First Step to Becoming a CBT Therapist – The Counselling Skills and Ethics Course

By Nick Jones – CBT / REBT Therapist

These days, I am a fully qualified and accredited CBT / REBT therapist, with coming up for three years’ experience of helping clients. I’m still just beginning my professional career, with much more to learn, but here I am…

But before I began my training with the College of Cognitive Behavioural Therapies to get here, I had no experience whatsoever of counselling, therapy, psychology, or anything in those fields. I hadn’t even been for therapy myself (although I’m sure there were plenty of times when it would have helped).

What was my first step? My first taste of what was to come? It was the Counselling Skills and Ethics course, which I attended over two weekends. This is the course that sets you up with the basic skills you need to operate as a therapist. Completing it not only helps you become more affective at working with clients, for the completely inexperienced its completion is a prerequisite for moving on to CCBT’s Diploma in CBT / REBT.

If you’re completely new to therapy and counselling, as I was, you may well have no idea of what’s involved, and what tactics you need to deploy to effectively listen, build relationships and ultimately help someone who has come to you. Is it really sitting in a leather armchair asking someone ‘how does that makes you feel’? (OMG NO, we were to learn!)

When I turned up for my first day, just a little bit nervous, I’ll admit, my fellow students had a mix of CBT and counselling experience, with several students like myself having no psychology or clinical skills at all (my background is in digital and social media marketing). Some had had training in the past and wanted a refresher, and others had experience in tangential mental health fields but wanted to make the move to becoming a therapist themselves.

What the course covered

Over the two weekends, we were shown the basics of working as a CBT / REBT counsellor. Whilst we did not go into great detail about the REBT model (that comes later on the Diploma course), we were introduced to the concept of emotional responsibility (and to ask ‘how do you feel about that’ instead!), the basic structure of a counselling session, the three-stage counselling model, and perhaps most importantly to a complete beginner like me, the art and science of active listening.

Whilst the content covering sessions and counselling models is vital and fascinating, learning how to listen, reflect and summarise when working with a client, and the subtle ways you can encourage interaction and strengthen the all-important therapeutic alliance was a revelation. From body language to the use of silences, open questions to paraphrasing what’s just been said, these people-focused skills were practiced in several role-plays over the two weekends.

If like me role-play isn’t something you’ve done much of before, expect some cringing and corpsing to begin with but you soon get into the swing of things. By the time the course is over, you’ll be method acting like James Dean and be much more confident about eliciting the right information from a client.

These active listening skills are also something you can immediately take away and start using in your everyday life, whether managing conversations at work more effectively or being a better listener and communicator for you family and loved ones.

As well as the above skills around structuring and managing sessions and working with clients, the course also covers many of the ethical questions you may face when dealing with people’s most personal issues.

These range from the foundation concept of confidentiality and what that means in practice to discussions around more complex ethical dilemmas and how you, as a counsellor, should respond. These resulted in some lively debates where your knowledge is tested, and preconceptions challenged.

Upon completion, you are awarded a certificate and are then in possession of the basic skills you need to progress to the Diploma. But more importantly, you’ll have confidence in your own abilities to interact and work with others effectively and compassionately.

Although the things you learn on the Counselling Skills and Ethics course could be described as ‘basic’, or ‘entry level’, perhaps a more realistic description would be ‘foundational’. Throughout the rest of my training, all the way up to the Advanced Diploma in Integrative CBT / REBT, and now into my professional practice, the skills, methods and ideas I learnt over those two weekends have stayed with me and guided me through every session I’ve had with a client since. I would not be where I am today without them!

If you’d like to find out more about the Counselling Skills & Ethics course with CCBT, you can email the team at admin@cbttherapies.org.uk or check the next course here.

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REBT Helps You Accept Reality – Like It or Not

As you would expect from a school of CBT that calls itself Rational Emotional Behavioural Therapy, rationality and realism are at the core of REBT’s philosophy.

Albert Ellis, the founder of REBT, said ‘If something is irrational, that means it won’t work. It’s usually unrealistic.’

One of the main jobs of REBT is to help clients identify their irrational, unhealthy beliefs. These unhealthy beliefs usually begin with variation on one of three main themes: I must do well. You must treat me well. And the world must be easy.

However, anyone choosing to look at these statements above with a rational and realistic viewpoint will quickly see there is absolutely no reason why these demands ‘must’ be met. You may want to do well, but you don’t have to. You’d like people to treat you well, but experience tells us they won’t always, and we’d all prefer life to be easy, but for nearly everyone, it certainly isn’t.

Let’s say someone crashes into the back of your beloved car. No matter how much you demand that this event shouldn’t have happened, that everyone must drive carefully and your ability to drive about as normal must not be disrupted, that fact of the matter is, your break lights are broken and your bumper is hanging off. Refusing to accept the reality of the situation will not get you through your MOT.

Whilst that may be a silly example, a more common one during therapy might be ‘My partner must be honest with me at all times.’ But what if we know for a fact that sometimes they aren’t? Refusing to accept the reality won’t change anything. It will only lead to disturbance, hurt, jealousy or anger.

Accepting reality is not the same as condoning it

It is at this point it’s useful to remember that accepting something does not necessarily mean condoning it. We can accept that hunger and war exist around the world without thinking these are good things. In fact, by accepting them as real, we can choose to do something about them.

And our client can come to accept that their partner is not always honest, without condoning or agreeing with this behaviour. By accepting the reality of the situation, they can now choose to change how they think and behave in order to affect real change in how they feel as well as in their relationship. They may not enjoy this new reality, but at least now they can accept it and do something about it.

Accepting the reality of life, rather than how you might be demanding it to be, is a turning point for REBT clients, and something a therapist will spend a lot of time working on. And although we called this blog post ‘like it or not’, in the end, most people agree that rationally accepting reality is the first step to liking everything a whole lot more.

If you’d like to train with CCBT to become an REBT counsellor, find out all about our pathway to accreditation here.

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