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A Therapist-Free Therapy?

  • September 30, 2022 12:56 PM +06

    Cognitive-behavioural therapy (CBT) is widely used to treat anxiety and depression. Many people don't have access to a CBT therapist because none are nearby, in their insurance network, or too expensive. Seeing a therapist every week can be difficult if you work or have children.

    As mentioned by Neuromuscular Treatment Seeing a CBT therapist for anxiety or depression may not be necessary. Self-help books and the Internet offer CBT without a therapist. Self-directed CBT is effective, according to studies.

    33 studies found that self-help treatment reduced anxiety; 34 studies on depression found similar benefits, especially when CBT techniques were used. Both reviews found self-help treatments were moderately helpful. People who did the treatment felt better—not "a new person," but less anxious or depressed.

    People who do self-help CBT for anxiety and depression tend to keep their progress over time, which is encouraging. CBT teaches you skills to "become your own therapist" after treatment ends. These studies show that self-taught CBT skills can help people feel better.

    Is therapy dead? Nope. CBT with a therapist is more effective than self-help CBT, so working with someone directly can be beneficial. Self-help treatment can also be done with limited professional input, such as a weekly phone call, which can boost results. Working with a therapist may be beneficial not only because of expert advice but also because of consistent encouragement.

    Self-help CBT is part of stepped care, which matches treatment intensity to a person's needs. A severely depressed person who can't get out of bed probably won't benefit from self-directed CBT and will need professional help. Persons with mild to moderate anxiety or depression who can function well may benefit from a CBT book.

    ABCT maintains a list of books with their "seal of merit" if you're interested in self-directed CBT. I also wrote a book on CBT for anxiety and depression.

    My book and others include:

    Identifying mental habits.
    Understanding how thoughts affect feelings and behavior.
    Checking your thinking.
    Replace bias with realism.
    Techniques include:

    Scheduling enjoyable and fulfilling activities.
    Knowing how your actions affect your feelings.
    Time-management planning.
    Breaking down big tasks into smaller ones.
    Slowly and methodically overcoming your fears.
    These approaches are simple and obvious. Indeed, what drew me to CBT in the beginning of my graduate training was how straightforward and intuitive it was, making it well-suited to self-directed therapy. As I've said before, CBT's effectiveness comes from its systematic approach and emphasis on practice.

    If you choose self-help CBT, consider these guidelines:

    Find a meaningful book. Different people prefer different approaches, tones, etc. If the book fits, you're more likely to read it.
    Pick a well-researched book. Self-help therapy takes time and effort, so choose a solid program.
    Focus on the program. Any therapy has good and bad times. While you may always have competing activities, it's best to avoid being overextended and putting therapy off.
    Stay on track. It's easy to skip self-help parts we think won't work or that we already know. If a program doesn't work, we won't know if it wasn't right for us or if we only did two-thirds of it. Following instructions help us benefit and learn what works for us.