What about CBT without a therapist?
Although cognitive behavioural therapy (CBT) often works best with the help of a trained therapist, some people prefer to tackle their problems themselves. It's still very important to see your doctor to make sure CBT is right for you.
There are many self-help books available. Some are excellent, but many are not. If in doubt look for self-help books that have been recommended by a professional organisation or by a health professional. For example:
- 'Overcoming' self-help books. In the UK, the Royal College of Psychiatrists endorses the Overcoming self-help series. These books and CDs are based on CBT and cover more than 30 common mental health problems. Titles include 'Overcoming Anxiety', 'Overcoming Low Self-Esteem' and 'Overcoming Grief'. They are available from bookshops and libraries. You can also download them from the Overcoming.co.uk website.
- Books on Prescription. You can also find NHS-endorsed books for common emotional and mental health problems on the 'Reading Well Books on Prescription' website.
Online mental health services
In the UK, some online mental health services have been approved for use by the NHS. Research shows that these can be just as effective as face-to-face therapy with a therapist for depression, anxiety and other mental health problems. The kind of support offered by online mental health services varies. Some allow you to work through a self-help course online with support from a health professional. Others offer live therapy with a therapist via instant messaging or a webcam.
You can also join an anonymous online community where you can meet and interact with other people who have similar mental health problems to you. You don't need much experience with computers or technology to use them.
Phone and email CBT
Phone and email CBT can be ideal if you're shy or don't want to meet the therapist, or if you can't find one in your area. They save travelling time, can avoid the problem of finding childcare and are available during evenings and weekends. Phone or email CBT is just like having a face-to-face session, except that you talk to a trained therapist over the phone. Phone and email CBT are increasingly being offered by private therapists and sometimes by workplaces and charities.
There are a number of interactive programs available that allow you to benefit from CBT with little or no contact with a therapist. In the UK, Beating the Blues (beatingtheblues.co.uk) is approved for treating mild-to-moderate depression. However, there are many similar computerised CBT packages that may also be effective. Some people prefer using a computer rather than talking to a therapist about their private feelings. However, you may still benefit from occasional meetings or phone calls with a therapist to guide you and to monitor your progress.
Further reading and references
Computerised cognitive behaviour therapy for depression and anxiety; NICE Technology Appraisal Guidance, February 2006 (last updated May 2013)
Gartlehner G, Gaynes BN, Amick HR, et al; Comparative Benefits and Harms of Antidepressant, Psychological, Complementary, and Exercise Treatments for Major Depression: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016 Mar 1164(5):331-41. doi: 10.7326/M15-1813. Epub 2015 Dec 8.
Pompoli A, Furukawa TA, Imai H, et al; Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database Syst Rev. 2016 Apr 134:CD011004. doi: 10.1002/14651858.CD011004.pub2.
James AC, James G, Cowdrey FA, et al; Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2015 Feb 182:CD004690. doi: 10.1002/14651858.CD004690.pub4.
i have bipolar disorder, anxiety, mood disorder, and ADHD. I recently found out about the ADHD and am seeking care and understanding in that. My son however has a mild form of Autism and ADHD. I am...rebecca 13760
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