The Aspiring Psychologist Podcast - What Is CBT? How Cognitive Behavioural Therapy Helps with Anxiety, Depression & More

Episode Date: September 8, 2025

Cognitive Behavioural Therapy (CBT) is one of the most widely used and researched psychological therapies for anxiety, depression, and low mood but what actually happens in CBT sessions, and how does it work?In this episode of The Aspiring Psychologist Podcast, Clinical Psychologist Dr Marianne Trent is joined by CBT therapist Sahana to explore what CBT is, how CBT works, and what clients can expect. From breaking unhelpful thought cycles to graded behavioural experiments, you’ll discover how CBT helps people with anxiety, depression, social anxiety, and more.Whether you’re thinking about accessing CBT therapy, supporting someone else, or training as a psychologist, this conversation gives you a clear, compassionate understanding of CBT and why it’s such a practical and empowering approach.Timestamps: 00:00 – Introduction: What CBT is and why it matters01:08 – First steps: nerves, myths, and accessibility in CBT02:31 – Making therapy accessible: online sessions, adaptations, and barriers04:39 – Thoughts, feelings, behaviours: the CBT cycle explained07:45 – When everyday worries become overwhelming09:58 – What keeps problems going? The role of formulation11:32 – Homework vs “between-session practice” — what clients can expect13:22 – Graded exposure and behavioural experiments16:13 – Case example: how CBT can help after relationship breakdown20:01 – Problem lists, goals, and building awareness23:06 – Balancing validation with change in CBT25:17 – How many CBT sessions do people usually get?27:56 – Collaboration, feedback, and challenging the ‘therapist as expert’ myth30:56 – The role of safety-seeking behaviours vs adaptive coping36:20 – Who CBT might not be the best fit for38:47 – Other approaches and the stages of change39:21 – Closing thoughts and next episode preview: training as a CBT therapistLinks:🫶 To support me by donating to help cover my costs for the free resources I provide click here: https://the-aspiring-psychologist.captivate.fm/support📚 To check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0 📖 To check out The Aspiring Psychologist Collective Book: https://amzn.to/3CP2N97 💡 To check out or join the aspiring psychologist membership for just £30 per month head to: https://www.goodthinkingpsychology.co.uk/membership-interested🖥️ Check out my brand new short courses for aspiring psychologists and mental health professionals here: https://www.goodthinkingpsychology.co.uk/short-courses✍️ Get your Supervision Shaping Tool now: https://www.goodthinkingpsychology.co.uk/supervision📱Connect socially with Marianne and check out ways to work with her, including the Aspiring Psychologist Book, Clinical Psychologist book and The Aspiring Psychologist Membership on her Link tree: https://linktr.ee/drmariannetrent💬 To join my free Facebook group and discuss your thoughts on this episode and more:

I'm Jo and I work as an assistant practitioner in a CAM service in Lancashire. I bought and read Marianne's book The Clinical Psychologist Collective to accompany me while completing the clinical psychology training application. It proved to be really good company. I found it sparked ideas of how to build experience and skills, but more than that, it offered the chance to get lost in people's stories. It provided a timely reminder not to get so cold, up in an end goal and to value and enjoy each job we fulfil along the way, because the work we do now is important and matters to those we sit alongside as well as ourselves. It also gave the reassurance that there are eclectic roots into clinical psychology, which is important for me as someone who's had a meandering journey and not a typical route to the profession.

I wholeheartedly recommend the book for both personal and professional reasons. Be prepared It's put evening tasks on hold for a while though, because once you've started reading, it's tough to put it down. Struggling with your thoughts, wondering why you feel stuck or how to finally move forwards. Cognitive behavioural therapy or CBT is one of the most widely researched and used therapies in the world today. But what actually happens in CBT and how does it help? Whether you're considering therapy, supporting someone else or training to be a psychologist

yourself, this episode is for you. I'm chatting with Sahana, a qualified CBT therapist. I'm Dr. Marianne, a qualified clinical psychologist. Please like and subscribe for more, and Sahana and I both hope you find it really useful. Hi, welcome along to the aspiring psychologist podcast. I'm Dr. Marianne, and I am a qualified clinical psychologist. I'm joined by my wonderful guest for today, Sahana. Hi, Sahana.

Hi, Marianne, thanks for having me. Thank you for being here, and you are here in your capacity. as a, both an aspiring site, but also a qualified CBT therapist, don't you? Yeah, it'll be interesting to talk about CBT in a different setting. Normally I'm used in like a therapy setting or work setting. So yeah, I'm very excited to share my thoughts. Perfect. And I know you'll do a brilliant job. So the aim of today for anyone watching is that we're going to think from a service user perspective

about what CBT is, kind of what it might be used for, and I guess a bit about what they can expect if they're understandably feeling maybe a bit nervous because they've received maybe a letter or an email through the post telling them that they've got their first CBT appointment and they're like, oh, oh, that's really normal, isn't it, to feel nervous about stuff

that maybe you've not done before? Yeah, of course. I think CBT is quite well known, but I think a lot of people haven't actually tried it before. So yeah, getting that letter through the post and not knowing what it's about, is it going to be, you know, I've had clients say, you know, is it going to be beyond my control, you're going to read into my body language, so there are a lot of myths out there that would be helpful just to bust them, but yeah, it would be helpful to kind of clarify that a bit more today. Yeah, and obviously I know when I've worked in services for the NHS, sometimes we're offering services to people that actually find it really hard to leave the house because they might be feeling. really anxious and maybe even with something like social anxiety which CBT can be really useful for the idea of sitting kind of across from someone that can feel

really difficult can't it yeah so I've always spoken to you Marianne about my social anxiety and actually CBT has personally helped me and I've always the equivalent I would draw in CBT when you have social anxiety is you know therapists were like you know you're scared of spiders but you know you're gonna sit there with a spider we're going to expose you to that so it's definitely nerve-wracking but there are ways to kind of work around it so since the pandemic obviously we've made therapy more accessible so I'm offering remote therapy but also across NHS as well that's an option out there and I think we we try to make it as accessible as it

can be work around those barriers and that people might initially face when trying to access therapy. Amazing. So I guess if it feels insurmountable, maybe speak to the service and ask for maybe whether there's any accommodations that can be made. Oh 100%. So usually we would, what we would actually do is do an assessment to gauge kind of are there any practical barriers, any barriers when it comes to sort of their mental health, that could inhibit them from getting the help that they need and then to kind of cater towards that you know even um you know there's been a rise in being neurodivergent and then we actually

at the start of the assessment ask are you neurodivergent or even if you're not diagnosed is there any adaptations we can make just to make therapy a bit more accessible so yeah definitely if there there's anything as always we might miss something so definitely do raise it with us or let them know because i do think the one thing that we would want is that honesty and rather than just suffering in silence. So yeah, a small call or a simple question can really help iron out things and make it a little bit more, I don't know, it's seamless to eat into a very difficult process. Exactly, because we want people to be set up to thrive and to do really well at this. We don't want them to be thinking that it's already outside their comfort zones. So tell us,

CBT stands for cognitive behavioural therapy. But what is it? So if I was to describe it as like a one-liner, like a newspaper headliner, it's the relationship between your thoughts, feelings and your behaviours. So usually I'd like to explain why it's important to look at those three areas. And I'd like to show a bit of a cycle that kind of showcases those three areas. So when we talk about situations or how we feel, we usually say that a situation makes us feel some type of right? So we might say, I got really anxious at that party. But actually, if it is just that a situation makes us feel some type of way, then that same situation would have the same feeling

for every single person. And that's not the case. That's not what we find. So our emotions can vary in terms of its intensity, but also we might even have like complete different emotions. And what that really boils down to is the meaning we attach to those situations. So by meanings, we can call them our thoughts. You know, we might have mental images. We might have past memories that might come up, even if it's kind of related to an upcoming situation, but that really dictates how we feel. So if we have a look at this particular example, the thought is, I'll embarrass myself and, you know, one might feel slightly anxious. And that can have a knock on effect in terms of how we behave them. So we might be less inclined to go to that party.

On a similar wavelength, if someone thinks I'm really excited, it's about big day, and then celebrate, that same situation party could be excitable, it can bring on emotions of joy, and then the behaviour would be completely different, so it'd be eager to go, eager to plan, set up. So these three components have a knock-on effect with each other and keep that cycle going, and cognitive behavioural therapy or CBT basically looks at breaking down those patterns. So by focusing on the behaviours or the thoughts, that would naturally have like a knock on effect on our emotions. And so if we shift our thoughts from, I'll embarrass myself to, well, let's see how it goes. We might be more open and curious as opposed to feeling quite anxious.

Perfect. So nicely done. And I guess it might be useful for us to think about when we would intervene. So of course if we are feeling a little bit anxious about something, like maybe doing something like this today or before we went on camera, we were talking about something that I'm doing that's new and different, and you're like, do you feel nervous about that? And I was like, well, not in that particular instance, but often in this instance, I do. And it's absolutely fine to feel those feelings, especially if they are novel. But I think we're looking at when it becomes so that you aren't functional or so that your well-being is affected. So we're not aiming to kind of immunise people

against normal emotions but it's when they're crippling or paralysing isn't it that we owe it to themselves to intervene or ourselves even absolutely so you know i'll embarrass myself might be it might be a very normal thought to have but again i think it lies down to the severity of how you might feel that way and the frequency as well um so as i've told you when um i went for CBT for social anxiety the level of impairment that I had, you know, I couldn't even order a restaurant. My best friend had to do it. You know, I couldn't talk. So it had such a restrictive impact on my life.

And that's when CBD can be really useful. So we're not trying to kind of abnormalize or kind of make scary of like everyday situations, everyday natural reactions, like feeling nerves or being nervous in a particular situation isn't a problem at all. It's when it starts having that ripple. and it's so intense and it's difficult to deal with. That's when CBT can be a really helpful intervention. I also think the nice thing about CBT is that its perspective is

all of these sort of problems, if you'd call it, actually stem from really natural kind of emotions. So social anxiety, you know, we all have a natural tendency to want to be light, to be impressionable, you know, we're social creatures, we want to be accepted. but if it becomes kind of more pervasive and it controls various aspects of your life to sort of really great lens. So CBT can actually help people if they're feeling quite restricted and limited with their anxieties or low mood to live a richer quality life so that it doesn't have such pervasive control over them. Yeah, because everybody deserves to have a good shot at thriving

And actually from a variety of reasons, maybe from bullying or kind of the way that we've been raised or just the people that we find ourselves maybe working alongside, we can feel really undermined and that can get to us. Often, you know, we do the thing called formulation, don't we? We make sense. So if we're using like a longitudinal formulation, we look at what might have contributed to this, like what we think about as the precipitating factors, don't we? Could you tell us a little bit more about that? yeah so CBT really banks on that so it looks out what keeps the problem going so it has a very much here and now focus so I might tell my clients you know if you fell down the stairs and now you're afraid of walking down the stairs just because you know you knew how you fell down the stairs doesn't necessarily mean that will get rid of the problem we need to look look at what's

keeping the problem going so what might have set it off might not carry on it might look very different now, the actual problem. So within the context of, so when we say, when you mention formulation, Marian, what I show there is like a silly tool version, like a very simplified version, but it kind of looks out, what keeps the problem going, you know?

Is it the thoughts? Is it the behaviors? And that's largely down to working together with the client, with full consent and knowledge. I'm just asking them and exploring that problem in it detailed analysis i suppose so that way once we've identified okay so these are the things that keeps the problem going we can then look at what can we do to kind of manage them and not let that

interfere our lives so much so we can dismantle that cycle basically amazing and is this going to be like a super heavy thing for clients to do in between sessions because often actually clients do want own work or homework so that they can practice some of these skills. What are people likely to be sent away with or asked to do? Yeah, I think in the earlier sessions, the therapist usually takes the lead with the between session exercises or homework or, as you would say, own work, which I've started using now. What it would usually involve is collecting data, that's what I'd call it. So have a go at this week. Just see how you're getting on, drop down some of the things that trigger.

your cycle. And that can really help us to really reinforce, is this the problem that we're actually working on? And that's really important during the early stages, because one of the underpinnings of CBT is that we want to have a problem of focus. If we spread ourselves too thinly, we might not have any real benefits. So if we have like an overarching problem and we're working towards that and we're kind of bringing our awareness skills to the table, you essentially become your own therapist, really, through that experience. and once you sort of then collect the data, then we then move on to kind of the intervention part where we would then give tools and techniques for them to try.

So there's quite a lot of between session exercises, and people don't really expect that, you know, when they, the first two sessions normally are spend time just assessing suitability for CBT with them. Does it meet their expectations? Because at the end of the day, we don't want people to feel like that they have to do something like a certain approach because they've been told to it's a very much a collaborative effort that you know CBT so we usually ask them how do you feel about homework or you know between session exercises is it daunting for you or is it not your cup of tea writing things down this is what

CBT work looks like this is how it works so how do you feel about that so having those sorts of conversations is really important so that way we're on the same page and that collaborative tone is there from the get-go. Yeah, it's not something that's being done to you. It should be feeling like something that you're part of and we're kind of working with your window of tolerance. We don't want someone to be feeling over-aroused, under-aroused, so hyper-aroused, hypo-aroused,

so that they're not able to be functioning. And I guess, you know, with CBT often there'll be an element of kind of behavioral activation, doing something a bit different and kind of seeing how that goes. but what that is not, is not, it's not flooding, you know, so actually if social anxiety is what you're being seen for, you know, in between session one and two, the therapist should not be saying to you, right, go out and stand in the middle of, you know, Lester Square. Like, that's, that's not fair. That wouldn't be right. That wouldn't be okay. But what they might say is,

could you maybe consider being in the background when the postman comes to the door and your partner answers it like we literally trying to break down on a scale almost of one to a hundred what would be step one and helping you to to manage yourself to to make changes I think that's the great thing about CBT the fact that it's graded it's a gradual approach it's not kind of we're putting you into the deep end off you go let's see if you kind of manage but also the activities that they'll do is aligned with their values and we make sure that it's meaningful and important to them. So that way there is that motivation to do that, which is, yeah, I really feel held back when I'm in the staff room and I'm so anxious. I can't even talk to my colleagues.

So we kind of gradually build sort of activities to work towards that point where they are able to do that specific situation. It can be quite empowering. I think most importantly, it's done together with the client. You know, we don't want to kind of, do activities where it's not challenging at all because then what are we really learning here? And I think that's very much the essence of CBT. We're sort of asking ourselves all the time, you know, myself as a therapist, I always ask, what did I learn about this session from you today? And what did you learn about this session from this session rather?

So that generally that learning component is there underpinning all of this. So we want to make sure that the distress or the discomfort is there enough for them to kind of take away something from that experience so we're constantly like working like detectives really like testing out hypothesis and we're not literally holding magnifying glasses but we're looking at these thoughts with a magnifying glass metaphorically speaking and we think well is this true you know how likely is it can we find this out does it feel safe enough but albeit a bit uncomfortable and then we kind of roll with it and see how we get on all right

So let's try and kind of get a sense of maybe an imaginary person with real problems that might benefit from CBT and how we do that. So if I pluck a random made-up person out of my head, Jay, he's 32. He has been cheated on by his partner and it's led to his mood really lowering. It's also led to him thinking like he's not good enough and, you know, that he's feeling lots of shame and everybody knew about this and have got things that they're saying about him and maybe his manliness,

he wasn't enough to satisfy his partner. And he tried to go back on a dating website, but it was really crippling for him and led to him feeling really anxious, really self-critical. It's impacting on his work. He's feeling like he doesn't want to go to work because there's kind of people at work and they all know and it's, oh, you know, the referral comes in

and it's all feeling too much. How could our treatment with Jay progress with CBT? I mean, there's a lot there, isn't there? And I think in the first two sessions, I like to just create a bit of like a problem list where they can kind of get it all in there. So that way, you know, we've kind of got the main problems, but also if there are any knock on effects, that's also on there.

So when you mention dating scene, that's a key trigger at a minute. but also it started off because of the relationship breakdown and perhaps there's some self doubts as well about how he sees himself or maybe some negative thoughts like for example I'm not good enough so we'll write that all down on a bit of a list and then we'll kind of cluster them you know are these problems relevant to each other are they linked to each other so then that makes a problem a little bit more manageable and actually we realize it's the same problem having a knock on effect and having these symptoms I suppose once we've identified the problem of focus and it could be anxiety we could specify that a bit more we don't have to do that at this

stage but we could just label it as anxiety but then we also look at their goals for therapy does it align with that anxiety problem of focus so if they're saying i really want to become confident when I am out there going on dates or you know on dating apps you know I'd like to put myself forward for that and anxiety is what's stopping me from doing that so then we then we kind of coincide both and once we do that then what happens is we start building on that skill of awareness so this is the stage where I might take the lead a little bit more and I might say okay well let's find out what happens and how often it happens you know it can't just be dating scenes there must be more to this but that's okay you know often we're not aware so let's try and hone in on that skill

of awareness from the get go I'm already kind of fostering that sense of agency to them you become your own therapist go out into the real world and find out what's going on because I don't know and I'm very open about that I don't know that's what you're here for you know you're the expert of your difficulties and I'm the expert of CBT so let's work together here so they'd go out and they'd bring back their data sheet of like a week's worth of triggers and that will then give us a great understanding of what are the areas that need to working on and what are some of the things that keeps the problem going and like i showed you the previous sort of cycle marian that's kind of what we'd draft up together and it's done together with the client it's

always everything every part of this is done with a client and I always ask the feedback I ask them does that make sense or have I went off the rails then usually it'd be like yeah no I I get that or they've add to that can I add a little bit more to that there's something else that's just come up now so we kind of build on that model and then we start looking at the intervention side of things so what do we need to look at working on or managing so if it is that there's intense avoidance, so they're not even on dating apps at all because they're thinking, I'm going to make a fool of myself, I'm going to overshare, or I feel ashamed, I don't know

how to tell them about anything that's happened in my past. We look at managing those sort of negative automatic thoughts, we call them. And there's lots of different interventions, but we might look at that as a set intervention, give them some worksheets to work towards managing their thoughts. We're not trying to replace the thoughts of something positive, but just kind of bringing it back to more realism. And then that can have a knock on effect. So if they're thinking, I don't know how I'm going to cope, you know, I don't know if I can even tell them. I can never be myself with another person, a potential partner. We can, that might shift from that to actually, yes, I've had an awful experience in the past

and my brain is obviously on the lookout for that. But that doesn't mean it's always going to be that way. There are, maybe there are people out there that can understand me and it can take time. Over time, I can build that trust and open up to them about my relationship. So already the thoughts kind of shifted to something more grounded and balanced. And then their anxieties might be reduced. You know, might not completely go away.

But then that would then promote. It would then put enough doubts in those thoughts to then test them out now I always rely on skepticism if someone's like completely like no I'm not doing it then we kind of work on right what's going on here we need to improve we need to get a bit of flexibility there that you know or maybe there's a reason why about very valid reason why there's something that's not explored but if it's more that actually it's anxiety it's coming from the past and it's manifesting now jay might find that actually maybe i could give us a go yeah I feel really nervous but maybe I can install a dating app and just test

someone or swipe someone I'm interested in. So already there is a shift there isn't there from not being on dating apps at all, being engulfed by that fear to, well, let's just see how it goes. It's scary, but we can find out. Yeah, and I guess we want, we don't want him to forget that this has been really sad and that he wanted this to work out. But also, we want him to believe that he deserves to be in a relationship where if, you know, just being kind of monogamous is really important to him, that's someone that wants to treat him in that way with respect for what they've got together and that there is a possibility that can happen again in the future. Yeah, absolutely. I think CBT, although it focuses on the hearing now, if it is

connected to a relevant past experience, I think it's really important to acknowledge that. It's obviously coming from a place, a place of hurt, a place of fear, even a place of trauma. So for Jay, that relationship, you know, it probably meant the world to him, hence why his brain is on that overdrive to protect him and not put him through any kind of that sort of situation again, right? And so it's really important to validate that place. So we're not sort of dismissing it and saying, well, focus on the hearing now and, you know, you'll be back to like how you were, but actually realising, you know, that's really devastating that you'd been through something like that. it's no wonder that you feel the way you do makes a lot of sense and then thinking about does it align with what you want you know how you are and and the way you're dealing with this and it really it's down to the individual really whether they're ready to kind of think

about doing something different it might be that you know in a complete different scenario Marianne if they're not ready and they're thinking I'm really really lost and this relationship has taken such a toll on me I don't even know where to start that's a person that really needs that time and space to process things and yeah but they might not be quite suitable for CB2 which we'll look we'll talk about a little bit more later but yeah it's really important to validate you know that's one of the fundamentals you to understand the person their story what have they been through, you know? What are their difficulties? Does it connect with the past? And kind of connect with that story and almost build that picture at the back of your mind, but also share it with

them as well. So you're on the same page as them at all times. Amazing. And I appreciate how long is a piece of string and different services are different. But what is maybe typical for what someone can expect for kind of number of sessions they might be offered for CBT? So I work at like an adult service at the minute. So it really does depend, like you said, on the service. So it can go up to 20 sessions. On average though, it's 12 sessions. So it really depends on the nature of the problem.

What we usually do to help facilitate that and to make sure it's not abruptly ending or you're not sure where it's headed. We do regular reviews. So I do like every four sessions, I do a bit of a check-in, how are we at, where we are, are you feeling is this something that fits your needs and sometimes you know CBT might not be it you know the structure might not work well for that individual so it's important to sort of catch it early and you know in the first couple of sessions when you explain these are the principles this is what's expected

does this fit your bill you know is this what you're looking for and I know actually I really don't like work cheese and that's that's for us to think about well what else can we look at but in general if you're happy with CBT we look at every four sessions or so, it just depends on the clinician really about, are we headed in the right direction or have we drifted? And does it require a bit more work? And then we might extend the sessions with justified reasons. Yeah, I guess we don't want this kind of video or podcast episode to put someone off. Like if they've already got it booked, it's much better to go along, try it. And then if you think it isn't working for you, talk to

the clinician about that because they might well be able to help make the right referral for the thing that might be the thing that works. So please don't just not turn up or just, you know, drop out. Like always talk to the person because that ultimately is going to help you to get where you're going to be having your needs best met, I think. Absolutely. I do think generally speaking, although, you know, as clinicians, you know, we strive to make sure that it's collaborative, you know, we're always constantly asking for feedback, aren't we marrying what asking, is this all right? Does this work for you? And it's not that we were in short, we just want to make sure that they're on the same page as us, really. But often what we

find is there is still this sort of air of the clinicians, the expert, you know, they know what they're talking about, you know, they're the one spearheading this. And if they, they know what they're doing and I should just follow Sue. It can't be further from that. That is so far from the truth. And actually, what would honestly help, and I always say this to my clients is, if there is a bit of you that feels like I don't really like this I don't even connect with a therapist let me know you know there's nothing personally taking that whatsoever just let me know I'd rather you let me know than struggle in silence because by being transparent you're kind of asserting your rights there aren't you which is this is really working for me I'd like to

explore other options or other pathways here and I just want to foster that a little bit more because I don't think that's done enough from my experience. I don't see a lot of that. Despite, you know, trying to kind of create that sort of environment, there is still that discrepancy of, well, the therapist knows, the clinician knows, I'm just going to follow and see where it goes. So, yeah, if we do ask, how are you feeling about this, how are you finding it? The best thing is to be transparent so we can kind of be on the same page.

Yeah, and when we're stretching and we're growing, actually, things might not always feel super comfortable, but they shouldn't feel so awful that it's painful or overwhelming. And it's making me think about when I'm doing personal training sessions with my lovely personal trainer. And sometimes even when I'm doing the exercise, I go, I'm going, hate it. Hate it. I'm really makes a laugh. But like, it doesn't mean that I don't want to do it. It's just actually, oh, this is, this is harder that I thought. And I know if I was by myself, I wouldn't do this. But because I'm with you, I feel safe. to do this and i know you'll keep me safe so it's it's okay to have a little bit of that

discomfort like because that can mean that we're growing yeah no absolutely um i think our brain does that thing doesn't it at the moment it feels discomfort i hate it and stop doing it um it's like you said like when but if you push past it a little bit and you know you actually might find that this is so rewarding and it's such an achievement looking back on it right we've always been there even just doing this i'm like oh there's a bit of that resistant where the brain's like oh do you really want to be doing this but actually now that i'm here it feels great you know i feel like i'm really kind of stretching myself here so and i think that's the key um i think we stop usually before we get to that point don't we as the moment we feel just

come but we're like oh i'm just going to stop now i don't really like it um just because it's and you don't really like it doesn't mean that it's a bad thing actually and I think that's where the wise part of the brain is like when you kind of push through just a little bit if it's within your window of tolerance like you said Marianne and when you look back on it you actually feel wow I really did do that you know I really put myself out there in the podcast and spoke about CBT right and in Jay's instance it's like wow like when was the last time I'd ever actually opened up to someone on my terms. What a great feeling.

But again, it's like to say that, well, I don't want to be feeling any kind of discomfort to do that. It's like putting the horse behind the carton, isn't it? We can't really achieve that. So I think that's important to keep in mind to you. That's a really good point, Marian. Yeah, and we've got these things called safety-seeking behaviours, haven't we? So when I'm going to get in my car and go out shortly,

I'm going to put my seatbelt on, and that's an adaptive safety-seeking behaviour. But if I'm standing in a shop and I'm feeling a bit hot and flustered and I think, oh, I'd better get my water out my bad. Oh, oh, God, that's not helping. I'll blot, you know, I'll vent my top a bit, try and get a bit there. But, oh, no, I'm not going to cope with all this noise

and it's too much. And I leave the shop. And then I get outside and I go, thank God I did that because I never would have coped. Actually, I probably, in different circumstances, with enough resources would have coped sufficiently to buy my bread and my milk. But I've almost invalidated myself, I've drafted and pulled in that safety-seeking behaviour, which has made me feel like that saved me, because then I've got outside

and my kind of distress levels have dropped, okay? But I guess often when I'm thinking with clients, I think about actually how much longer would it have needed until you naturally plateaued anyway? and then you did cope. And often what we find is that people will put in these safety-seeking behaviours just at the point when they were going to ride it out anyway. And then they begin to think, well, I always need that. And I know that CBT can help people to focus in on their safety-seeking behaviours

and think about which ones are adaptive actually make really good sense and which ones maybe we can just maybe implement a little bit later or use a little bit less or think about using a different one that gets us to stay in, that situation so that we can have that incredible feeling of mastery and satisfaction that comes when a client says to you, oh my God, I did it. I felt anxious, but I stayed. And then I had this really great chat with someone and it went like really, and you know, you almost see someone come back online. And once you've almost taken control of that beast and, you know, you've shown it. Actually, I'm not having a panic. I'm not doing that. I've ridden it out. It almost

kind of inoculates or kind of kills off the panic it can't get you in the same way absolutely I think recognising the difference between adaptive and safety-seeking behaviour is really important I think especially when working with sort of if someone's autistic and then naturally needing to self-soothe in social situations because it makes them overwhelmed that's an adaptive behaviour because that's kind of helping them deal with that situation in that moment so that they can engage in day-to-day life and do their things however that same behavior can be a safety-seeking thing when they don't go out at all and they're afraid and worried about judgment so if i was to even bring up an example of

working with someone a made-up client if they're going to go out somewhere and they're thinking i'm going to be so overwhelmed i don't even want to bother going out actually what are some of the adaptive adaptive strategies that you've got there you know is it kind of headphones. What else do you do? Is there anything that you can kind of, anyone you can go with? So that way, when they put these resources in place, they're still able to go to that situation. And despite having these resources to help ride the wave, actually to put themselves out there like that and to come back and say, actually, I went and did it. And I really enjoyed myself. Yeah, I had a minute or two. I went out for a break, got some fresh air,

put my headphones on. Actually, I went back in and I, you know, got down on the dance floor and had a really good time and it was on my terms. That's what we want to see more of. Safety-seeking behaviours. What we tend to find out is they might feel like, oh, this is really helpful in the moment, but it might not be on your terms in the long run. And that can be for any situation. So when you're going to the supermarket and you're overwhelmed and you're like, I'm going to leave now. It might feel like it's on your terms in that moment. But then in the long run, the next time you think about the supermarket, you might think, oh, let me just go with someone or, you know what, let me just order online.

It kind of almost build over time, don't it? And then it becomes this, you know, your life becomes very shut off and, you know, very small. But by recognizing that and actually thinking, you know what, if I can't stay in the supermarket for 10 minutes, let me try for five minutes, that's an achievement. If you leave the moment, you know, the anxiety kicks off. And then you might realize that actually, you know, the distress kind of, like you said, kind of starts plateauing a little bit. And that is scientifically proven. So CBT is based on empiricism.

So it's just a fancy term that basically means it's based on science, really. We're not, you know, we're not sort of spewing pop psychology or, you know, it's not based on nothing. It's based on real evidence. And it's well known that once your anxiety kicks off, if people kind of stay in the situation, it doesn't sustain it can't go on forever it has to come down and people like you said marion don't really just as they're about to kind of I guess desensitize or habituate or you know just as it about to plateau they don't really get there they kind of withdraw pull out before then and that is a safety behavior absolutely just before we finish sana who might not be a good candidate for cb

or what kind of conditions might not be a first choice for CBT? Yeah, so I think it depends. So I'll bring on like a few different factors. Because CBT can be quite structured, so usually you set an agenda and then typically that involves a bit of a check-in, how did you get on with the between-session exercises, looking at tools, and then setting, you know, what are you going to look at? if people don't really connect with that kind of structure, then it might not be for them.

And that's okay. You know, there are other approaches. It's not that therapy's failed you. It's just, it's not your cup of tea. That's completely fine. Another thing I wanted to bring up is if there were a lot of life stresses, and what I mean by that is I'm not saying that, you know, you shouldn't go to therapy. There's so much going on.

But if there were a lot of social stresses, if you're having like housing issues, financial difficulties, and that takes precedent over kind of your anxiety disorders or low mood, then perhaps I always say the kindest thing to do is look at how we can best support you on that. And it might not be CBT therapy, it might be something else. Another thing I wanted to mention, which I want to show a bit of a cycle to demonstrate this, Rocheska and de Clemente created this cycle for health-related behaviours and changes when it comes to that. So typically we want CBT is most effective when people are in that preparation stage or the action stage and it can really, we can really then bolster them to be able to look at making those changes and sustaining them and preventing relapse. However, on some occasions, clients might be quite unsure, you know, they might not be sure whether they're ready for that change.

the more sort of figuring out what's going on with them and for that that would require a different approach I think so that's why I you know I always show this cycle you know kind of where are you at in this sort of cycle you know are you still thinking that there's a problem but you're not quite ready to change but you want to talk about it that's not necessarily CBT but there is another approach for that like counselling but if you really kind of want to create that change you're ready for that but you're sort of wanting that extra bit of support then absolutely, you know, we can work together. Absolutely. Super, too.

Thank you so much for your time today. You're going to be joining us for another episode where we think about how someone can train as a CBT therapist if they wanted to or what a career in CBT might look like and what next steps are possible from that as well. So if you've enjoyed listening to me and Sahana, please do drop some Sahana love into the comments. And yeah, we'll be back along very soon with the second episode.

Thank you so much for your time today. Thank you. Thank you so much. It's been nice talking about CBT in this context. I appreciate you having me. Oh, you're so welcome. Thank you so much. Thank you so much for watching and of course for my guest, Sahana, in her time talking with us about what CBT is. If you have found it helpful, please do drop a comment, drop a like. Consider subscribing to the channel if you'd like to see more from me, especially if you'd like to see more from Sahana because she's back along next week. to. If you're watching this video because you would like to consider accessing therapy, please do consider checking out the Talking Heads book. It's your guide to help you to find a qualified

regulated therapist in the UK and it's a book that I wrote with my colleague Dr Tara. Of course, like any of my books, any of my resources, there are links in the description and in the show notes. Come and grab your free Psychology Success Guide on my website, www. aspiring hyphen psychologist.com.com.uk. Hi, my name is Emily. I am a master's student studying clinical psychology at Southampton. I bought the book The Clinical Psychologist Collective to help myself prepare for my first round of doctorate applications, and I'm so glad I did. Seeing how others have reflected on their journeys has been so insightful, and it's given me a lot to reflect about with my own journey and skills.

It's also helped to put things into perspective and reminded me that if I don't get on to the doctorate this year, that's okay. I think the most unexpected pleasure of this book, however, was just how inspirational each and every person's journey was. And using these stories as my morning motivation each day has been such a pleasure. I'm almost reluctant to come to the end.