CBT or Person-centred Therapy? Do we need to question?

So, which is more effective - CBT or Person-centred Therapy? It's a question that practitioners have been debating for decades.

Many mental health services and their clients are of the opinion that Cognitive Behavioural Therapy (CBT) is the best therapeutic approach for depression and anxiety. However, it would appear that this prevailing opinion may be due to CBT being the most researched form of therapy (Frontiers in Psychiatry, 2018; 9: 4; published online 2018; © 2018 David, Cristea and Hofmann) and to the predominant use of CBT in the NHS (Mental Health Today, June 2017).

Now, with the British Association for Counselling and Psychotherapy's (BACP) recent announcement of the results of research into the efficacy of Person-centred Experiential Therapy (PCET) compared with CBT, such opinion looks set to change. For, according to the findings, PCET is as effective as CBT for depression.

'The most important finding from the study was that it found no evidence of any meaningful difference in the outcomes that participants achieved between PCET and CBT either at six months after entering the trial or at the end of their therapy. This finding held across a range of outcome measures and the evidence strongly suggests that PCET is as effective as CBT in the treatment of depression in the short-term' (BACP, May 14, 2021).

The hope of the BACP is that the findings, published in The Lancet Psychiatry ( May 14, 2021) will encourage the National Institute for Health and Care Excellence (NICE) to recommend a wider choice of talking therapies. This could see a change in the provision of counselling in the NHS.

The BACP funded research was led by the University of Sheffield. The BACP is a professional association for members of the counselling professions in the UK. The NHS offers CBT, Eye Movement Desensitization and Reprocessing (EMDR) and talking therapies.

You can find out more about Person-centred Counselling, CBT and EMDR, using the following links:

https://www.bacp.co.uk/about-therapy/types-of-therapy/person-centred-counselling/

https://www.bacp.co.uk/about-therapy/types-of-therapy/cognitive-behavioural-therapy/#:~:text=Cognitive%20behavioural%20therapy%20(CBT)%20is,these%20to%20manage%20your%20problems.&text=%E2%80%9CYou%20and%20your%20therapist%20work,that%20will%20bring%20eventual%20change.%E2%80%9D

https://www.bacp.co.uk/about-therapy/types-of-therapy/eye-movement-desensitisation-and-reprocessing-emdr/#:~:text=EMDR%20(Eye%20Movement%20Desensitisation%20and,your%20mental%20health%20and%20wellbeing.&text=EMDR%20helps%20you%20to%20see,symptoms%20that%20you%20were%20suffering.

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/counselling/

References:

https://www.bacp.co.uk/news/news-from-bacp/2021/14-may-person-centred-experiential-therapy-is-as-effective-as-cbt/?_cldee=bWFyeV9wYXNjYWxsQHlhaG9vLmNvLnVr&recipientid=contact-d5d4b3b001dce71180f13863bb349ac0-db55b5a830c847709340c3b741a7df97&esid=4013a7a3-18b7-eb11-8236-000d3ab51ca1

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00083-3/fulltext

https://www.mentalhealthtoday.co.uk/cbt-vs-counselling-what-s-next-for-the-mental-health-of-the-uk

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/#:~:text=(2)%5D%3A%20(1)%20CBT,most%20researched%20form%20of%20psychotherapy.

The fear that's hard to voice

At this stage of the pandemic, as we approach a so-called 'return to normal' in the UK, many are wondering exactly what 'normal' is going to look like. Some can't wait to return to the playground. Some remain wary, concerned about the possibility of another spike, like the increase that followed last Christmas and the devastation seen elsewhere.

And there is another concern, not so readily shared: that for some of us, lockdown restrictions have offered some respite; a great escape from the hurried pace of the world.

Pre-lockdown not everyone was enamoured with their schedules and routines.

Undeniably the move in and out of lockdown in response to Covid-19, over the past year, has challenged the mental health of many. But, pre-lockdown, not everyone was enamoured with their schedules and routines.

If you were struggling to achieve a work-life balance, lockdown blew that all away. After a period of adjustment, some have recognised a preference for a slower pace. Now, faced with a 'return to normal', they are dreading a return to a lifestyle that had previously left them feeling challenged and depleted.

This is a fear that is not easy to voice - not in the face of the loss and devastation caused by the pandemic. You may feel guilty for wanting what has been brought about by necessity and you may fear being judged for this.

You may feel guilty for wanting what has been brought about by necessity.You may fear being judged for this.

You may feel fortunate to have an income, a job where you do not feel at risk, micro-managed and under pressure to increase your output. Perhaps you switched to working from home and have discovered that you are comfortable working this way. You may be on reduced hours or have been furloughed and have found that you have been able to use your available time in a fulfilling way.

It may be worth taking some time to evaluate where you are now, what works for you and whether this can continue. And if fear of judgement and feelings of guilt are causing anxiety, it's worth seeking support.

If you think therapy may help, you can consult your GP or self-refer through the NHS online. Your employer may offer an Employee Assistance Programme (EAP). If you are a student, you can approach Student Welfare Services. There are charities offering free and low-fee counselling services.

If you wish to seek the help of a registered private therapist, you can search the therapist directories offered by counselling bodies and networks, such as BACP and BAATN.

You may find the following links useful:

https://www.mentalhealthatwork.org.uk/toolkit/transition-out-of-lockdown-and-the-impact-on-your-work/

https://www.anxietyuk.org.uk/

https://youngminds.org.uk/blog/why-i-dont-want-lockdown-to-end-for-my-mental-health/

https://children-ne.org.uk/returning-to-normal-is-it-something-we-should-strive-for/

https://www.familylives.org.uk/how-we-can-help/confidential-helpline/

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/how-to-find-a-therapist/

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/#:~:text=Anyone%20who%20is%20registered%20with,therapies%20service%20(IAPT)%20online.

All change and back to 'normal'?

It's approaching a year since lockdown restrictions were first introduced and we have slowly adjusted to a routine of work, education, entertainment, exercise, shopping and social connection - all from home. Many of us would relish a change of scene right now. The UK has been particularly hard hit by the pandemic and COVID-19 restrictions have made the world a much smaller place.

Those of us who have struggled with the limitations may be eager for the rules to be lifted. Perhaps you can't wait to meet up with family, friends and colleagues, dine out, date, shop in your local high street, attend university, be part of an audience, take classes, visit your library, play team sports, travel - whatever it may be.

But what if, over recent months, you've become accustomed to a lockdown lifestyle?

But what if the thought of mingling with others fills you with dread? What if, over recent months, you've become accustomed to a lockdown lifestyle? What if you've discovered that in many ways, a simpler, slower, smaller way of doing things actually rather suits you?

If the thought of returning to 'normal' is making you feel nervous - increased freedom of movement, returning to working outside the home and meeting people face-to-face - then allowing yourself a period of re-adjustment may be helpful. The same may apply if you're feeling anxious about safety.

It may be worth considering which aspects of lockdown have been of benefit to you and which of these you can realistically take forward.

We're not going to immediately return to how we were before the pandemic - there will still be restrictions in place. But if you're feeling any anxiety around the changes it may be worth considering which aspects of lockdown have been of benefit to you and which of these you can realistically take forward. Whether it's more you time, time with a significant other or immediate family, or time used for personal development. Perhaps you have preferred working from home or enjoyed having more time for interests and hobbies. Perhaps less time spent being busy with others has allowed you to be more yourself.

Perhaps less time spent being busy with others has allowed you to be more yourself.

Give a thought to how you may be able to take any helpful aspects of lockdown forward. You could make a list of what you have and haven't appreciated about lockdown to help you decide how you want life to be for you when restrictions begin to ease.

If you feel you are experiencing anxiety around this issue and are unable to manage, speak to your GP or you can self-

refer to NHS Talking Therapies online https://www.nhs.uk/conditions/stress-anxiety-depression/free-therapy-or-counselling/

The mental health charity Mind may also be of help https://www.mind.org.uk/

Alternatively, you can seek an independent counsellor through BACP https://www.bacp.co.uk/search/Therapists

or BAATN https://www.baatn.org.uk/find-a-therapist/

For help with urgent mental health issues, call 116 123 to talk to Samaritans or email: jo@samaritans.org for a reply within 24 hours. Or you can text SHOUT to 85258 to contact the Shout Crisis Text Line. If you're under 19, you can text YM to 85258 or call Childline on 0800 1111.

You may find the following links useful:

https://www.mentalhealth.org.uk/coronavirus/looking-after-your-mental-health-we-come-out-lockdown

https://www.rethink.org/advice-and-information/covid-19-support/how-to-manage-feelings-of-anxiety-as-lockdown-eases/

https://www.bbc.co.uk/programmes/articles/33qv759mMrv7RWjc3cKbKfC/post-lockdown-anxiety-not-everyone-is-excited-about-restrictions-easing

https://www.stylist.co.uk/health/mental-health/post-lockdown-anxiety-back-to-normal-overwhelm/487565