How Cognitive Behavioural Therapy is Done

We work with clients to identify specific goals for treatment and develop strategies to achieve those goals. In Jane’s case, specific treatment goals included challenging and modifying her negative thought patterns, learning relaxation techniques to manage the physical symptoms of anxiety, and engaging in exposure exercises to confront her feared situations.

How did we do this?

We worked collaboratively with Jane to identify and challenge her maladaptive thinking patterns, such as catastrophising and overestimating the likelihood of negative outcomes, and we discussed potential scenarios and the likelihood of them happening.

We also delved into Jane’s miscarriages, how they made her feel, and how they had exacerbated some of her worries. We worked with her to identify and process the pain and fear she was carrying, enabling her to understand the full extent of the impact her miscarriages had had on her and, by extension, those around her.

When Jane shared numerous examples of how people close to her had let her down in the past, we explored how these incidents had affected her. She was fixated on having a routine for her baby and often felt disappointed by the performance of others when they cared for her child. She was concerned about lapses in concentration by her husband or helper, believing these could lead to catastrophic outcomes. Whenever her husband urged her to relax or see friends, she felt misunderstood, causing her to withdraw further.

To address these challenges, we utilized the Socratic method of questioning to encourage Jane to explore new perspectives and come to self-generated conclusions (Kennerley et al., 2019). Cognitive restructuring techniques also helped her replace negative, irrational thoughts with more balanced, realistic ones.

As part of the process, we assigned “homework” tasks after each session, such as encouraging Jane to take small steps in building trust by giving her husband and helper more opportunities to help with childcare while communicating safety was her top priority. Rather than shutting down in difficult situations as she had done previously, we encouraged Jane to increase her active communication to improve her household’s understanding of her thought process and the areas where they could provide more helpful support.

We also encouraged Jane to engage in exposure therapy, which involved gradually confronting situations that triggered her anxiety, like leaving the house for short walks. While initially uncomfortable, this approach allowed her to feel a sense of normalcy during her walks. We suggested gradually taking more time off, and Jane went on to pursue self-care activities she was interested in but had previously not been able to prioritize. Through systematic desensitization and graded exposure, Jane learned to tolerate and eventually overcome her anxieties and fears. Additionally, we incorporated behavioural activation techniques to increase Jane’s engagement in pleasurable, rewarding activities, thereby boosting her sense of accomplishment and enjoyment.