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what's your CBT look like?


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So the title is a broad topic, but I mean it to be broad.  Seeking any and all experiences as to what CBT looks like for your every day, normal session.  Assume we've gotten past the basic get to know you/background/psychosocial history/etc stuff. 

I'm asking because in IOP/PHP settings, CBT sessions were always pen and paper worksheet sort of things, but my current therapist isn't like that at all.  Which definitely isn't a bad thing.  But I'm curious to what degree what we're doing falls under the CBT umbrella as opposed to something else. 

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I’ve never done worksheets in individual therapy - only in group sessions like IOP/PHP.

CBT with my current Tdoc is informal and mixed in with various other approaches. Very commonly, she’ll identify or push me to identify cognitive distortions as I say them. “I can’t do xyz so I’m a failure” - she might say something like “are you sure?” Or “is that the only option?” Or even, if I’m pretty stuck, “that’s pretty black and white”

We talk about facts and feelings. She’ll have me re-phrase things to make it clear it’s a feeling, not a fact. Feelings are valid, but they’re not necessarily true.

We talk through “cognitive restructuring” and “thought records” where if I say some blanket statement (“nobody likes me”) she’ll ask me to list proof for and against it, then re-phrase it to something more accurate (“I struggle to form close relationships with people at work”).

...but we don’t talk about the names of these skills. The closest we get is identifying distorted/irrational thoughts. Mostly we just talk through this stuff. So it’s less formal than on a worksheet in IOP.

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  • 3 weeks later...

my counselor did some kind of CBT certificate and to her CBT means interrupting me before I'm done expressing something so she can ask me which of the cognitive distortions I am employing. All I can say is something like "yeah I KNOW I'm mind reading but..." and then it doesn't go anywhere from that. It's rife here. Everybody writes "CBT" on their business cards because it's a buzzword but they've only done these short courses in CBT, their real qualification is in something else,  usually an "integrative" course which means a tiny bit of everything. and a lot of people here hate CBT because they've never actually had it. There are only like 5 qualified CBT therapists in a city of over a million people. I never get actual cbt homework and the homework I get isn't phrased as optional and I'm not asked how I feel about it. It's a mess. I'm learning a lot about the state of mental health in my country, I really am. The thing is, because she doesn't listen, she is getting me to rephrase and reframe all this surface stuff, because I never got into the real feelings or the real thoughts, so I reframe it and the words fall dead and everything feels artificial and wrong. Woebot is better and that's a god damned app.

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yeah, I've seen advertisements for CBT certificates.  Not sure if it's the same one, but it's something like $250 for 5 hours.  Or maybe not that exactly, but the hours are minimal.  I'd think you at least need a class in grad school. 

That does sound like a mess.  Are you stuck with her or can you look around?

I'm planning to talk to my therapist on Tuesday about how he sees the CBT piece incorporated into what we're doing.  I don't want it to come across as a challenge, because I find his approach helpful.  But I just want to understand better. 

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