• They are based on the cognitive model of emotional disorders - the way we think makes us feel bad and behave in an unhelpful way
• They are brief and time limited - for mild to moderate depression treatment in general does not last longer then 12 sessions
• A sound collaborative therapeutic relationship is essential - the therapist and the client need to work together on solving the problems
• They are structured and directive - the therapist will have a plan and share this with the client
• They are problem orientated - the therapy is focused on getting the problems out of the way
• They are based on an educational model - teaching the clients to become their own best therapist is a key feature of CBT
• Homework is an essential feature - the client has to work between sessions at overcoming the problems

CBT model for the processing of events

• Early Life Experiences
• Unhelpful Beliefs
• Unhealthy Negative Emotions
• Self-defeating Behaviours

Early Life Experiences

These are things that happened in the past (the earlier in life they happened the more influential they may be). These events can be very bad things (such as childhood abuse) or events that were interpreted in a way which was damaging (given a catastrophic meaning).

This can result in the child or young person having a hard time, or feeling anxious, terrified, depressed, during their childhood or younger years. In the end the person develops a range of unhelpful beliefs.

Examples of (early) life problems

Our lives can be influenced negatively by very bad things that happen to us, or in more subtle ways. Most of the time we are not aware of the things from our past that have shaped us as we are today. Whether something has a bad effect on the person depends on his or her personality style. If your style is to love the peace and quiet, to do things in a quiet methodical manner, then growing up in a very loud and chaotic family will have a strong impact. A mismatch between the style (or personal needs) of the child and what the environment is able to provide often leads to problems. Subtle ways in which an environment can shape unhelpful beliefs are:

• A school or family environment where the best is not good enough!
• A school or family environment where you never get praised only criticised
• A family environment where you are told to be careful, life is a dangerous place

Many people's lives are of course hurt by terrible abusive situations in their childhood. This could be physical abuse from teachers, parents and others. It also can be more emotional abuse. These events often leave life-long scars, sometimes resulting in problems immediately and at other times leading to a delayed reaction.

Unhelpful Beliefs

A person will develop a range of beliefs about themselves ("I am unlovable"), about other people ("other people are better than me"), the world in general ("the world is a mean and hard place") and the future ("the future is filled with misery").

As a result of these beliefs the person has a way of making sense of things that happen to them, based on their beliefs. For example, their partner is a bit late home from work which leads them to think "See, I am no good, if he/she really loved me they would not do this" .

Thinking Errors

Unhealthy Negative Emotions

Holding on to unhealthy beliefs and using them to make sense of ones life will result in some very strong and/or chronic unhealthy negative feelings.

Not all negative feelings are bad. In cognitive behaviour therapy we distinguish between three types of feelings:

Positive feelings

Feelings such as happiness and love, feeling appreciative, excited, relieved, surprised etc.

Healthy negatives

These feelings are appropriate reactions to negative things happening to us. Walking at 1 AM in the morning through a dark street in a seedy part of town would lead to healthy negative emotion of apprehension, even mild anxiety. When a friend lets us down, a healthy negative emotion is sadness or disappointment.

Unhealthy Negative Feelings

Healthy negative feelings and unhealthy negative feelings are on a continuum, meaning that the unhealthy ones are similar to the healthy ones, but a lot stronger. Because they are stronger they are more demanding in wanting action - the action these strong feelings want you to engage in is often very unhelpful.

Self-defeating behaviours

Feeling bad leads to doing things that are not helpful. No one wants to experience these unhealthy negative feelings. So what do you do?

Most people try in a trial-and-error way to get rid of these feelings. Unfortunately the most unhelpful strategies produce quick results. However these quick results only last a short time. Avoiding a situation that leads to anxiety gives relief, but when you have to go back to the anxiety provoking situation, guess what? You are anxious again.

Depression makes people inclined to follow their belief ("It is all pointless") by doing less and less. Staying in bed with the blankets over your head may bring short-term relief, but will make the depression worse in the longer term.

People find many ways to stop feeling bad, here are some examples:

• Drinking too much alcohol could stop you feeling bad for a brief period, but after the effects have worn off, the old problems will return
• Avoiding social situations (social phobia) which make you anxious will result in making you less anxious, but most things that make people anxious can’t be avoided forever!
• Avoiding leaving home, or only going to safe places (panic disorder & agoraphobia)
• Doing certain things over and over again (obsessive compulsive disorder)
• Worrying a lot (generalised anxiety disorder)
• Critisising and putting other people down.