BEST and WORST cognitive behavioral therapy (CBT)
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- čas přidán 31. 05. 2024
- How do you know if you're getting bad CBT? Therapy is mysterious, there are no goals, you aren't learning skills, there's no homework, and you never leave your chair.
Special thanks to Elizabeth S., Tyler D., Anna H., Arnt J., Collin P., Evan A., Imran M., Sam D., Ryan L., Sophie Y., Ahmed Y, Israel P., Neuro Transmissions, Eric E., Eve P., Lauren K., BrainCraft, Aaron F., Samuel H., Marisa H.,Tae T., Steve M., Anne Claire B., Bryan T., Nicky C., and Samuel A. for making this episode possible! Learn how you can help me make The Psych Show and get exclusive behind the scenes access in return at / thepsychshow .
0:00 - What is (good) CBT?
1:21 - Therapy is mysterious
1:57 - Treatment has no goals
2:57 - Not developing new skills
3:27 - No homework
4:46 - Never get out of your chair
Topics Discussed:
- cognitive behavioral therapy (CBT)
- exposure therapy
- Acceptance and Commitment Therapy
- Dialectical Behavioral Therapy
- #CBTworks
Learn more about CBT and find a CBT therapy: www.findcbt.org/xFAT/?fa=WhatI...
Connect with Ali:
Twitter ► / alimattu
Facebook ► / thepsychshow
Instagram ► / alimattu
Snapchat ► / alimattu
Patreon ► / thepsychshow
Email ► ali@thepsychshow.com
Website ► alimattu.com/
THE PSYCH SHOW! Creating mental health videos that educate, entertain, and empower! Produced, written, and edited by clinical psychologist Ali Mattu, Ph.D. All videos are provided for informational purposes only and do not constitute clinical advice.
If you or someone you know needs help immediately, you should take one of the following actions:
- call 9-1-1 in the United States or your country's emergency number: en.wikipedia.org/wiki/List_of...
- call the Lifeline at 1-800-273 TALK (8255) in the United States or a global crisis hotlines: www.iasp.info/resources/Crisis...
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- go to your nearest hospital emergency room
Have you tried CBT? What was your experience like?
The Psych Show do you offer personal therapy or how do you recommend finding a good local CBT? I’ve been interested for a long time now but I’ve never had the commitment. Thanks, love the channel!
I do practice through the Columbia University Irving Medical Center. You can also find a CBT therapist close to you using this link: www.findcbt.org. Thanks for being here and a part of our community!
I read this book called "The Brain Mechanic" by Spencer lord. Really good book for me. I love small 100-200 page books about this stuff.
Have you written one? Do you have one to recommend?
Yes! I did an art-based one. Sometimes I didn't always connect with the exercises, and my therapist was awesome in letting me refuse exercises I felt didn't serve me. We also had a great system of where she'd support and help me explore CBT exercises I have done on my own. In South Korea when I realized I had PTSD (from sexual assault, and separately an abusive relationship) I did my own research to figure out what I was going through and did my own CBT (mainly journalling exercises) to process and understand what I was going through. I sometimes still do my own CBT homework on my own as well. But always when I recognize that I'm in a stage where I need professional help I go seek it out. Thanks for the great video!
Unhelpful because I'm on the autism spectrum and don't have the ability to identify emotions. So yeah I wasted a lot of time because everyone HAD to do CBT before other therapies were offered. 😑
I don’t know if I got bad CBT or CBT in general just doesn’t work for me, but I’ve always found that it makes me feel so invalidated. And exposing myself to my fears has only made my anxiety worse.
The point of exposure to *irrational* fears is to show you that it wasn't as bad as you thought it would be and you can survive it etc
Just going through more trauma doesn't do that. If they don't build up to it and support you, or if your fears are REASONABLE, it's only going to make it worse. You're SUPPOSED to be scared of unsafe stuff.
That's why that kind of technique doesn't work a lot of the time, they invalidate our fears because they don't relate. It's easy to say BE YOURSELF WHAT'S THE WORST THAT COULD HAPPEN?! if you're not realistically at risk of being haight crimed, for instance. The worst that could happen is I would get beat up again but worse?? Like get outta here
It took me 6 therapists to find mine. Therapists are just people. Hugs
You are supposed to only slowly incrementally expose yourself to fears, I think
@@no_peace I don't know any licensed therapist who would tell a person who is experiencing issues related to safety regardless to what or why that would tell the person "just be yourself."
@@janedoe3648You don't have to. There is gradual exposure and flooding. At the end the client has to decide, which depends on their distress tolerance, motivation, goals etc.
Another sign of bad CBT: The therapist focuses exclusively on behavioral management and skills training while minimizing or outright ignoring the structural issues that give rise to the supposedly maladaptive behaviors, and working to reinforce docility and obedience in the face of oppression. CBT makes sense when applied to limited or specific circumstances, but becomes behaviorism when taken to a general scale.
Yesssss 🙌
Karissa Ann yasss queen slayy
I find it on the whole a rather superficial kind of therapy for precisely the reasons you highlight in your comment
I think you have a good point. Maybe the question is: is there something we can do with what we have right now to solve this problem? If there isn't, maybe conformity is something to ease the suffering, if there is, maybe we just don't see the solution yet
3 years until I got diagnosed with Persistent Depressive disorder, generalized anxiety, and ADHD about a year and a half was spent in CBT talking about how i do not have goals and questioning what my diagnosis actually should be. Best case scenario CBT turned into doing things so the therapist felt better. At worst it felt like an interrogation. I'll say whatever you want but it doesn't change anything on any sort of fundamental level.
It felt like being trapped in a box with someone until i said i was better so they could say they did a good job and get paid.
This Cognitive behavioral therapy is a horrid therapeutic approach that should only be used for targeted cases.
Instead CBT seems to be used as a cheap means to churn out therapy and therapists.
Accurate. Run of the mill CBT therapists are basically mental technicians and you can do that on your own with surface issues unless your reality testing is massively impaired.
For complex issues you need someone to work at a deeper level. CBT is at best a patch or treatment for very specific issue like a phobia.
absolutely true!!!!!!!!!
Ha! I am having very bad CBT right now. Let me just rant for some minutes. For the last two sessions the guy was just questioning everything I was saying, regardless of if it was important for me or not. He asked me how I was doing and why, and I could not even finish my sentence he was just interrupting me all the time at each answer and branching to other questions so I could not even get to my point, which was that I was ignored by a girl and it gave me strong suicidal thoughts again. AAAAHHH! I don't even know what we are doing. Each time he gave me assignments and we never looked at them. He was just asking me about my procrastination and ended up giving me homework about my addiction problems that I did not want him to deal with. I could not even say what I wanted. And I have years of experience about my depersonalization, for example, he didn't know what it was, had to ask a colleague (which is ok to me) and at the next session he tells me I don't have it because I did not describe the symptoms with the exact correct words (I said I felt like my body was a robot I was controlling from a distance, instead of saying that I don't feel like I am myself). F*ck that... I spent hours and hours learning about it and he doesn't even have a clue what I am talking about. I felt I had to justify absolutely everything I was saying, I was constantly invalidated, he wanted me to just drop everything I know about myself and just listen to him because after 5 minutes of conversation he knows exactly what I have and the 10 years of therapy I already had with other therapists don't matter, I can throw them to the garbage because now I met him and he knows everything. Absolutely everything I say just comes from my deluded thoughts and I have to surrender to the new truth he has about me after talking with me for 5 minutes. Thanks you if you were bored enough to read this until this point.
So sorry you went thru this. Hope you have found some better help. A good rant is the place to start then fire any clinician who doesn't listen.
I've got similar problems, but I had much less therapy. It makes me wonder how your journey went on? How did you find a better therapist?
Drop him, and try something else. Do yourself a favor: do not suffer fools that have no true understanding nor appreciation of what you are dealing with.
As for suicidal thoughts, it would be important to find a way to relax deeply and develop a silent witness perspective. The only potential obstacle to what I would typically suggest is the depersonalization.
I went through something similar to be honest. I ended up dropping him when he brought up something i asked not to (since its something that makes things worse for me, makes me feel worse). then called me the next day telling me “thats what happens when you don’t work with me or do your homework, nothing helps”. Tore me down even more. I literally lost all trust and respect ive had for therapists, psychologist, etc. Made me realize that i can only help myself.
I hope you find a really good therapist if you continue your journey.
Yup. When your CBT therapist gaslights you. I know this one well.
I had CBT but it did more harm than good. I was often criticized so that I ended up feeling like I couldn't do anything right. The therapist even told me that her other clients were all doing better than me.
It seemed to me that there was no allowance for the bad behaviors of others. I was always at fault for responding wrong. So I came to believe that CBT is just gaslighting the client. When I complained to the therapist, there were repercussions, so I felt like I was being punished for standing up for myself.
These things, and many others, led to me quitting CBT. Maybe I just had a bad therapist, but CBT has been poisoned for me.
The sad thing is that people see the "CBT is the most effective therapy" as a medium to avoid being a human being with another human being; and usually goes defensive whenever someone has a bad experience with people practicing the model.
Thank you for sharing this!
Sorry but your therapist was terrible. It's not your fault and they shouldn't compare you to others. Did you give therapy another try with other approach that was better for you? Please don't give up, I had 2 bad experiences with CBT therapists but it taught me some things. If a therapist doesn't understand and respect you, there's always other.
@@michelleoliveira121I'm working on looking for another therapist.
0:22 - What is (good) CBT?
5 signs of doubtful CBT:
1:21 - Therapy is mysterious
1:57 - Treatment has no goals
2:57 - Not developing new skills
3:27 - No homework
4:46 - Never get out of your chair (with exceptions)
5:57 - Questions for us (the viewers)
Thank you very much! Kind regards!
If your not getting any of these things, the therapist just sucks.
6. no *b a l l s t r e t c h e r*
"At least you have a family that loves you" "I deal with abusive workplaces all the time and im ok" "no excuses"
I've done CBT in the past and they never worked me for me. I've done the homework but rarely will be discussed on the next session, sometimes I had to repeat myself and talk again about how I feel (it can be a bit frustrating sometimes) and besides I struggle identifying my own emotions. Most of my mental health problems have been treated with meds and through psychodynamic therapy and it did help a lot. I don't think CBT is overall a bad type of therapy but I think is only useful to certain people, so it's not for everyone.
When I was in South Korea I discovered/ realized that I had PTSD. I had a painful flashback which made me realize I had survived sexual assault and an abusive relationship. I didn't fully understand it was PTSD but through the symptoms (being angry and belligerent, which is very uncharacteristic of me, when hearing we would watch a film about comfort women- aka women who were systematically raped and abused, being cold and shivering on a day that was hot summer weather, remembering experiences and being frozen in place for extended periods of time) I realized that something was wrong, and I had to figure out myself. Since mental health is severely stigmatized in South Korea, I was learning Korean, and there weren't many options out there for foreigners I looked after my mental health on my own. I did research and did my own CBT homework. I researched my symptoms, I understood what I was dealing with, how it's affecting me, and I journaled about it a lot which helped me deal with what I was going through. When I got back to Canada, and realized I was dealing with depression and anxiety, I went to a professional therapist in my hometown and did CBT art therapy. Sometimes I didn't feel like doing the art part- I'm artsy but didn't really always connect to the exercises the therapist suggested- and I was free to refuse the exercise if it didn't serve me. My therapist helped me realize I felt guilt and release that, and understood myself and my experiences better, and she utilized my experience in doing my own homework. So basically I want to say it's ok to not always connect to the exercises a therapist suggests, and not every relationship with a therapist will be amazing- sometimes you gotta shop around. And if you don't have the financial means, and even if you've done therapy before, there's online resources to help you do your own CBT exercises and find a way to better understand yourself and what you've been experiencing.
Thanks so much for sharing your experience here! It so wonderful that you were able to do so much on your own. Writing about traumatic experiences can often help people develop a narrative about their trauma and understand the impact it has had on their lives. A lot of the trauma CBT treatments focus on doing exactly that - developing a narrative and making meaning of the impact of trauma. Also love what you said about it being okay to not be okay with homework and your relationship with your therapist. Something I always encourage people to do is to talk about those feelings with their therapists. Hopefully this will create an opportunity to work through those problems. If not, then it might be time to look elsewhere.
cbt is so expensive and i feel like people aren’t open to the idea of it not working sometimes. thank you for making this
Ali, these imperfect videos are amazing. I think this is what the internet needs. You're addressing issues, you're teaching us, you're sharing psychology. These are important things. But also, you are giving us an authenticity that we crave and makes your videos easier to receive because they come across as more familiar. This is how we experience university lectures, conversations, and therapy sessions. Thank you. I hope these videos show you that they are less imperfect than you expected them to be. Perfection only ever exists in light of criteria that depend upon the situation and the person(s) prescribing the criteria.
THANK YOU THANK YOU THANK YOU for this feedback! It is so helpful and healing and encouraging. I will definitely keep up this style moving forward! Again, my deepest appreciation!
Agreed. I just found this channel so I can attest to the appeal from a once non-subscriber👌
cbt is the bwst but quite tough so some time it can cause suicide to a client . best is abc model of cbt and time management of cbt
@@drali make new ones please ! I love your channel
I went through CBT about two years ago and watching this video it seems like they did everything right! And I mean, I felt myself that the treatment helped me, but it's still a relief hearing from a professional that I seemed to have gotten what I was supposed to get.
My experience of CBT is making me feel like I’m almost at fault for my own behaviours as if what I’m doing is out of complete intent. The same things are said to me about: if I had suicidal thoughts, have I planned to commit suicide, some of the things I tell myself aren’t true, what is it that I want from them? I’ve tried medications such as Sertraline and Fluxoteine and neither of them worked, in fact they given me mood swings for months.
I grew up with a mother who passed away when I was 11 years old but up till then I didn’t get the proper development as a child. I was exposed to a lot of malevolence and deceit. Watching my mother go from one addiction to another(drugs to alcohol). Entangled with drinking buddies and people who didn’t have her own well-being at heart. If it wasn’t that it was with partners that would beat her up, all of this made me miss a lot of school, and personally I think it hit me hard as I grew up. I have mood swings either way where I go from 0-100 in such quick succession then back to 0 in quick succession, to periods of very low moods where I don’t want to leave my bed, wash or even go outside at all.
DBT and trauma therapy should help you😊💖
Maybe CBT doesn't help much because your symptoms may call for a different approach, DBT perhaps.
Hi, hope things are better. I have suicidality too. To the point of a process addiction. Very rough stuff. This isn't something that's really understood or dealt with. Especially the more planned/ chronic cases. Some just assume it's impulsive when you attempt. I guess that's because the BPD/ DBT narrative rules in suicidality now.
Maybe DBT or certain aspects would be for you. That would be ideal probably, as it is often the only option given. Unfortunately, it's often costly.
I've had CBT for my chronic fatigue. It was horrible, I only got worse and worse. The team kept saying I had to get worse to get better. However towards the end of the therapy (the point where they said beforehand that I would be 'cured') I was the sickest I had ever been. It then took me and ny parents about a full month to convince them to let me stop, which then resulted in mental problems from the experience. I can't believe there were two psychiatrists and a doctor who all decided to let me do this. Now, a year later, I'm almost mentally recovered but am still angry at the fact that they let me (and others like me) do a therapy that has been proven to do harm for some cases of chronic fatigue. I hope that there aren't many people around who have gotten bad CBT, it sucks!
Did they emphasize exercise for you? That has never worked for the chronic fatigue aspect of my condition. It’s also no longer a recommended treatment for CF. But, I am in CBT with a great therapist who has improved my psychological health using the proper methods Ali discussed in the video (especially by dismantling toxic thought patterns).
@@DirseCT Yes! It was 100% focused on building up exercise, which I know now doesn't work but you know, one gets desperate after a while... I think as long as your psychologist doesn't promise to cure you but just to help you live with chronic fatigue and the mental struggles it comes with they can really help you, but that was not the case with my CBT there at all! I'm so glad to hear it's helping you already😊
Yikes, I'm so sorry to hear you experienced this! Sounds like it wasn't a collaborative relationship. CBT should always feel like a collaboration between you and the treatment team, never like you are being force to do anything.
Glad to hear you're working with someone you trust!
Situations like this show the limitations of CBT and that a CBT-based approach is extremely inappropriate for certain situations. Trauma has a strong social component that needs to be recognized. Solely focusing on cognitive reframing, "behavioral management", and "skills training" isn't going to help if a person is stuck in an ongoing abusive situation that isn't likely to change anytime soon and where there are structural and financial issues severely limiting someone's options. If someone is regularly being beaten by an abusive spouse and has no money to"stay positive" and find positives in the situation -- your husband is just beating you, he hasn't broken any of your bones or doused you in acid -- is to further perpetuate the abuse and dismiss the pain of the victim. And as someone from an immigrant background, Dr. Mattu, I'm sure that this is something that you're quite familiar with, along with the "CBT-like" approaches family members might use to minimize the degree of abuse or to otherwise gaslight the victim.
CBT, I knew there was a reason I liked you 😎
After 4 sessions of CBT this is what it looks like to me (Example)
Patient: I'm scared of water.
Therapist: Ok for your homework go jump into a pool.
Next session:
Therapist: So how did it go?
Patient: I didn't do it, how am i even supposed to do that?!
Therapist: So why are you here if you're not doing what i ask?
Lol, I don't know any licensed psychotherapist who would do what you stated. Most would understand that exposure is not simply telling the client to just go do the thing that frightens them. One important key statement you made is " this is what CBT looks like to me." That statement alone speaks volumes. Your perception is extremely important as a client. Because it is your perception (what it looks like to you) doesn't mean that's what the therapist actually did. They may have taken the proper approach to the exposure however it may not have "looked" or felt that way to you. It is also possible you just got a bad therapist if they actually implemented the practice in the manner it appeared to you.
Now that’s bad cbt
I had CBT when I joined a psychosis program, I had no idea how it was supposed to help me and I still don’t really. While I loved talking to the pdoc who was treating me, I did not get anything out of it and I’m very closed off about trying it again.
As a novice clinician, I was a bit nervous to watch. Then, I thought of thank God. Thank you for your videos. I love them and find them super helpful.
Im 23 and been in therapy for 10 years and have received no good CBT.
Love your channel this is great and it’s important we all get the right therapy. There are amazing educated people out there. Thank you
Before I became a licensed therapist and I was working as an MSW, I was in therapy and I kept asking for TANGIBLE skills. Talk therapy was not useful. I would tell my therapist that I WANTED homework and although I knew about CBT, I needed someone to guide me through the activities. I can teach others, but it is difficult to teach myself, ya know? It was the most frustrating thing. My therapist would just talk and I felt like I was getting nowhere (I eventually found a better fit, but it took years). Now I work in a private practice and I always work with my patients to find homework and activities that work for them, and I ask for feedback almost every session. So important. I also explain the theory and reasoning behind everything and I try the activity on my own before assigning it to a patient.
Hey, thank you for your insight. :) I also wanted to share that I am very thankful for your last video, where you talk about anxiety and perfectionism. Your courageousness facing your anxiety inspires me to be more brave myself, to let mistakes happen and be more imperfect. I feel that you were quite open and honest in the last video. I appreciate that very much! Thanks!
Thank YOU for your comment! The community's feedback this week was SO healing for me. Really appreciate you being a part of it!
Have never had CBT and was beginning my research on what it's all about. This is the first video I have watched to enlighten myself of what this approach consists of. I live in a Miami area and I will definitely be looking into a practitioner in my area. Thank you and may all those who see this find the peace and help they need in order to live a fulfilling and abundant life.
Love this, navigating different types of therapy and trying to figure out if the treatment I'm getting is right is a big challenge. This was very informative!
Glad to hear it was helpful! Thanks for your comment!
As a psychologist who just started cbt training and practicing some skills, this video enlightened me for long journey. Thank you
Thank you! I’ve watched some of your videos today and i find them very informative snd helpful.
Holy cow my entire life of cbt was nothing like mention. The only thing was homework but even there all I did was just tracking things what was super tedious and it felt like didn't do much?
But the worst one I have received so far was exposure theraphy with my massive phobia. I have quit it half way and overcame things by myself because it was just so unhelpful. NHS mental health services are just so bad due to underfunding.
I am really glad you are making these videos, they are soooo helpful you can't imagine
As a therapist who provides CBT (among other modalities) I can say this is pretty spot on. I have gotten referrals from people in "bad CBT" looking for a new direction, and it's safe to say they are often astounded when they find treatment can be effective. Consumers of therapy: vet your therapist. Look up their resume and their experience. Remember every therapy session is an interview for future sessions. Don't be afraid to "cheat" on your therapist and try out a few before you settle on someone you want to stick with.
The fifth one!! ITS SO REFRESHING TO HEAR ABOUT EXPERIENTIAL PRACTICE IN THERAPY!!! Roleplaying and practicing is so important and I thought that was soley something used in adventure therapy settings.
This was helpful to reassure me that I'm doing some things right in my therapy sessions, I agree with all these points :)
Thank you! I’m reassured I’m providing good therapy 😊
Nicely done. I would say your key points can be applied to what to expect from good therapy/therapist!
Thanks so much Amina!!!
I appreciate your discussion to help me evaluate the treatment I am receiving. After several years with a prior therapist, I still had no idea where I was headed or how/when I might reasonably get there.
I hope this video was helpful in re-evaluating your treatment, or at least starting a dialogue with your therapist about your treatment.
Wow... I wish I knew about this years ago! I eventually got a lot out of my therapy, but I didn't know what good CBT was supposed to look like.
As a counsellor who also has needed to find therapy for myself, I’ve found a lot of practitioners who advertise as a CBT therapist are what I call a worksheet therapist. I’ve attended a first session where the psychologist, without knowing who I was or what I needed, started the session with a cbt worksheet in front of him because he had already decided that that was what he was going to do with me.
The reality is, cbt can be powerfully helpful as a psych tool, but in part the array of prewritten worksheets and templates can make practitioners forget to first treat a client as an individual and, frankly, be lazy.
Good CBT by comparison feels personally meaningful and directed to the client.
This is exactly what my cbt therapists have done with me. It’s been very frustrating, bc like you said, they don’t try to understand me as an individual. They operate somewhat robotically with their treatment program (worksheets).
@@jewelsbarbie That's been my experience too. It's very infantilizing, as if there is a one size fits all approach. Half the time I ended up making paper fans out of the worksheets because I quite frankly found them redundant and tedious.
As a newer clinician, I rely heavily on worksheets, but I ask for input and I try my best to tailor it to the client. Thank you for the reminder to meet the patient where THEY are.
@@bkvlg227 True! I don't have a problem with CBT or with worksheets - we just need to remember that they are tools, and as mental health workers, we should have more than one tool in our toolbelts, and use them with care and consideration.
yep its a cookie cutter machine mentality
I did couples CBT therapy. The therapist ignored why I presented - a partner who did daily verbal abuse & was shoving me around. No surprises here - therapy made him worse since therapist did not directly address these issues. After he assaulted me, made me unconscious, breaking bones, I left him & Seattle. When I told the therapist about what he did she wrote back to me feel free to contact her when I get back to my creativity.
There is something truly wrong with a lot of therapists, just like nurses, teachers and cops. They get into it to hirt vulnerable people
My cbt made me a believer in "getting what you pay for".
The clinic i went to did not charge me for therapy. Maybe thats why it wasn't so great. :\
Ironically, the best therapy I got was from a walk in consoling center.
Maybe they just cared more.
I'm at the point where I will not do therapy if I have to pay. Many years ago I was willing to pay out of pocket because I had faith that it would be effective, I trusted when people told me it was worth it, you need to take care of yourself, you'll be glad you did, all to spend thousands of dollars and achieve nothing.
The CBT I've been getting is text book sort of stuff. I had to quit and walk away.
I've explained how much mental pain I've been in for the past 25 years and how it's just at a critical point now. It just didn't sink in with the "Therapist". The goals are not obtainable because the root problem can't be solved.
I understand CBT but it's not working with my apathy and anhedonia.
Thanks so much! I’m about to start with a new therapist on Friday because of these reasons. Let’s hope this one’s a bit better! :)
Good luck! I hope you have a great meeting this Friday!
I'm in an Intensive Outpatient Therapy program (IOP, meeting Monday through Friday, 8:30 to Noon). By day #3, I requested to be switched to the Partial Hospitalization Propgram (PHP, meeting Monday through Friday, 8:30 to 2:30) because IOP was not teaching me enough. My experience is, that we are not given true homework. Our daily check in clinical therapist challenges us to accomplish things but there is no true accountability. We are not all getting out of our chair enough and when it does happen, it is volunteers illustrating a coping skill. We are given handouts and read from them and asked for examples from our personal experiences and "what it might look like". So when the clinician charts out or illustrates a DBT skill on the board with a behavior example, I have been inserting my own type of behavior or issue into whatever chart or illustration being used in order to maximize my learning experience. Kudos to you for getting your group off their chairs when appropriate and giving them homework.
I feel like my therapist is a good CBT practitioner, but I just don't mesh well with it.
She tries to get me to set goals, but I don't know what to tell her.
She tries to get me to develop new skills, but I constantly fail to acquire them.
She gives me homework and I almost never do what is asked of me, and when I do, it doesn't feel valuable.
We have gotten out of the chair often, and I've always hated it, it made me feel extremely anxious.
This happens a lot with ADHD and "ASD" (this platform doesn't like us to talk about that one). Anyway you might look into those if you haven't. It could be anything of course but you just sound like me and I have both. Part of my issue is that I'm under soul crushing stress but the other part is I CAN'T DO STUFF WITHOUT ADHD TREATMENT AND SUPPORT lol
I need way more support than just "oh go do this after we leave here" i literally need someone to talk for me a lot of the time. There's probably something else going on even if it's not these issues. Just thought I'd mention it just in case
This is a great explanation and set of recommendations for something that’s sometimes vague (even for me, who’s halfway through med school haha).
Thanks for your feedback! It always bugs me how vague everything in the world of mental health can be if you aren't embedded in the system.
I have used the EAP from my employer, so I didn't have to pay out of pocket, but I have had some counselors who didn't seem like they had direction. One of them had me read a book as my homework, but that was about it. I will look for these methods going forward.
Thank you. This helped me.
Whenever i leave my sessions i feel so nervous become it seems like there's even more loose ends and i gained nothing
Thank you for this
great, ive done CBT since 2013 (with some periods without) and at every single organization they did all the bad things you just listed… im starting again in 2023 and I’ll focus more on these things from now on
I will say this: Ever since finding you, Ive been using your techniques to get me through too. Due to moving i had to transfer my case within same county, however, Im not getting good service now. At the former office I was active and had group sessions. We did homework and art therapy. In the new office its a struggle to be seen but apparently the receptionist is getting my dates wrong. I feel like its worth driving the 30 mins to my old office instead of the 5 mins the new one is from my house. Im also using the techniques from old office bc thats whats kept me feeling better.
I tried cbt on myself... that doesn’t work so well 😅😅
ball stretcher
I've tried a lot of different therapy for both learning and personal purposes. Also I've met so many CBT therapists in training that do not have their own personal therapy, which seems absurd when you realise how much insight and awareness is gained from being the client! I've tried CBT where the practitioner did not pick up on trauma symptoms and this was a time when symptoms were worsening, which wasn't helpful and frankly damaging. I've also seen an ACT psychologist who often avoids talking about feelings or actively disagree with how I feel or perceive things, it's just a lot more work as the client. The biggest thing here I feel, was that they had not assessed whether or not the treatment was right for me( they were not on a whole bad therapists but I would argue that maybe I wasn't in their remit), I was on a list , I had to make do, they had to get results, not a productive scenario. A positive experience of a more cognitive style of counselling is when the practitioner actively listened and worked with me and was able to reframe and guide thoughts into more constructive ones, there was more of a healthy feedback loop and I think that was an example of when cognitive therapy helped produce real change. I would like to see more cognitive therapists recognise client choice, experience and insight rather than having the paperwork and theory on behaviour always be the authority , it can turn into what can feel like a school session or the therapist feels even more like a parent and there is a risk with breeding co dependence or the client feeling that the resources to take responsibility aren't within themselves.
Yes I liked this video :) Great job Ali!
Thanks so much!
I've had CBT, and I am currently in what I think of as maintenance. I have PTSD (with some other stuff) and I find my monthly appts really helpful in staying on track. Luckily I live in Australia and have access to ongoing treatment with little hassle. I have mostly had a good experience with CBT and I know that I am more of an issue than my therapist...im resistant, stubborn, fight myself and go back to unhealthy thoughts very easily. I think my therapist is the bomb, he pushes me, and challenges me and I wouldn't be heading off to Uni this year if it wasn't for his continued input.
Thanks for sharing your experience! Glad to hear you've found a good match with your present therapist.
I don't think any of the therapy I received was CBT therapy specifically, but many claimed to be using CBT in their treatment. From 1994 until the present, I have worked with 17 different therapists, off and on. Some I saw only once. Others I worked with for years while making no progress whatsoever. The longest I stayed with the same counselor was off and on from September 2013 through August 2017. Most of that time I felt confused, unclear of what exactly we were trying to accomplish. Since I returned to therapy due to a resurgence of PTSD symptoms and severe depression, I had hoped my symptoms would eventually subside. On the contrary, my symptoms only grew worse and worse. For the last 2 years, the depression has been the worst it ever has been (mostly catatonic), which is saying a lot considering I never thought I would survive '98 - '99 when I experienced terribly traumatic events that led to my developing PTSD in the first place. The best I can hope for at the facilities where I've received mental health treatment is a printout from the internet about CBT techniques with little to no discussion and certainly no actual "practice" of anything CBT related. I'm lucky if I get an appointment with my current counselor once every 6 to 8 weeks. (This has been the case for many years now at 3 different facilities.) I've only seen this particular counselor twice since September. Although he has mentioned trying EMDR therapy to alleviate some of the PTSD symptoms, I worry that the infrequency of appointments would negate any progress I could possibly make, not to mention the fact that I'm not even sure he's licensed to offer a treatment such as EMDR. It's like the blind leading the blind here in TN.
Amazing video!! Can you please make a video on DBT too? Thanks😊
YES! It's on my list for February. Will likely make a 5 part series on DBT.
I have adhd and was having difficultly dealing with negative emotions from chronic pain. I felt a great deal of guilt as a parent and because I had had to quit working and I felt resentment toward my husband for not being more supportive. I was seeing a psychiatrist for adhd and insomnia who I loved because he was always compassionate and told me he thought I was doing the best I could with my circumstances. He suggested a therapist that worked out of his office. I wanted help managing my emotions. Right away, she didn’t seem to understand how my adhd had affected my life and would tell me how she did things and expected me to be able to suddenly be organized and able to implement routines or time management techniques that I have never developed. She didn’t express compassion or appreciate how vulnerable I was. Meanwhile my 7th grade son was experiencing an exacerbation of social anxiety to the point where even my husband agreed we should homeschool him. It was the third week of 7th grade and he was already truent. The school wasn’t helping, nor was his pediatrician or his own mental health provider. We really felt we had no other option. So, my 3rd or 4th session I told my therapist about it. She was incredulous, never asked why or what the circumstances were, just immediately said things like, “You have NO right to take him out of school” and “He needs to be in school” “you are in no shape to home school him”. I just sat there speechless for a time, could feel the tears coming, gritted my teeth and said “you don’t have to make me feel any more guilt than I already feel.” I left the session as soon as I could stop crying and didn’t go back.
At Kaiser, I can only see my therapist once every six weeks. Sessions are so spread out that I wonder if there's any point to this at all. I hear people talk about weekly therapy and it sounds like a pipe dream.
I've heard this is part of the reason some clinicians at Kaiser went on strike last year: www.sfchronicle.com/business/article/Kaiser-mental-health-workers-strike-citing-long-13455550.php.
I've recently started training as a CBT therapist in a program called CETA. It's a short-term American (John Hopkins university) program to help mostly those who suffered due to military conflicts and don't have access to a lot of trained therapists. We were instructed about getting active, setting goals and being transparent about the techniques, so I guess it's a 'good CBT' after all.
I can't find it's page on Wikipedia but there are some articles in NCBI.
Have you heard about it in your professional surrounding? I
My CBT sessions missed all 5 points. No wonder I feel it’s not working. Funny things is I was starting to looking for goals, new skills and home work myself.
I'm in CBT for social anxiety disorder. I get all the things you mentioned. My problem is getting over the avoidance 'bump' for the exposure experiments. It happens again and again and again and makes me feel like more of a loser than I did already
It may be too late but if you’re having trouble pushing through the anxiety to DO the exposure exercises figure out with your therapists how to break them down into smaller components (rather than going to the mall go to a gas station or instead of going at shopping peak go late at night; instead of talking to a stranger make brief eye contact) and build up from the smaller pieces.ask for help scaling the distress and engage in multiple exercises that cause lower anxiety repeating them often until they feel okay then step up to a slightly harder one. You aren’t failing if each time it happens you’re learning more about what you need to do or think that builds you.Never confuse a single failure as a bad thing or as a final defeat!
My therapist gave me lots of charts to fill in and use as visualizations which really helped me conceptually. I find the homework hard to do the further I get from my session because I worry and forget how to achieve the goal. Like how do I recreate being scared of a type of person without putting myself in that situation again? Anyways I think my fav cbt thing so far is asking myself “what’s my narrative here? Vs what is happening?” And then “what would the person I want to be say?”
I had to look up this topic as I've been in cbt therapy for 6 months and I've never learned anything from it as it was too easy and not mind provoking enough. I realized a year ago that I had been doing cbt techniques since my late teenage years, but without it having much of a positive effect on my anxiety and depression. It just made me look put together from the outside but inside it was as messy as always.
When I found out I'd been doing it for more than a decade without results I thought I might just be resistant to this therapy, but still felt I should give it a chance with a professional, cause they could probably teach me a bunch of new stuff. It being the most successful therapy for what I have.
Well, I guess I got a not very versed psychologist, because it adds nothing to what I've ever done. When I tell him I'd maybe like to try something else, he persists even though I tell him it's a bit too easy for me and is exactly what I've always done. Now the last 2 sessions he haven't given me any exercises cause he "couldn't think of one to give me".
Keep on feeling like I should trust him cause after all he's the pro, but when does one have to just give up on the therapist and seek another one?
Maybe try a different modality? Like psychodynamic therapy?
I hate CBT. I had a male therapist who would treat me like my brain just didn’t work right. He never validated me or let me feel the way I felt. He just said “but you’re not fat. You’re not ugly, you know that so why do you feel that waY” UGH !
Also I told him I wanted DBT and all he did was CBT it pissed me off
Most of my therapists have been like that. They only did the therapy and treatment they chose despite the fact that I never felt better with the stuff they chose which was always CBT stuff.
Just started working with a CBT therapist but she is not strictly CBT. She has given me homework but it is hard to do as my PTSD symptoms are out of control right now
i use it in oil form, but thc is stronger
Ha! I see what you did there...
🤣🤣🤣
J.H. Miretskay hehe can I kiss you
Best neurostabilizer for a human is cbd. You don't have to get high.
I'm lucky enough to live in a place that offers government subsidized CBT group therapy. Probably not AS effective as one-on-one sessions, but incredibly valuable none-the-less. Life-changing, if you keep up with your daily practices
I did CBT for a year for social anxiety and really struggled to make any real progress. I then started taking antidepressants for an unrelated reason and all of a sudden the anxiety response disappeared and I was able to use the techniques I learned in therapy to progress and better myself
Those pills ruin your ability to feel. They numb your mind. 17 years of citalopram here, felt great at 40mg. Dr lowered dosage more and more even though I pleaded not to. I forced myself of them. I'm just a numb empty shell.
I have a question: do you ever use ACT since you made a joke about it? I am a big fan and proponent of it and I find it much deeper, much more personalised and compassionate than CBT. I get great results with my clients that suffer from an array of issues like anxiety, depression etc. What are your thoughts about that?
I tried a therapist via the site Betterhelp, and watching this video made me realize how bad this resource was for me (having depression + social anxiety). It was the most cost effective option for me at the time, but there wasn’t homework or goals during my time with the therapist! He did offer some ideas + books to check out (The Velveteen Principles, Daring Greatly by Brene Brown) but there was no expectation that I’d be working on anything. I don’t know. Maybe it isn’t considered “real therapy,” because it was online therapy?
Thanks so much for sharing your experience, tskcello! One of the reasons I haven't accepted any sponsors from online therapy services is so I can openly talk about them. Online therapy in itself can be very helpful, especially for people who couldn't otherwise access services. But just like in person therapy, there is a big range in the quality of treatment you can access. Here's a great resource on thinking through the options: thewirecutter.com/reviews/online-therapy-services/.
All five signs where in my CBT sessions. The one that was more pronounced was how mysterious it was. The sessions were blurry she never told me anything about goals or new skills. I became very anxious depressed and suicidal. I had to admit myself into an inpatient clinic. I stopped going after that. Idk what went wrong but i never want to go to therapy again.
In addition to the mystery I got a lot of dismissive put-downs. Very early I asked what his part was in the process. Typically, he replied "what do you think it should be?" I said I expected his involvement, not just quiet passivity. I expected his thoughts, evaluations, perspectives. Suggestions for things I might do, articles I might read. Very reasonable I thought. His response? "Sounds like you're just looking for easy answers."
That was typical. Got to where I became increasingly reluctant to say anything for fear of another blunt dismissive reply. After several months I just stopped going, finished an appointment and never re-scheduled.
@@gmansard641 I'm ahtistic but wasn't diagnosed yet when i was much younger. Went to a therapist and told her i felt like people didn't like who i really am because i was literally intentionally pretending to be someone else (masking) so they wouldn't be mean to me, and she said "oh you think you're so much smarter than everyone else that you can trick them?" Like yeah i guess so because it's working isn't it lady
100% agree. I think CBTs first intervention would be to explain CBT and how the ABCs work. I'm coming from Beck's Cognitive Therapy.
Ive had CBT before and felt almost immediate changes, now I am doing it again and its been 7 months, I feel maybe 10% better but actually nothing has changed. I don't know what to do now, change therapist again, i feel almost as bad as when i started therapy and I can't keep living like this
Hey Doc, I'm wondering what psychotherapy school to start with. In my area there are CBT (REBT), Gestalt and Transactional analysis. I'll be graduating psychology soon and I also want to specialize in clinical psychology. Could you give me any advice?
You're foreigner and your therapist doesn't ask how to pronounce your name. He can't remember where you're from so he always referrers to your home country as "your country" even you moved for good. He seems bored. He gives you CBT sheet and says to challenge your thoughts.
omg that sounds terrible, I’m so sorry that you had such a terrible experience
I don't know if it was CBT or not. It was never explained. I had done research before hand and had heard that one of the first thing you do in therapy is develop some goals. Goals were never discussed. I thought, okay, maybe that is not how it works here. I also heard that homework was a thing. None of that, either. In fact, every time I went in seemed to be a whole new day with no connection to the last session. Every time I left I felt defensive and confused. Just reaching out to ask for help takes a tremendous effort and leaves one feeling anxious and vulnerable. Even more of my resources were being taxed trying to figure out how counseling worked. By the time I realized I was going to have to ask, I just felt stupid. After a handful of sessions I could see this simply wasn't going to be useful and stopped going.
I'm wondering if there is another more positive word for "homework" ? Most of my patients have had very negative/traumatic experience during their school years and thus mentioning "homework" might trigger emotional flashbacks.
How about "action plan"?
Take-away ?
I actually don’t know what I had. I always was thinking what is this! How this going to help me! There is no goals or anything! and my anxiety got worsen after 8 sessions
Great video! I'm a social worker looking for further my cbt proficiency. Do you have any recommendations on schools or seminars I could attend?
Thanks for watching! Absolutely. I'd look exploring ABCT - www.abct.org/Home/. They're a wonderful resource for CBT.
Dr. Ali I'm not sure if you still read comments after a year, but I'm just now finding your channel and it's been very helpful. I do have a question, can I begin CBT if I am currently taking Klonopins? I have Panic Attacks, with Agoraphobia, and Generalized Anxiety, and I'm literally getting sick of it and need a change, but I dont have enough money for therapy, so I'm using videos and books on CBT. Thank you for your videos!
Absolutely you can! A cognitive behavioral therapist can work with your other healthcare professionals to see the best way to integrate your medication use into treatment.
Thank you Dr. , I love your show and your beard! I've started watching your show because my panic attacks have got worse lately bringing on agoraphobia and GAD, but your show is literally saving my life, what other youtube channel can say that
My psychologist (just dropped me🤷🏻♀️) gave me tools. Listen to music and relaxation podcasts. We’ll work on trauma next. 2 1/2 years nothing. Just added another trauma. I’ll never trust again. My first psychologist had a frontal lobe glioblastoma. His partner took over my therapy. Took a while to trust him. But he convinced me he understood my suicidal thoughts and was the perfect person to help me. Made me feel like part of his family. Then recently he started acting distant. Finally told me he wasn’t my therapist anymore. Ummm...huh? Pulled the world out from beneath me. I’m still angry, devastated, hurt. He even sent back the gifts I gave them for Christmas. Not any of the other gifts. I’m lost. I can never tell another soul the things I shared with him. And I love that little family so much. Mine all died between 2010 and 2013. Just breaks my heart.😔
Do you have thoughts on the book "Theraputic Communication: Knowing What to Say When"?
Would you recommend self directed cognitive behavioral therapy for someone with extremely severe depression and anxiety?
Really wish I lived by this guy. 😣
So helpful. I think I’m in a mediocre CBT.
Can you suggest some best cbt books for practical sessions
I did CBT in the UK back in 2015 as it was the therapy of choice due to the alleged evidence. Somone in the comment said that she had a CBT therapist describing the clinician as a worksheet psychologist. This was my exact experience, I felt that the whole process was way too mechanical. My mind doesn't work in that way and it will never be. I was then referred to a clinical psychologist but lately discharged because I moved out from that specific area. I also had person-centred counselling, but it was a short course in the midst of the pandemic. I tried again CBT back home and the therapist wasn't able to help me out, even though I made things clear in my notes, so I just spent 500 euros for nothing. I think CBT is not for me, I have deep-seated issues so I'm considering doing psychodynamic. CBT might come handy later down the line as maintenance therapy.
Oh, I now understand why my counselor wanted me to color or go take to her German boss in German, but we got busy talking about my problems and things we needed to work on.
What type of client would not be good to use CBT on? Like are there certain things that one might want to work on where CBT would not be a good treatment to use.
Complex trauma, attachment difficulties, childhood trauma, etc
Autism
Ugh ... Check, check, check, check, check.... I've seen 6 different counselors over 15 years, and only 1 met at least some of that criteria. Why is it so hard to find good counselors?
What if a patient has multiple problems? For example, like depression, anxiety, and phobias?
That's when it's become REALLY important to have a good conceptualization that best captures the problems the person is experience. I discuss that more here: czcams.com/video/_oQGCOe7Vvc/video.html
My only experience with cbt was horrible for me. There was no warning the therapist just dove right in and made me explain my most painful traumatic experiences in depth. When I asked her why she said “it’s how it works”, I couldn’t summarize my life in a 20 minute session and left the office crying since I’d just unlocked feelings I hadn’t felt since I was a child or a while ago. I understood a bit of where she was going but nothing was laid out for me, they didn’t ask about what my goals are, how I feel, what I’m comfortable with, what I want to achieve.
I’m going to try again with a different therapist because after the pandemic, I’m just now realizing that I’m not functioning like myself at all & I’ve been on autopilot just taking care of everyone else for so long, I don’t even know who I am anymore. I know who I was but I don’t feel like that person I liked. I want to get back to feeling like myself again so I can succeed at work, improve my relationship, see my friends and family again & get back to feeling like the person I was before the depression and anxiety took over.
As a former You Tube creator this a perfectly timed and crafted you tube video
Thanks so much!!! Glad to hear it was helpful!
Is cbt the “most effective” because it has been researched the most?
Right now I am seeing a psychologist twice a week for the past 4 months. And I don’t think it’s helpful at all.
Hi can u suggest me any book on cbt
The acronyms of psych techniques sound like the names of scheduled drugs.
IDK if someone already asked this, but when should you give up on a certain therapist and decide to find another one? like how many sessions?
First, let the therapist know your concerns so that you two can come up with an alternative plan. Discuss what you have and haven't found helpful. Ask them to explain their approach to help you overcome your problem. Determine if it's a style issue. For instance, a CBT therapist approach is very different than a humanistic approach. Also, think about what your expectations are and whether or not your urge to give up has more to do with them than you and vice versa. Whatever the case may be, be upfront and honest because therapist won't know there's an issue if you don't say anything. Sometimes it's just not a good fit and you'll be able to recognize it.
Thinking about your expectations are important. Some clients come to therapy expecting a quick fix, just validation, or for their problems to be solved in a certain time frame and etc but it doesn't work that way.
@@ShiekaG I think I was given more of a humanistic approach. I went every week for 3 months, 12 sessions total. Overall, it helped, but became redundant and I don't think it was a good fit. I'm the type to not give up too early on people so I feel satisfied she helped me as much as she possibly could. Thanks for taking your time to respond to me. I appreciate it.
If you feel like it's not getting better after a certain point and you feel like your therapist acts like you're weak or judges you and doesn't seem to want to talk about things at all/any kind of talk therapy when you feel like you need at least some in your life or at least to work out a plan that's motivating, is that CBT gone too far? (My main issue is OCD. But my experience with my old therapist almost makes me subconsciously not to want to get better and practice what she kept telling me to do in a slightly disrespectful and dismissive way, so many years later, so that she isn't right.)
Yes CBT not working me Dr say don't compare your from your past image, or other ,it's maintain your anxiety. This word stop my recovery
I have been receiving cbt for depression for a year and my therapist recently said that i need two more years of therapy. Is that normal? Does it take that long?
Stumbled across your question and as a cbt therapist thought I’d answer in case it helps. That is not at all normal for a cbt therapist, it sounds more like a psychodynamic therapy approach….even then I’ve not heard of a therapist making such an assumption.