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Wednesday, 6 October 2010

Why CBT often isn't what it seems

I would like to share with you today a piece of research that I recently came across.

Isn’t it interesting how stereotypes develop? Many practitioners and clients expect CBT to be prescriptive, directive and "top down". A recent study by Westra et al (2010) * certainly questions such stereotypes:

In the study, eighteen clients were interviewed following 8 sessions of CBT. 84% of them stated that their experience of CBT was not as they expected. Most related to the fact that therapy was more collaborative than expected and that they learnt more about themselves than anticipated. Even in instances where the outcome of therapy was negative, clients typically still remained positive towards their therapist and attributed lack of progress to other factors such as time constraints.

The gap between prejudice and reality is a common psychological and social phenomenon with pre-existing attitudes often leading to selective attention. CBT is not only a valuable approach and toolkit of strategies which therapists can use to help change emotions and behaviour – it also "bolts onto" other existing modalities of helping people to change.

If you are interested in exploring the reality behind the myth and the prejudices surrounding CBT, have a look at our Introductory CBT course:


if you have your own thoughts or experiences on the topic let us know by reply or commenting on our blog: .

As a "big tent" training organisation we are interested in all views on this subject... supportive or otherwise. :-)

Best Wishes
Paul Grantham

* Westra, H., Aviram, A., Barnes, M., & Angus, L. (2010). Therapy was not what I expected: A preliminary qualitative analysis of concordance between client expectations and experience of cognitive-behavioural therapy. Psychotherapy Research, 20 (4), 436-446


  1. Dear Paul,
    I like anything that helps me question a stereotype. I admit that my general view of the theory of CBT has been that is seems directive, and top down. This has been tempered by listening to individual therapists who use this approach. However, what intrigues me about this research is the comment, 'Even in instances where the outcome of therapy was negative, clients typically still remained positive towards their therapist ...' This leads me to ask the question: 'is this as much proof of the power of the counselling relationship, as evidence of the efficacy of CBT?'

    07974 388412

  2. Hi there,

    I am open minded about all types of therapy. Seeing that people are so
    unique I don't believe we can, as practioners , afford not to be. That
    would just be too egotistical!

    I would love to do your CBT course especially experiencing you on the course
    in Newcastle. I like your style and your approach and openness.

    I will not travel to London to do training these days. After years of
    travelling for training and meetings and work related things I just find it
    is too expensive with overnight stays and travel costs.

    It's alright for those who have an employer to pay for them, but I lose
    money by having to take my working time off, unpaid, and then the other

    Put it on in Newcastle and I would almost certainly do it, but I know you

    Looking forward to the next course on groups which I am about to book up.




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