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What is cognitive behavioural therapy?
Cognitive behavioural therapy (CBT) is a type of talking therapy that enables people to examine how they think and behave with the support of a therapist. It is a technique used primarily for people with mental health problems, particularly those associated with negative emotions, such as anxiety and depression.
In a CBT session, you and the therapist will discuss the way you think in certain situations, and how that affects the way you then feel and the way you act in response. The idea is that by talking about how you could change your mindset in these circumstances, you can change your emotional response and behaviours to be healthier and more positive.
There are other formats of CBT apart from face-to-face sessions. These include online sessions and self-help options, such as with books or apps.
Cognitive behavioural therapy is not a cure, but it can be a highly effective treatment in managing symptoms and improving wellbeing.
How can cognitive behavioural therapy help people with dementia?
Dementia is not a mental illness, but a neurological condition. Cognitive behavioural therapy cannot treat dementia itself but can be helpful for mental health symptoms that often result from dementia.
Dementia and depression have many overlapping symptoms, including low mood, anxiety, apathy and poor concentration. Depression is also more common in older people who have dementia than those who don’t. CBT can help to improve symptoms associated with both illnesses.
Several studies over the last 20 years have found that CBT can be effective in treating depression and anxiety in people with early stages of dementia. It was found to improve their self-esteem, independence and relationships.
A difficulty is that people living with dementia often find it difficult to find the right words to express the way they feel, as well as having trouble forming new memories. They may struggle to remember how to apply the skills they learn in therapy. They become confused or mentally fatigued during therapy. For this reason, the standard CBT methods used by therapist need to be adapted for people with dementia.
A 2008 US study funded by the National Institute of Mental Health and led by Dr Melinda Stanley found effective methods of adaptation, including:
- Having patients repeat information and make reminder cards
- Using Space Retrieval during therapy, a method of improving recall by asking questions at regular intervals which require the patient to engage their memory. For example, they might be asked ‘What is your grandson’s name?’ or ‘What is your address?’
- Shortening sessions to 30-40 minutes, rather than the standard hour
- Only practising one or two skills per session
- Having the patient’s carer present during sessions so that they could implement skills learned at home
- Providing simple written instructions that cover the skills learned and a clear, manageable plan for practising each skill between sessions.
How to access cognitive behavioural therapy
Through the NHS
You can access CBT by being referred by your GP.
If you live in England, you can also refer yourself to the NHS Improving Access to Psychological Therapies service, but you must be registered with a GP to refer yourself.
In Wales, Scotland and Northern Ireland, you must be referred by a GP.
Private therapy
Getting cognitive behavioural therapy privately can be expensive but many people choose it. It allows you to choose your therapist and how often you have CBT sessions. Most therapists offer online or telephone sessions, and many offer face to face therapy.
You can find the official register of accredited CBT therapists in the UK here.
Self-therapy
It is possible to learn and apply cognitive behavioural therapy skills without a therapist. There is a wide range of self-help books available, in print or as audiobooks.
You can also use phone and tablet apps such as Headspace and Mindshift CBT. You may wish to accompany these with dementia apps designed to improve memory, such as MindMate or Luminosity.