Friday, 20 May 2022
Friday, 23 April 2021
As the number of private CBT clinics and providers continues to increase in response to the demand for Cognitive Behavioural Therapy, how can you ensure that you are getting good value for money?
Cognitive Behavioural Therapy (CBT) continues to set the gold standard in the treatment of anxiety conditions and mood disorders. CBT is highly effective in the treatment of short and long-term problems, providing good psychological insight into the causes of the problem and practical strategies for supporting sustainable change.
The research evidence demonstrates that CBT delivers good therapeutic outcomes in a relatively short period of time. It is therefore highly popular in both the NHS and private practice and is the NICE treatment of choice for a wide range of psychological problems.
Whilst CBT can be accessed free of charge via the NHS “Improving Access to Psychological Therapies” (IAPT) services, waiting times can range from six to sixteen weeks, extending into several months for specialist CBT treatment or child and adolescent therapy.
Private CBT therefore provides a fast and flexible way of accessing good therapy with the added advantage of choosing the specific therapist that you want to work with.
The problem is that there are literally thousands of therapists offering CBT and wide variations in quality and price. So finding the right therapist and ensuring good value for money can feel complicated and confusing.
In this article, we offer some guidance on how to judge good value for money and some pointers to help select the right Cognitive Behavioural Therapist.
How Much Should You Expect to Pay for Private CBT?
The cost of Cognitive Behavioural Therapy (CBT) typically depends on the qualifications, experience, success rates, commercial orientation, location and availability of the therapist. In our survey of 46 accredited CBT providers operating in the UK we found CBT costs ranging from £45 to £250 depending on the size, accreditation status, location and commercial orientation of the private provider.
We also found that the CBT costs of services provided by the same therapists often varied significantly depending on the organisation or platform through which their services were offered.
It’s therefore difficult to establish a clear benchmark for good quality CBT, however we found that clients should generally expect to pay £70-£95 for one-to-one CBT appointments with a qualified and BABCP accredited Cognitive Behavioural Psychotherapist.
Where Cognitive Behavioural Therapy is provided by larger commercial organisations via subcontracting arrangements, the cost of CBT is inflated to cover organisational overheads and profit margins. We looked at fifteen popular / well-known private CBT providers in the UK and calculated a mean average of £117.60. The range was £75-£146 for a standard 50 minute daytime appointment. There were no discernible differences in the therapists or services offered within this price range; indeed many therapists worked across several private providers.
How Many CBT Sessions Will be Required?
To understand the costs of private CBT, clients also need to know how many sessions may be required. The number of CBT sessions will vary depending on the presenting problem, the client’s therapy goals and the level of complexity. Most anxiety and mood conditions can be treated within 6-16 sessions and the CBT process should always follow an agreed therapy plan. Our advice is to budget for a minimum of eight CBT sessions and agree the therapy plan following the initial appointment.
Value for Money
CBT is not a protected profession in the UK and the qualifications and credentials of therapists varies significantly from medically trained psychiatrists to untrained individuals offering CBT with superficial online training only. Whilst it’s reasonable to assume that individual’s with wider or more in-depth psychological training will charge more than unqualified therapists, this is not always a reliable gage for assessing good value for money. Higher charges are frequently driven by the therapist’s pricing policy rather than qualifications, credentials and experience.
Quality Assurance Standards
The recognised UK benchmark for Cognitive Behavioural Therapy is set by the British Association of Behavioural and Cognitive Psychotherapy (BABCP). Accreditation with the BABCP ensures that the individual has achieved a post-graduate specialist qualification in CBT, demonstrated competency in assessed clinical practice, committed to ongoing CBT supervision and undertakes regular and relevant professional development.
It’s therefore important to check the accreditation status of your Cognitive Behavioural Psychotherapy provider. Whilst there are non-accredited therapists with the relevant qualifications and clinical experience, attempting to objectively assess CBT qualifications and clinical experience can be a minefield. BABCP accreditation provides an established quality assurance standard that is universally recognised across the health, legal and insurance industries.
Whilst there are many examples of counselling businesses offering cheaper CBT, these services are often operating well below the recognised threshold set by the BABCP. We found that over 70% of “therapists” returning results for CBT during 20 randomised psychology and counselling directory searches had no formal CBT qualifications and were registered as counsellors or psychotherapists. It’s not unusual for therapists from other approaches to offer Cognitive Behavioural Therapy with limited CBT training.
There are also many private businesses and individuals advertising as CBT providers without recognised CBT credentials. There are training organisations offering CBT diplomas in as few as eight hours online training and a number of private businesses claiming recognition with spurious accreditation bodies registered via the complementary health industry.
In the UK, the only recognised professional body for Cognitive Behavioural Therapy is the BABCP. This is not to be confused with the BACP; a counselling body that does not accredit Cognitive Behavioural Psychotherapists.
You can check the CBT accreditation status of your therapist by visiting https://www.cbtregisteruk.com/ You can also use www.cbtpages.com to find independent Cognitive Behavioural Therapists and Practitioner Psychologists with CBT specialisms.
In the final analysis, the real question should be what constitutes good value for money. To help with this, we have offered the following points as a check-list for securing the right therapist at the right price.
1. Is the CBT psychotherapist qualified and accredited by the BABCP?
2. Does the therapist have specific experience of working with the presenting problem?
3. Will the therapist follow the published evidence-base in determining the treatment approach?
4. Will there be agreed treatment timescales and a structured therapy plan?
5. Will therapy goals be used to set direction and monitor progress?
6. Is there a formal feedback process to refine the approach and address issues during the course of therapy?
7. Will there be a lapse or resilience plan at the end of therapy?
8. Can I establish a good interpersonal working relationship with this therapist?
About Think CBT
Think CBT is an independent network of BABCP accredited Cognitive Behavioural Psychotherapists working across the UK. we operate on a commercially ethical basis. This means that we strike a fair balance between client charges and the market rate for good quality CBT. Our operating model is driven by our commitment to providing the highest standards of CBT at an affordable price. Our standard daytime charges are £75 and evenings and weekend appointments are £85. We charge less as we keep our overheads to an operational minimum without exploiting the commercial gap between the therapist and the client. Many of our associate team members choose to work with us because of our commercially ethical position and our commitment to working in the joint interests of the client and therapist.
You can find out more about our approach by visiting www.thinkcbt.com
The content of this article expresses the author’s opinion and does not represent the position of any other professional body.
Tuesday, 6 October 2020
How the Cognitive Model is Used in CBT to Tackle Long-term Problems
The Importance of Cognition in CBT
Levels of Thinking – a Model of Human Cognition
How Negative Schema Develop
Thursday, 16 April 2020
Cognitive Behavioural Therapy – CBT for Chronic Pain
What is Pain?
The Evolution of the Pain Model
- Nociception: the signal that is sent from the peripheral nervous system to the brain to alert the body to potential harm or damage.
- Pain: the subjective experience of the pain signal as processed by the brain.
- Suffering; the emotional response to the nociceptive pain signal.
- Pain Behaviours: the action that the individual takes in response to the experience of pain.
The CBT Treatment Process for Chronic Pain
Key approaches in the CBT treatment process include:
- Identification of pain thresholds and activity baselines.
- Psychoeducation on the maintenance factors for chronic pain and development of a chronic pain formulation.
- Activity pacing and management of medication schedules.
- Multimodal relaxation training.
- Behavioural activation and behavioural bandwidth experiments.
- Focus of attention training and mindfulness exercises.
- Memory rescripting – particularly where trauma is implicated.
- Cognitive change and defusion techniques.
- Sleep strategies to cope with pain during sleep time.
- Relapse and resilience planning.
Monday, 6 April 2020
Friday, 20 March 2020
Coping With Isolation
Over the coming weeks and months, many of us will be asked to self-isolate or be instructed to stay at home if we have been infected by the Coronavirus. This will place us under significant pressure and change many of our normal coping mechanisms. So for example, if we are used to engaging in social activities such as sports, events, bars, shopping, contact with close friends and family, we will need to develop a new approach to maintaining good psychological health to get through the isolation period.
At Think CBT we have developed a simple framework to help people plan, structure their time and act in a way that makes the period of isolation more bearable.
This approach is called the “PACE” framework. The PACE framework draws on tried and tested CBT methods to help maintain good emotional and psychological health. You can download a free copy of the PACE Framework at PACE or by visiting our Resources page at www.thinkcbt.com
PACE is a simple acronym that stands for Physical, Achievement, Connection and Enjoyment.
Each of these areas are directly linked to the upkeep of different biological and emotional processes in the human body and nervous system.
Physical – This involves diet, exercise and sleep patterns.
Achievement – This is what we do to get a sense of purpose, completion or satisfaction.
Connection – This involves our key relationships, feelings of closeness, community or bonding.
Enjoyment -This includes the things we do for fun, for interest or pleasure.
During the period of isolation, it is important that we plan and structure our time to address each of these areas. We should be aware of the risks of falling into patterns of unstructured and passive behaviour. Taking an unplanned or reactive approach during long periods of isolation can lead to problems with anxiety and depressed mood, which in turn can have a significant impact on our physical health.
In-depth studies into the affects of isolation in prison or detainment populations have shown the profound affect that a loss of structure, engagement and purpose can have on psychological health and well-being.
So how do we apply the PACE framework?
Let’s take each of the four areas in turn and outline what this involves:
Physical Time – It’s important that we maintain good diet, sleep and exercise patterns.
Diet: Diet means planning and sticking to a well-balanced, varied and nutritious diet during the period of isolation. So without stock-piling, we can buy or have fresh food delivered. We can plan a weekly menu and really stretch our imaginations to try recipes that we don’t normally have the time to prepare through work or other commitments. The key to this is planning and sticking with the weekly menu.
If you are living alone, this can involve contacting friends or checking out recipes online or on channels such as YouTube.
If you are isolated with other family members, this can be planning and preparing food together.
The important thing is to have a plan and stick with it.
Exercise: Exercise is crucially important. Mr Motivator said on the radio just this week that your home is your gym. You should make the time and space to undertake regular exercise or gentle stretching movements to physically activate the body. You can find countless online home based exercise plans by simply entering exercise at home into your search engine.
It’s also important to remember that isolation does not mean staying at home. You should try to walk, run or take exercise outside in daylight, always taking care to maintain physical distance from other people to avoid the risk of infection.
Sleep: A healthy sleep pattern is key to good emotional balance and we know that sleep is often the first thing to suffer when we experience periods of stress. There are some strict rules about practising good sleep hygiene and bedtime rules to improve the chances of a good night’s sleep. Some key points are stick to a regular wakeful and sleep timetable, keep the bedroom clear of screens and other distractions and only go to bed when you are tired. There is a special type of Cognitive Behavioural Therapy for Insomnia called CBT-I and you can learn more about this by visiting www.thinkcbt.com
Achievement Time – This involves planning and allocating time to undertake activities that give you a sense of completion or satisfaction. This can range from work-related tasks for those people working from home or school, but it can also involve domestic tasks such as tidying, cleaning, gardening, home improvements or odd jobs around the house. Make a list of those jobs that you never seem to have time to complete and use the PACE exercise which you can download from www.thinkcbt.com to schedule these activities.
For those of us looking after younger children, this may also involve some support for home schooling. Again, having a structured plan for schoolwork time is crucially important.
Connection Time – This is an important human need to engage and connect with other people. If you are living alone, you should reach out to friends or acquaintances, join online groups or make contact with some of the social organisations that work to eliminate loneliness. Some of the organisations that can help include:
UK Youth, The Silver Line, The Way Foundation, The British Red Cross, Age UK.
If you are isolated with other family members, you can schedule time to sit together, play games, eat together, talk through your feelings, concerns and offer support.
Physical human contact is a highly important aspect of this, so take the time to cuddle up and exchange hugs on a regular basis. The Danish have a specific phrase called “Hygge” (pronounced hooga) where they take the time to connect, particularly when the weather is cold and inhospitable. Again the key to this is planning and scheduling daily “hooga” time, so that you spend quality time with your partner or family members without other distractions.
Enjoyment Time – This involves just doing things that are fun, interesting, fulfilling or exciting. For many people this period of isolation could be an opportunity to learn a new skill, take up a hobby, learn some key phrases in a different language, to read books that you don’t normally have the time to engage in, to watch that box-set with a good bar of chocolate or to relax in a hot bath. Make a list of the things that you really enjoy doing and schedule something enjoyable each day. This doesn’t have to be a momentous thing and could just involve a brief moment of relaxation.
Enjoyment always has more impact when it is linked to a sense of reward for having the personal discipline to stick to your weekly plan for Physical Time, Achievement Time and Connection Time.
You may find that some activities cross the boundaries between Physical Time, Achievement Time, Connection Time and Enjoyment Time. This doesn’t really matter provided the activities are planned in advance and applied with good self-discipline.
To find out more about the PACE approach, you can visit the Think CBT website at www.thinkcbt.com
Finally, if you need specific support and feel that you might benefit from working with a professionally accredited CBT expert, you can organise online video or telephone CBT on 01732 808626 or via email@example.com
Our CBT experts can provide professional guidance and support for the full range of anxiety conditions and depressive disorders. We know that the Coronovirus will be particularly challenging for people with a pre-existing anxiety condition or problem with depressed mood. Don’t suffer in silence.
We have made special provision for online Cognitive Behavioural Therapy and the research evidence shows that it can be as effective as face-to-face work. We don’t just use messenging or email contact like some other online services. Our online sessions are conducted via a video connection where the CBT materials and exercises are shared on-screen as we work with our clients. This is a fully interactive experience and we use exactly the same approaches that we use with our clients when working together in the same room.
Our online CBT page explains how the online CBT process works and provides access to free online psychological assessments. If you want to find out more about online Cognitive Behavioural Therapy, visit https://www.thinkcbt.com/online-cbt
Disclaimer: the information in this article reflects the opinions of Think CBT and does not represent the position of any other professional / membership body.