Cognitive Therapy in London

Help with depression, stress, anxiety, worry, indecision and low self-esteem  through CBT (Cognitive Behaviour Therapy)      

 CBT from Wise Therapy author Tim LeBon is available now in  Central London (Fleet Street/Chancery Lane)

Cognitive Behavioural Therapy is particularly suited  if you are suffering from stress, depression, anxiety or low self-esteem. CBT  is an evidence-based approach that can also help with panic attacks, feeling worried, decision-paralysis and low self-confidence.  If you have been diagnosed with OCD (obsessive compulsive disorder),  social anxiety (or social phobia) or GAD (generalised anxiety disorder) then  CBT is also the NICE recommended treatment.

Find out about how to get  a consultation today.

I offer an affordable, timely  service with the extra benefit of the possible Skype and e-mail sessions and a Central London location

(Fleet Street/Chancery Lane ). 

      What is CBT?
     How can CBT help me?   
     What  happens in  a typical session of cognitive therapy?  
      What further reading do you recommend on CBT?
      What else can I read on the web about CBT?
      Where can I find a good cognitive therapist in the UK?


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What is CBT (Cognitive Behaviour Therapy)?


CBT  (Cognitive Behavioural Therapy) is one of the most popular and respected forms of therapy practised in the UK, probably because it is evidence-based and can produce results  relatively quickly.  The central idea of  CBT is that our emotions are connected to our thoughts. By becoming aware of your thoughts, and substituting realistic thoughts for unrealistic ones, you can overcome emotional difficulties such as depression, anxiety as well as low self-esteem and relationship issues.


Although coming to prominence in the 1960s through Albert Ellis’s REBT and in the 1970s through Aaron Beck’s Cognitive model its roots lie in the ancient philosophy of the Stoics. Epictetus’s “ People are disturbed not by things but by the views which they take of them” is not so very different from David Burns’s: “By learning to change your thoughts, you can change the way you feel”

How can CBT help me?


If you have any emotional difficulty, CBT provides a structured approach to help. CBT is particularly suited to deal with depression, anxiety, anger-management, low self-esteem, relationship issues and stress management.  It aims not only to relieve symptoms, but also to help you acquire longer-term coping strategies and modify underlying beliefs and patterns of behaviour.

David Burns, a leading cognitive therapist says there are three steps to CBT:-


1) Understanding your moods: distorted thoughts cause negative feelings

2) Changing the way that you feel: Spotting distortions and answering back to them

3) Developing a Healthy Value System: digging deeper to rules for living and the bottom line


Understanding your moods: distorted thoughts cause negative feelings


The Cognitive theory of the emotions – the ABC model


The cognitive theory of the emotions posits that thoughts (including beliefs, inferences and evaluations) play a major part in determining our emotions and moods.


A =Activating Event

Kate does not say hello to Oliver as she passes him in the corridor


B – Belief

-          inferences  Oliver infers that Kate doesn’t like him

-          evaluation  Oliver fancies Kate so thinks this is terrible


C – Consequences

-          emotional consequences  Oliver is upset for the rest of the day

-          behavioural consequences Oliver does not ask Kate out as he planned to.


2) Changing the way that you feel: Spotting distortions and answering back to them

"Cognitive Distortions":       The 10 Types of Twisted Thinking (adapted from David Burns,The Feeling Good Handbook)





1. Jumping to conclusions

Drawing a conclusion in the absence of sufficient evidence

Mind-reading "He thinks I'm stupid"

Fortune-telling "They are going to turn me down"

2. Overgeneralisation

Drawing a general rule or conclusion from isolated instances

"No-one appreciates me”

3. Mental filter

Not noticing positive things

“Its been  a lousy day” (when you had a very nice morning)

4. Discounting the positive

Noticing positive things but saying they are unimportant

“You are just saying that to make me feel better”

5. All-or-nothing thinking

Placing experiences in one of two extreme opposite categories

"I've blown my diet completely"

6. Magnification

Catastrophising about bad things

“It’s a disaster”

7. Emotional Reasoning

Assuming that your emotions are always a good guide

“I won’t go to the gym until I feel like it.”

“I feel like I’ve no future, so there must be no future”

8. Shoulds and musts

Unrealistic personal  rules

“I should feel OK all the time"

“ People must always treat me with respect.”

9. Labelling

Unfairly using pejorative and emotive and negative terms to describe oneself and others

"I'm a failure"

“He’s a plonker.”

10. a) Personalisation

      b) Blame

Relating external events to oneself or others when there is no basis for this

"It's all my fault"

"It's all their fault"


Ways to Untwist thinking (adapted from Burns, The Feeling Good Handbook)


Way to untwist


1. Identify the Distortion

Which one of distortions 1-10 applies?

2. Examine the evidence

Look at actual evidence for and against belief

3. The Double-standard method

Talk to yourself as you would to a sympathetic friend

4. Experimental Technique

Experiment to see if belief is correct

5. Think in Shades of Grey

Rate from 0-100; look for learning points

6. The Survey Method

Ask friends if they agree with your belief

7. Define Terms

e.g. Ask yourself what a real "failure" is or even if anyone really is a complete "failure"

8. The Semantic Method

Use less emotionally loaded language about yourself

9. Re-attribution

Think of many factors that could have contributed to problem

10. Cost-benefit analysis

What are the pros and cons for having this feeling, belief or behaviour ?


Developing a Healthy Value System: Digging Deeper to The Bottom Line and Rules for Living

Automatic thoughts can be compared to the top of the weeds spoiling our garden; rules for living and bottom line are the roots.(these are sometimes called silent assumptions and core beliefs respectively)


A) The Bottom Line (Core beliefs)

Your own assessment of yourself, or the world, or other people (in general)


Examples: “I am not good enough”, “The world is dangerous”, “People are hostile”.


Having  negative bottom lines can have a major negative effect on your life. It can lead to you having unhelpful rules for living, automatic thoughts and psychological problems.


B) Rules for Living

Guidelines, policies and strategies for getting by, given the truth of the bottom line.  Situational (as opposed to the bottom line which is global). Often  “if … then .. statements   or “musts”.


 Examples:     “Unless I do something perfectly, it will be viewed as useless”.

“If I let people see the real me, they will reject me”


In the short-run,  rules for living often have a pay-off – e.g. avoiding discomfort, especially caused by situations where the bottom line is shown to be true. In the long-run though some rules for living can maintain harmful patterns of behaviour.




Sometimes your bottom lines and rules for living are obvious, sometimes they become clearer in therapy. One technique specifically designed to identify them is Burns’s ‘Vertical Arrow Technique’ .


1)       Instead of challenging a negative thought, buy into it

2)      Write down the thought, and underneath it a vertical arrow.

3)      Now ask ‘If this is true, why does this matter, what would it mean to me?’

4)      Repeat steps 2 and 3 until you have got to what you think are really basic, silent assumptions or ‘core beliefs’ e.g. (from Burns, p. 124)

a) If I don’t study harder,  I may blow my exam

                                                â (why does this matter?)

b) If I blow my exam, I may fail the course

                                                â (what would this mean to me?)

c) That would mean that I was a failure and people would think less of me?

                                                â (why does this matter>)

d) Then I’d feel terrible, because I need people’s approval to feel happy and to be worthwhile




This can be a much longer process than just dealing with automatic thoughts.  There are two basic ideas – one to challenge the old rules/beliefs (as in challenging automatic thoughts) – the other to construct new, more helpful rules and beliefs.


To construct a more realistic rule for living,  the following  questions (from Fennell)

  1. Where did the rules come from?
  2. In what ways is the rule unreasonable?
  3. What are the payoffs of obeying the rule?
  4. What alternative rule would be more realistic and helpful?
  5. What do you need to do to ‘test-drive’ your new rule and put it into practice on a daily basis?


The new bottom line may well be the opposite of the old bottom line,  and may well be less all-or-nothing than the old one.




Behavioural Experiments are a key way of breaking unhelpful rules for living.

Experiments designed to gather evidence for and against either new or old predictions, thoughts , rules & bottom lines.  When designing experiments, you should write down

- what you are testing

- how much you believe it now

- what you will do, where and when

- what problems are likely and how to deal with them

After the experiment

- the outcome – what happened, what you  observed, what you have learnt

- what next

Melanie Fennell's Overcoming Low self-esteem is highly recommended on experiments


What  happens in  a typical session of cognitive therapy?

CBT  is a collaborative process between therapist and patient that ultimately teaches patients how to identify and manage their negative thoughts.  

A session may typically begin with client and therapist deciding on an agenda for today’s work. This is important as it gives you the chance to decide on what the session will cover, and to prioritise agenda items. The agenda will often start with a review of the week and any ‘homework’ set from last week. The main part of the session may focus on a particular incident that occurred in the week, with a view to increasing your awareness and ways of dealing with such issues in future. For example, if  are anxious about a job interview, then the therapy may look at the thoughts leading to your anxiety as well as how these relate to underlying beliefs about yourself and the world and more – and less – helpful behaviour patterns. The session will often end with a summary and an agreement on homework tasks for the next week.

Sometimes ‘bibliotherapy’ is used – the homework may be to read a chapter of a book, for example.
Cognitive therapy alos uses socratic questioning and guided discovery, which is a very 'client-centred' way of helping the client discover their own answers.

Socratic Questioning and Guided Discovery

CBT’s collaborative and educational nature makes Socratic Questioning (sometimes called Socratic Dialogue or Guided Discovery) a key technique. Socratic Questioning aims to use a process of careful questioning in order for the client to reach their own conclusions.  It is used:

 (i) clarify or define problems;

(ii) assist in the identification of thoughts, pictorial images or assumptions;

(iii) examine the meanings of events for the client, and

(iv) assess the consequences of specific thoughts and behaviours.


 Example of  a depressed man staying in bed all day

Therapist (Beck): What is the probability that you will go back to bed when you leave the office?

Patient: About 100 per cent.

Therapist: Why are you going back to bed?

Patient: Because I want to.

Therapist: What is the reason you want to?

Patient: Because I’ll feel better.

Therapist: For how long?

Patient: A few minutes.

Therapist: And what will happen after that?

Patient: I suppose I’ll feel worse again.

Therapist: How do you know?

Patient: Because this happens every time.

Therapist: Are you sure of that?...Have there been any times when lying in bed made you feel better for a period of time?

Patient: I don’t think so.

Therapist: Have you found that not giving in to the urge to return to bed has helped you at all?

Patient: I guess when I get active, I feel better.

Therapist: Now to return to your wish to go to bed. What are the reasons for going to bed?

Patient: So I’ll feel better.

Therapist: What other reasons do you have for going to bed?

Patient: Well, I know theoretically that I will feel worse later.

Therapist: So, are there any reasons for not going to bed and doing something constructive?

Patients: I know that when I get involved in things I feel better.

Therapist: Why is that?

Patient: Because it takes my mind off how bad I feel and I am able to concentrate on other things.

Recommended Reading

For the general public and therapists 

Burns, D The Feeling Good Handbook (Plume) [particularly recommended]
Butler, G. and Hope, T. Manage your Mind
Fennell, M Overcoming Low self-esteem (Robinson)
Burns, D Feeling Good: The New Mood Therapy (William Morrow)
Greenberger ,D and Padesky, C Mind Over Mood
Young, J.E., & Klosko, J,S. Reinventing Your Life (Plume)
Williams,M.  Teasdale,J,  Segal, Z & Kabat-Zinn, J. The Mindful Way through Depression
Wilson, R & Branch, R        CBT for Dummies
The “Overcoming ….” series published by Robinson is highly recommended


For Therapists

Westbrook An introduction to CBT [particularly recommended]
Beck, J Cognitive Therapy: Basics and Beyond
Dryden, W (ed) Brief REBT (Wiley)
Wells, A Cognitive Therapy of Anxiety Disorders: A Practical Guide
Sage, N et al. CBT for Chronic Illness and Palliative Care: A Workbook and Toolkit
Segal, Z  et al. Mindfulness-based Cognitive Therapy for Depression: A New Approach to Preventing Relapse
Young, J.E. Schema Therapy
LeBon, T Wise Therapy (Sage)
Hawton, J,  Salkovskis, P, Kirk, J & Clark, D CBT for psychiatric problems (OUP)
Beck, Rush, Shaw & Emery The Cognitive Theory of Depression
Padesky, C & Greenberger ,D  Clinician’s Guide to Mind Over Mood


Training Institutes

I run short courses at the the City Lit, London and also privately - contact me for details
Highly recommended for longer training is the Oxford Cognitive Therapy Centre (OCTC)     
Once a year specials - see for Christine Padesky’s courses (some in the UK)


What else can I read on the web about CBT?


Here is a selection of useful links on CBT.                         British Association for Behavioural and Cognitive Psychotherapies                                     Free on-line CBT self-help CBT    Fact sheet from Royal College of Psychiatrists Good links to resources           Wayne Frogget’s intro to REBT                                             Aaron T. Beck's organisation's site                                                            Albert Ellis Institutre                                              David Burns’s site                                        Centre for Stress Management              Articles for therapists interested in CBT


How can I find a local therapist who can help me by using CBT in Central London?

I offer private CBT which can help you if you are suffering from a number of problems including stress, panic attacks, worry,  depression, self-esteem related problems and problems relating to indecision.

The therapy will normally be for up to 12 individual weekly sessions. The fee is  £60-£80 (depending on what you can afford) per 50 minute session.

Enquire now to book your session or find out more details..

Keywords: CBT, Cognitive Behavioural Therapy, Cognitive Therapy, Psychotherapy, London, Central London, London City, London Fleet Street, 

Chancery Lane, counselling, therapy, depression, anxiety, stress, low self-esteem, CBT London Therapy, CBT London

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