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Cognitive Behavioural Therapy for Work

In recent years Cognitive Behavioural Therapy (CBT) has been increasingly used to treat conditions such as anxiety, depression and other mental health disorders. Its aim is to help people to deal with their problems more positively by examining their thoughts, attitudes and behaviours. Often it is offered as a talking therapy, but it can also be accessed via self-help books and exercises or online programs. Rather than delving into one’s past history it has a more here and now focus, and a more practical emphasis than some other talking therapies. According to research a significant number of people have benefited from the approach.

The CBT approach can be helpful when applied to workplace issues, particularly because of its practical, here and now focus. Most of us experience stress at work at times and, whilst a certain degree of stress can be motivating, too much can lead to anxiety, irritability, poor concentration, sleep difficulties and physical health issues. CBT may not take the problem away but it can help us to understand how our personal beliefs and expectations can increase the pressure and encourage us to challenge those beliefs and related behaviours. This guide is not intended as a substitute for seeing a qualified CBT practitioner but it will provide a basic introduction to the approach and explores some ideas that you can apply to your own work life.

What is CBT?

CBT is a method that examines the connection between our thinking and behaviour as a way of bringing about positive change. The way that we think about a given situation influences the way in which we respond. Frequently our thoughts are triggered automatically and are out of our awareness so as a consequence we are not fully in control of them. Because of this limited control we can behave and respond in ways that are ultimately unhelpful.

CBT aims to bring these automatic thoughts into awareness so that we can make better behavioural choices. Here is an example using a simple ABC model.

A.The situation: Let’s imagine that Sam is walking down the street and sees a colleague from work on the other side of the road. Sam smiles at them but they do not smile back, they lower their head and walk quickly down the road.

B. The thoughts: Sam thinks their colleague must be ignoring them and angry with them for not doing a good enough job on a recent joint project. Sam concludes that their colleague no longer respects them and fears that they will tell others how bad they are.

C. The behaviour: Back at work Sam avoids communication and eye contact with the colleague and tries to ensure they do not work together again. Sam looks for further evidence that the colleague has talked to others about their work by watching others and listening out for possible criticisms.

The only part of the ABC model that is reliable is A – the situation. B and C are responses to the situation based on personal thoughts and beliefs. There are many different ways to interpret what happened, and it is entirely plausible that the work colleague may have been late for an appointment, distracted, or in a hurry and did not see Sam. The fact is that Sam did not know why their colleague did not smile back and instead made assumptions that further damaged their working relationship and led to unease and mistrust
with other colleagues.

Negative Automatic Thoughts (NAT’s)

Automatic thoughts are like short cuts that enable us to make quick decisions and inform our actions. It is necessary to have these thinking short cuts because if we dwelt on every decision we made life would become overwhelming and little would get done. They reflect our values, our internal rules about how we perceive the world and how we would like things to be done. Some rules and values are learned from our early carers and authority figures while others are based on our life experiences and more mature beliefs.

We all have individual biases. As the previous ABC example shows when these personal biases are negative they can cause us problems. These are also known as Negative Automatic Thoughts or NAT’s and by their very nature they are self-sabotaging. An automatic thought is not necessarily negative, but most of us have
some negative beliefs that impede our progress and wellbeing.

A helpful way to explore some of your own beliefs and NAT’s is to come up with sentences beginning with ‘I must’, ‘I should’ or ‘I ought to’ that describe your attitudes. For instance ‘I must not show weakness’, ‘I should always be helpful to my colleagues’ or ‘I ought to be able to deliver a perfect report’. You can think of these in relation to different areas of your work such as your career aims, your work ethic, and also what you expect from other team members e.g. ‘colleagues should always begin meetings on time’.

Thinking styles

Many of our NAT’s correlate with patterns of unhelpful thinking styles. Below are some examples that you may recognise:

Catastrophising – anticipating worst possible outcomes and disaster if something minor goes wrong e.g. ‘If my presentation is not perfect I will lose my job and then I won’t be able to pay my mortgage and I’ll lose my house’

Exaggerating – magnifying weaknesses rather than recognising positive aspects or strengths e.g. ruminating over one careless thing you said in a meeting rather than remembering the other good points you made and overall successful outcome

Black and white thinking – taking an ‘all or nothing’ view rather than seeing other possibilities e.g. ‘If I don’t do this perfectly I am rubbish’

Overgeneralising – concluding that everything is awful because of one bad experience e.g. ‘Bad things always happen to me’

Ignoring the positive – overlooking positive aspects of life and personal strengths and dwelling on negative aspects e.g. paying attention to criticisms and overlooking praise and achievements

Scanning – searching for things you fear e.g. never taking risks or challenges as you fear what might go wrong

Over control and perfectionism – never content with anything that is less than perfect, having to be in control all of the time

Dealing with NAT’s

When you have acted on your NAT’s you may notice that you are left with confused or mixed emotions. Pay attention to what you are feeling, whether you are sad, angry or anxious and ask yourself what you were thinking at the time. If an event occurred that distressed you ask yourself what you told yourself about that
situation and what it meant to you. Use the ABC model and break things down so you can identify your thoughts and actions in relation to the situation. Write down your thoughts so that you can begin to understand them better.

In CBT you can change things by either changing your thoughts or your behaviour. You can decide what you feel is the best option.

Reality Checking

Once you know what the thoughts are you can judge whether they are helpful or not and whether they are based in reality. Look for evidence both for and against your thinking. Consider whether you were affected by unhelpful thinking styles. In the earlier example if Sam had evaluated the situation more robustly they may have remembered that their colleague had been friendly earlier that day, and that others had shown appreciation for their work on various occasions. Think about how you might have changed your beliefs
in order to reduce anxiety in that situation.

Change behaviour

Once you are aware of the situation and your corresponding thoughts you can choose to behave differently. Often a change in behaviour can interrupt our habitual ways of responding. Using the example of Sam, they could have chosen to ask for some feedback about their work. This way they could get a more realistic picture of how well they were doing and whether there were any areas where they could improve. This feedback could have taken away their automatic assumption that their work had been poor. When you are stuck in a situation think about what you would automatically do, and then think about what alternatives there are.

Further Support and Reading

British Association for Behavioural & Cognitive Psychotherapies (BABCP) www.babcp.com
Practical CBT guide and self help resources: www.getselfhelp.co.uk
CBT for Work: A Practical Guide by Gill Garratt

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