CBT for Anxiety and Depression
What is CBT?
Cognitive Behavioural Therapy (CBT) is a structured, evidence-based therapy that focuses on the links between thoughts, emotions, physical sensations, and behaviour.
Difficulties such as anxiety and depression are often maintained by patterns that develop over time, such as avoidance, safety behaviours, rumination, self-criticism, or attempts to control uncomfortable feelings. While these strategies may bring short-term relief, they often end up keeping anxiety or low mood going in the longer term.
CBT aims to help make sense of these patterns and gently change them, so that difficult thoughts and feelings have less influence over your day-to-day life. In my work, I aim to bring calm, collaboration, and structure to sessions. We work at a pace that feels challenging but manageable, paying attention to what feels useful and what feels too much.
Alongside CBT, I may integrate approaches from ACT, DBT, or Compassion-Focused Therapy where this supports your goals — for example, building emotional tolerance, increasing flexibility, or developing a kinder relationship with yourself.
Who can CBT help?
CBT can be helpful for a range of difficulties. You don't need a diagnosis to seek support as throughout the initial consultation, assessment and first treatment sessions we can work together to understand what feels most important for you. Below is a summary of the most common difficulties people find CBT helpful for.
Generalised anxiety and panic attacks
If you feel anxious or worried most of the time, often about many different things to the point that it's hard to switch off.
Or if you experience sudden waves of intense fear with intense physical sensations, such as racing heart, breathlessness, dizziness, and a feeling of losing control or dying.
Social anxiety and specific phobias
If you feel very anxious in social situations, often worrying about being judged or doing something embarrassing despite wanting to connect with others.
Or if you experience strong fears around certain objects or situations (such as flying, driving, animals, blood) triggering avoidance and significant impact on your day-to-day.
Obsessive Compulsive Disorder (OCD)
If you have unwanted, intrusive thoughts that cause anxiety and lead you to feeling driven to repeat certain behaviours or mental acts to feel safer. For example, you may worry about contamination, things needing to feel "just right", or having repeated, unwanted disturbing thoughts, often leading to behaviours and rituals to cancel out the thoughts and anxiety.
Post-Traumatic Stress Disorder (PTSD)
If you feel on edge or distressed after a traumatic experience, and find it difficult to stay present. Memories, flashbacks, nightmares, and strong reactions can make it difficult to perform day-to-day tasks and engage in activities you once enjoyed. When faced with reminders, you might experience a sense that certain people, places or situations as threatening.
Depression and low mood
If you have been feeling persistently low, hopeless, numb, losing interest or pleasure in activities that once used to energise you. Difficulties with motivation and self-criticism can also be very common, making work, socialising and engaging in chores or hobbies really difficult. As time goes on, you may notice your self-esteem lowering, feeling not good enough even though others do not see it that way.
Body image concerns
If you have been experiencing intense distress about aspects of your body or facial appearance. Oftentimes you may feel like these aspects that bother you are not noticeable to others, but you find the thoughts hard to stop.
Sometimes distress about appearance can lead to the urge to pick at skin, bite nails or pull out hair which creates relief in the moment, but is followed by regret long-term.
Why CBT?
CBT is recommended by the National Institute for Health and Care Excellence (NICE) as a first-line treatment for many anxiety disorders and depression, and is widely used within the NHS. A large body of research supports its effectiveness in helping people reduce symptoms, regain confidence, and move towards the life they want to live.
While CBT provides a clear structure, it is not about “thinking positively” or ignoring difficult experiences. Instead, it focuses on understanding what keeps problems going and finding more helpful, sustainable ways of responding.
How CBT works
1
Initial therapy sessions involve:
Building a shared understanding of how your difficulties developed and what is maintaining them now
Mapping out patterns in a simple, visual way, which then guides our work (similar to a roadmap
Monitoring thoughts, behaviours and emotions and making changes that can support with alleviating symptoms sooner
Sessions are active and practical, with time to reflect, ask questions, and adapt the work so it feels relevant and manageable.
2
As sessions progress, depending on your goals this may involve:
Identifying and responding differently to unhelpful thought patterns
Gradually reducing avoidance and safety behaviours
Learning to tolerate uncertainty or strong emotions
Developing compassion towards yourself rather than self-criticism
Practising new skills during sessions and between them
3
Final therapy sessions involve:
Reviewing progress and learning across sessions
Creating a plan to build on the progress made in therapy
Developing a clearer understanding of relapses and how to manage them
Addressing any fears or questions about long-term progress maintenance and next steps
Additional considerations
Structure and length of therapy
The length of CBT varies depending on the nature of the difficulty and your goals. Many people attend weekly sessions for a time-limited period, though this is something we would decide together and review as therapy progresses.
A note on inclusivity and safety
I work in a way that aims to be respectful, inclusive, and emotionally safe, and I keep my practice informed by ongoing research and developments in the field. Therapy is shaped collaboratively, recognising that no two people’s experiences are the same.
If you're struggling right now or feel unsafe with your thoughts, please reach out for immediate help. Below is a link with services that can help.
Please note that I am unable to provide crisis or emergency support. If you need emergency or crisis intervention, contact NHS 111 or go to your nearest A&E.
