View Full Version : Your experiences with Cognitive Behavioral Therapy


Nightwing
07-05-07, 11:50 AM
Hi, I just completed testing for AD/HD about a month ago. I just started what is supposed to be cognitive behavioral therapy at a university AD/HD center. I had my first session last week and have to say it's not what I expected at all. I'm pretty disappointed.

I've been reading everything I can get my hands on for the last 3 months, since I typed "procrastination, trouble getting started" into Google and turned up a bunch of sites on AD/HD in response. Books, articles, web sites. So when we finished the first session, and I realized he hadn't told me one thing I hadn't already read, I had to ask myself, what is it I'm paying $150 a session for here?

The therapist had suggested I bring some concrete examples of what I wanted to work on, so I wrote down a number of areas I'm having difficulty with: cleaning and keeping my apartment clean; paying bills on time; keeping track of my doctor bills, submitting the insurance forms for them; developing a budget and learning how to stick to it. In return, I got a bunch of generalities and, as I mentioned, none of them that I hadn't come across already, and come across in much greater, more organized detail.

I'd appreciate hearing from those of you who have used CBT. Can you tell me what your sessions were like? Was it helpful? What specifically made it helpful? If you ran into bumps with your therapist, were you able to get across what you were looking for?

Thanks.

Nightwing

amythyst
07-05-07, 12:20 PM
I personally haven't tried CBT so i can't answer that. If you browse the "Therapy & Counselling" section of the forum you may find some useful information there.
:)

mickn66
07-05-07, 08:03 PM
I've never had CBT - although I may start soon - but I do know something about it (my dad is a psychiatrist who definetely does CBT, or his own variation of it, as well as other therapies). First of all, I hope you weren't expecting too much for the first session! CBT may be fast compared to some other kinds of therapy, but it's not that fast! Anyway, my understanding is that the CBT therapist should be talking to you about what you are thinking - about your thought processes, things you say to yourself in your mind, the way you analyze things, etc. Well, you probably know this already due to the research you did. The only other thing I can add is I do think CBT tends to be fairly specific, focusing on specific things, not just generalities. But then again, it was just your first session. Actually I'd be very interested in knowing how it goes for you.

Michiko74
07-06-07, 05:44 AM
So when we finished the first session, and I realized he hadn't told me one thing I hadn't already read, I had to ask myself, what is it I'm paying $150 a session for here?
Because reading about a symptom is one thing, and being able to properly diagnose it is entirely another.

I am sorry that you were dissapointed, but consider yourself to be a very educated patient :) and that someone isn't providing treatment that you don't understand or agree with.

Nightwing
07-06-07, 11:03 AM
Thanks, everyone, for the responses. I see him again this afternoon, and after talking with my regular therapist (who is really great, but not an expert on AD/HD or CBT), I've decided to go into what I've read and learned already and let him know that a) I already had covered in my own reading what he went over last week and b) I want to work on two projects with him, where we discuss in detail what I need to do, step by step, **how to get myself started**, how to deal with roadblocks when I run into them, etc. I know I need VERY SPECIFIC

Nightwing
07-06-07, 11:04 AM
WHOOPS...hit a key and accidentally sent that. anyhow, I need very specific goals, with dates and times and next steps and all that stuff, and that's what I need his help in developing. I'll let you know how it goes.

bliss22
07-30-07, 03:28 PM
i'm interested in hearing how this goes, too....

i've heard that it's a good form of therapy, but you have to be patient. no one can fix everything overnight.
change is a process... especially if you're trying to uproot patterns of thinking and behavior that have been there for years.

the therapist is only there to guide you and open your eyes.

if you think you can do it without any guidance, then maybe you don't need to be paying someone $150 a session. :p



anyway, good luck :)

kikins
07-30-07, 05:14 PM
I have actually been part of CBT...I went in to deal with some anxiety issues at which time we discovered I had ADHD....SURPRISE lol...I have had great luck with it...mostly what I find is I have to think more and analize stuff...differently then the millions of thoughts racing through my head...more like "organized" and "logical" thinking. Basically I find most of this stuff...is trying to squash bad habits and forming new behaviors.

PeterMac
07-30-07, 05:32 PM
Cognitive behaviour therapy has always struck me as one of those buzz-phrases that people spout without knowing what it actually is, simply because they've heard other people mention it, and 'it' sounds advanced and mysterious, and thus must be good.

I tried it; the therapist was rather stumped when she found out that I didn't have self-destructive thoughts, that I didn't put myself down, didn't have suicidal urges, didn't feel the need to punish myself for my failures etc, and the whole thing turned into a farce with her suggesting that I should keep a diary, make lists etc; all things that I implimented long ago, and which while helpful, were hardly the solution to all my problems, and which definitely didn't require a visit to a professional (and I use that term loosely) to find out. Fortunately I got it for free, so the only thing wasted was my time.

The basic premise of cognitive behaviour therapy seems to be that people are full of self-loathing and fail because they believe they'll fail, and when someone comes along with a neurological rather than a psychological problem, it's completely unable to cope. To me, cognitive behaviour therapy is a form of magical thinking; it's the belief that our thoughts govern reality, that changing our thoughts will change reality, and foremost that if our reality sucks, then it's our thoughts that are to blame.

QueensU_girl
07-30-07, 07:32 PM
I think CBT has a value, but my problem with it is that it does not deal with emotional issues. It concerns the cognitive brain and behaviour. The emotional brain is ignored.

Issues like Procrastination, IMNSHO, are very emotionally-brain based.

CBT ignores things like 'bottom up hijacking' which can be quite crippling for people, and is not expressed verbally.

CBT is a verbally based behaviour therapy.

A lot of early life emotional 'blocks' are not able to be accessed verbally. Our brain doesn't store things that way.

We have performance problems (work; social; mood; in/actions) and cannot 'explain why', during talk therapy modes.

It keeps the person in a state of "intellectualization", which we know is a defence mechanism, and an "immature" one, at that.

I think it is better to try another modality or channel.

CBT has been studied to death in clinical trials.... and the efficacy is never that great.


I prefer solution-focused therapy approaches, too. They target people right when they are IN CRISIS. This creates more incentive for immediate and intentional changes.

e.g. Bill O'Hanlon's books

racg0627
08-07-07, 11:33 AM
I feel that CBT is good on some levels but as for going for adhd I don't feel that there is anything that can change the way we think but ourselves and repetitive continual doing what we know that we are suppose to be doing. I had my daughter in CBT it had a tendency to set her back instead of lift her up she came home doing worse instead of better. This was after 9 months of threapy.

dede4004
08-14-07, 04:45 PM
Hi again,
I agree with QueensU-girl. The solution-focused therapy seems to be an "overall" type of cognitive therapy. An "overall" therapy in cognitive behavior, including emotional and intellectual. I'm not an expert and don't claim to be, but here's my reason for thinking this......

My husband is getting behavioral therapy as well as medication, but his CB tends to be more "intellectual" based than any other. It does seem to keep him in one mode of thinking in which he has always felt the most comfortable.
(intellectualism) It's not requiring him to broaden his scope of thinking in any other direction except HIMSELF, which to me has been one of our greatest problems. He is totally SELF-FOCUSED.

I know he needs to learn about himself and the add/adhd, but he has YET to start learning ANYTHING about me or our marriage, or our relationship. His counselor hasn't brought up emotions except MY emotions. He's also taught my husband not to react to any negative emotions that I might have, and how to diffuse any emotional issues I might be having and needing to discuss with him.
This is good in one respect, but the need for positive emotional connection and response is not being discussed or "put into action" I will say. This is very distressing for me. I almost feel like the counselor is working against me, or helping my husband be more controlling, (devious) than actually helping him learn to be a better person/husband/father overall. (that sounds paranoid)
Something just doesn't seem right here. Do I sound crazy?
Dede

At Heart
08-26-07, 02:26 PM
Hi there Nightwing,

I wanted to say first off that I have never personally attended therapy sessions utilizing CBT techniques. I have however taught DBT to adolescents (more for use with BPD). I do have some familiarity with CBT, in that it takes time to work. How are you going about identifying stressful things? Do you keep a diary. For instance you say that you have a hard time getting started with daily tasks (bill paying, etc). Is this reflected in your diary?

I think that what CBT attempts to do, is to help you identify why you keep failing at motivating yourself to do these tasks. The procrastination started somewhere. I know that I am a great procrastinator, and that at work, I can force myself to use a to do list - but at home, am rarely successful in doing so. How did I allow myself to get this way? Do I truly not see that I would be happier if I could get things accomplished at home too? What thoughts are going through my head when I think "I should go pay that bill - yet instead wait until the last minute it is due - and end up paying fee's because people who procrastinate are punished...

It takes time to identify what is holding us back. Are you on medication for AD/HD?

I wish you luck with your CBT.

At Heart

Crackerjack
09-02-07, 10:57 AM
I don't think this can be considered CBT, but it's an interesting "trick" I learned to deal with my procrastination.

One day I was trying to file away a sheet of paper and couldn't do it. I kept putting it down and walking away, then I'd realize what happened, so I'd go back to file it away again...and end up walking away without putting it in the folder.

I realized anytime I'd want to do something, my train of thought ran along the lines of "I need to do this...nah, I'll do it later." It was incredibly subtle.

So my workaround this was to actively add the thought "I'll do it now." So my thoughts go "I'll do this now...nah, I'll do this later...actually, I'll do it now."

It's worked quite well, and while not a 100% fix, I'm certainly getting more done than before. :)

higgledy
09-09-07, 10:33 PM
it's the belief that our thoughts govern reality, that changing our thoughts will change reality, and foremost that if our reality sucks, then it's our thoughts that are to blame.CBT teaches a patient that by changing his perception about a situation will change how he feesl about that situation. For instance, lets say I failed a calculus test. On the way home from college I beat myself up inside to the point that when I arrive home I am nearly depressed. CBT teaches me to catch my faulty thinking and replace it with a realistic thought like "just because I failed a test does not mean I am a bad person without any redeeming qualities." With CBT I will change my thinking to "I failed this test because I did not study. Next test I know that I will need to buckle down."

CBT is excellent for treating depression, anxiety, and faulty thinking (perception) that many ADHD people exhibit.

Also, the time in CBT therapy to treat depression is much less than other modes of therapy.

I was in CBT therapy for less than 6 months. The time I spent in CBT was one of the most productive and rewarding periods of my life. I personally grew in leaps and bounds and I better understood every relationship in my life. It is tetious and you need to vigiliant to journal in a notebook or it will not help. CBT is not a cure-all, but it is excellent treatment for depression and anxiety. An excellent book on CBT is The New Mood Therapy by Dr. David Burms you can get it off Amazon for like $10.

higgledy
09-09-07, 10:47 PM
I think CBT has a value, but my problem with it is that it does not deal with emotional issues. It concerns the cognitive brain and behaviour. The emotional brain is ignored.

Issues like Procrastination, IMNSHO, are very emotionally-brain based.

CBT ignores things like 'bottom up hijacking' which can be quite crippling for people, and is not expressed verbally.

CBT is a verbally based behaviour therapy.

A lot of early life emotional 'blocks' are not able to be accessed verbally. Our brain doesn't store things that way.

We have performance problems (work; social; mood; in/actions) and cannot 'explain why', during talk therapy modes.

It keeps the person in a state of "intellectualization", which we know is a defence mechanism, and an "immature" one, at that.

I think it is better to try another modality or channel.

CBT has been studied to death in clinical trials.... and the efficacy is never that great.


I prefer solution-focused therapy approaches, too. They target people right when they are IN CRISIS. This creates more incentive for immediate and intentional changes.

e.g. Bill O'Hanlon's booksEither you had a bad CBT therapist or you are looking to CBT for something it cannot provide. CBT does set out to deal with emotional issues only the paitient's faulty thinking.

ReekahPoetique
09-14-07, 11:10 AM
CBT teaches a patient that by changing his perception about a situation will change how he feesl about that situation. For instance, lets say I failed a calculus test. On the way home from college I beat myself up inside to the point that when I arrive home I am nearly depressed. CBT teaches me to catch my faulty thinking and replace it with a realistic thought like "just because I failed a test does not mean I am a bad person without any redeeming qualities." With CBT I will change my thinking to "I failed this test because I did not study. Next test I know that I will need to buckle down."

CBT is excellent for treating depression, anxiety, and faulty thinking (perception) that many ADHD people exhibit.

Also, the time in CBT therapy to treat depression is much less than other modes of therapy.

I was in CBT therapy for less than 6 months. The time I spent in CBT was one of the most productive and rewarding periods of my life. I personally grew in leaps and bounds and I better understood every relationship in my life. It is tetious and you need to vigiliant to journal in a notebook or it will not help. CBT is not a cure-all, but it is excellent treatment for depression and anxiety.
Indeed. Although I've only been to a few sessions with my therapist, who is CBT-oriented, I've understood that CBT is all about changing that faulty thinking practice. I am the kind of person who beats herself up for minor blunders that can be logically explained. However, once I learned about ADD and its tendencies, I realized that there was a reason, a method to my madness, so to speak :@P

Just having information alone helps. Of course, there really are not any accurate tests that can be performed in order to determine how severe someone has ADD/ADHD, as most of you would already know. There are countless evaluations and IQ tests, but no blood work or ultrasound can show just how unfocused you are. So having information is a step. If you beat yourself up for minor blunders, CBT may help you to change that way of thinking for the better. That's just another step. Maybe you do require medicine. That's another step. There's no way of knowing how many steps it'll take before you can get to a point where you can live with yourself well.

It's easy to go to a therapist a couple of times or even a couple of months, go through CBT and not feel like you're getting anywhere. That's to be expected, especially since we're human and we're all one of a kind. I'd like to think that we're all....snowflakes ::hehe:: Because we're all different, one treatment may work for one person but do nothing for another person. And I'm sorry that CBT doesn't work for a lot of people.

I'm not a fan of medication, and I told my therapist repeatedly that I'd rather try to help myself to cope with ADD first and use medication as a last resolve. I don't know about anyone else but I just don't see the rewards for a treatment if there's not self-improvement. Yeah, medication can help - but for some, like me, medication is the "easy" way out. For others, it's the only way.

And that's absolutely fine. But not one treatment should take precedence over another. Besides, doctors have only come so far in the medical field and certainly don't have all the answers yet - and they probably never will. But that's just something you take with a grain of salt and do the best you can with whatever personality quirks you have.

Anyway, I didn't mean to write a novel here - I've already got a novel going elsewhere! I just wanted to put my two-cents in, especially since I've only just recently discovered that I have ADD tendencies and am trying to cope with it as best I can.

Take care all!

ursus
09-14-07, 03:03 PM
I've been through a fairly complete CBT program with a therapist who knows me (from a couple of years worth of previous appointments), is CBT trained, and knows at least something about ADD. The program was specifically to see what CBT had to offer in terms of coping with ADD issues that were not helped by my meds (Adderall).

(Background, I find that the Adderall helps tremendously with increasing my ability to focus on a task and stick with it ONCE I HAVE PICKED IT UP. A package of things remains which are not helped substantially by the meds. Those things are called "executive function" and include time sense, planning, task switching, etc.)

I was hoping that CBT would help me build behavioral bridges around the neurological issues. It helps some. I can see a task-switching (or some other) issue on the horizon and tell myself "here it comes again, you know you really CAN do it, you've done it successfully at least a few times". So that's an advantage. A hidden, unsuspected, advantage, was learning some about things like black-and-white thinking, self-downing, and other "cognitive distortions" which plague me.

To the extent that ADD is a brain biochem thing, though, CBT isn't really that helpful. Would you try and think your way around tourette's or dyslexia? To the extent that ADD is a mental thing (in my case, years of beating myself up for failure to complete various things) therapy in general, and CBT in particular, are appropriate and effective.

CBT is a very specific program. It takes time because there are specific steps that go in a specific order. To the extent that these are new patterns of thought it takes time to wrap your brain around them and let the patterns settle in. One or two sessions isn't going to get you anywhere, nor put you in a position to be able to judge the effectiveness. It's a program as opposed to a philosophy.

In my experience CBT is not a cureall, definitely not a replacement for meds, and has definite value in helping me with some of my issues. On a 1-10 scale for life-changing, diagnosis was a 10, meds an 8, CBT a 3 (but still not a zero).

-u
(p.s. there is a relatively new book out purporting to be a CBT program designed specifically for AD(H)D. Most of it is standard-issue CBT, the part that deals with ADD is VERY superficial. Save your money.)

CloudWalker
09-14-07, 08:25 PM
The most important thing to do from the perspective of the person seeking therapy is to make certain you are dealing with an individual that:

1. Has no preconceived notions in regards to diagnosis. Sometimes when a carpenter is holding a hammer in their hand all they can think about is a nail.

2. Is willing to hear you out, and patient enough to let your history shape and define itself over time.

Sometimes you will deal with a "sentence finisher" or a "paraphraser".
I know I have had a difficult time catching the moments when the finisher/paraphraser just flat out gets it wrong. Unfortunately, this person will literally put those misspoken words and ill-gotten thoughts into your mouth as they scribble away on their notepad or type on their keyboard.

The first time I notice this from now on I put an end to it. Personally, I don't want to deal with a "sentence finisher" or a "paraphraser" and more than I want to be treated by a "conclusion jumper".

Somewhere in your therapist/PHD,PsyD is a "question asker", a person that asks you to clarify anything they don't understand 100%. That person seems to work best for me not just in a treatment setting but in life.

Rather than hope to deal with this type of individual it may help to look for this in a therapist, and not settle for anything less than what you are 100% comfortable with.

Colorful
09-18-07, 08:08 AM
I think CBT has a value, but my problem with it is that it does not deal with emotional issues. It concerns the cognitive brain and behaviour. The emotional brain is ignored.


I've done cognitive therapy, and I don't think it ignores the emotional brain, as our emotions are generated by our thoughts. By changing or modifying your thoughts you will be able to change the emotions that bother you. The drawback is that it can be a lot of work...

The therapy has helped me clear a lot of clutter in my head. But it has been hard, too. My moods seem to change from very positive to very negative, and sometimes I wonder who I am and what I really want from life etc. Seeing things in a more realistic way is also painful. Taking the meds means that I have more energy to think things through, and unfortunately this applies to the negative ones too. I often think of stuff in the past and the moments when I have done something stupid like blurted out something at work that has nothing to do with work. And realizing that I'm a bit different from others isn't always that much fun either because I often feel left out. But then on the other hand, before the diagnosis I dealt with these things in a more positive way, so I guess I could try to do that again.

zmarie
01-03-08, 11:56 AM
CBT is the most well researched of all psychotherapies and it has very good results for a lot of things. I've been in a form of cognitive therapy called Schema therapy.
I take issue with CBT for two things - deep, chronic emotional problems, and neurological problems=ADD.

Some CBT practitioners really get out of hand with their belief that all - ALL - emotional problems stem from "cognitive mistakes" and we just need to question and correct them. It's such a ridiculous oversimplification.

Schema therapy deals with this - it's a form of CBT aimed at helping people actually talk about and resolve the past experiences that cemented our current thinking patterns, as part of learning to change them. I went to a schema therapist and it was definitely helpful - except, however, for my ADD issues. Hm. No. Only a psychiatrist diagnose and adderall has ever helped that. Everything else seems doomed to fail by definition.

I've read that behavioral therapies have proven helpful for ADHD - I just can't quite imagine it. Not for me. My problem seems to be my enormous resistance to doing what I'm told and adhering to any kind of schedule with boring tasks to complete for any length of time. And a lot of behavioral modification is just that...

And whenever my therapist would try this with me, sit and talk to me about all the mental blocks I put up for myself and all the beliefs I had about myself that kept me from cleaning up my room when I was desperate because of how dirty it was - I would sit in therapy and agree and say yes, I felt like I would do it when I got home. And I NEVER would - actually I tended to space out more than ever after those particular sessions. The reason for this, if there was one deeply buried somewhere, wasn't uncovered in therapy and we both got frustrated with each other.

My feeling about therapy now is that the practitioner is more important than theory - that is, if they at least have a proper education and so on - if you have someone who is too rigidly married to their theory they will keep applying it to what you do no matter what you tell them.
Also, I've become more realistic in what I expect from therapists. They're just humans, they have to work using some kind of model trying to untangle our messy brains, of course the model will occasionally fail them.

That said - I really don't see anything wrong in changing therapists from time to time.

Wired
01-18-08, 07:10 PM
I've been in CBT since the begining of college. So far so good. We work on self anaylsis, behaviours in the classroom, techniques I could utilize to expel my energy, correcting self-destructive behaviours etc. It's quite interesting and amusing sometimes, because occasionally my shrink and I will switch roles and I am amazed to see how I act sometimes and I am completely oblivious to it. Havn't gone in over a month though, being on Academic probation I better make an appointment.

Sandy4957
03-15-08, 10:51 PM
Nightwing,

You are in Philadelphia, PA. Hunt down Dr. Maryanne Delaney. I call her "The Shrink Who Saved My Life." I was a mess when I went to see her, oh, gee, 19 years ago now. She "fixed" me using, in part, CBT. I think that she may have been some sort of pioneer in it. Now, mind you, I wasn't diagnosed with ADD then (I had a lot of other mood-based issues) but she was awesome. I think that she's at Drexel.

Sandy

vetver
03-18-08, 12:55 AM
I am curious about CBT.
I did experiential ACoA (adult child of alcoholic) for years.. in this they got you to focus on your emotions to take you back to childhood events to realize what negative self-messages you are carrying.
but in the past few years, things have been triggering those same messages. I think I know pretty precisely what the thinking pattern is, but I am often too lazy or busy to do the actual work of sitting down and journaling and doing the self affirmation type things.
I have also been sober and in 12 step recovery for several years. A sober psychologist with 34 years really likes CBT.

It's amazing how deeply I can bury what I am using against myself... and something happens, and boom, I am right there beating myself up. As my ADD has gotten worse as life has gotten more demanding, I beat myself up a lot.
Lately I have reached a real point of crisis with it all... and I know what to do, but man... I sometimes just want to sit and do nothing.

Chrisles
03-22-08, 07:37 PM
CBT was not really ment for me. I don't have co-exisiting disorders with my ADHD so I'm not sure if that had anything to do with it. DBT on the other had was much with. Dialectival Behavioral Therapy made me focus on my low-esteem, assertiveness and interpersonal problem-solving. They also have stuff for stress and emtional regulation but that didn't help as much.

mctavish23
04-05-08, 05:01 PM
If you get the chance, please go to :

www.schwablearning.org

Look for : Dr. Russell Barkley : ADHD,Theory, Diagnosis and Treatment Summary
(June 17,2000)


It's 40 pages, however, it's still the best thing I've ever read ( for what that's worth).

On page 26 ( I think), he covers ADHD and the Point of Performance

That explains quite a bit on the Executive Functions and how those deficits are best treated.

He also mentions CBT earlier, however, I don't have the reference at home, so I don't know the page #.

Hope this helps.

tc
mctavish23
(Robert)

ADDAWAY
04-05-08, 05:22 PM
Thanks. Although I couldn't locate that publication (2000) on the website, I did see other pubs of his as well as his website.

mctavish23
04-05-08, 07:30 PM
If you go to schwablearning and type in ADHD Diagnosis in the middle bracket under Search Our Site, you'll get 13 responses.

The fourth one down, listed as 4/11/05, is actually the one I'm referring to.

Hope that helps.

tc
mctavish23
(Robert)

texasmissb
04-18-08, 05:26 PM
Thanks for posting about Dr. Barkley's therory. Here is the direct link and you are correct that the explanation about Executive Functions is on page 26.
http://www.schwablearning.org/pdfs/2200_7-barktran.pdf?date=4-12-05

I found this fascinating and as much as I hate to admit this, most of this seems true to my life ;). I am wondering about the 30% rule though, after what age does this not really matter? I agree based on personal experiance that my own maturity level was behind. He is also very cut and dry, no nonsense.

Muxu
04-18-08, 06:54 PM
i see these posts are really old, but I want to say that CBT for depresion and anxiety works very well... ad that now there is a new book CBT applied to ADHD in adults and it really is an amazing help Susan Young: ADHD in Adults. I don't know CBT therapist who do treat ADHD, but certaitly any CBT therapist can apply this book for ADHD. I read the book and its really really good, but I need a therapist to apply it :)
Muxu