Is CBT “cold”?

Is CBT “cold”?

This week I have been reflecting on my feelings about Cognitive Behavioural Therapy.

CBT was devised to treat depression, and is now used for a variety of conditions, including anxiety, OCD, and PTSD. Even grief counselling, although the evidence for its effectiveness here is still small.

It’s no secret that psychologists tend to rely mostly on CBT, whereas counsellors and psychotherapists are rooted in a more person-centred style of psychotherapy.

But does that matter, since many clients don’t know the difference between cognitive behaviour therapists, psychodynamic psychotherapists, narrative therapy etc - they just want help with their problems?

It matters if the client doesn’t like the treatment. I’ve had numerous conversations with clients, friends and acquaintances who have experienced CBT and told me they felt the approach was ‘cold’, ‘overly scientific’ and ‘unengaging’.

Although my practice is grounded in what is generally thought to be the ‘warmer’ approach of person-centred therapy - with elements of narrative therapy, gestalt and existential therapy added as needed – I do often use CBT.

It’s often the best approach for treatment, and since I’m deeply committed to the idea of deploying whichever type of therapy will be most effective for my client, if I feel that CBT is the best option then I will use it.

(And many clients do appreciate the rational and scientific elements of CBT. After all, for many, science was their favourite subject at school).

But when I use CBT, I’m always very careful to take the time to build a strong rapport with a client and truly get to know them first. Then I hope the treatment does not come across as ‘cold’ and ‘overly scientific’, as it anecdotally did to so many of my acquaintances.