The origins of Cognitive Behavioural Therapy (CBT) can be traced back to the first century (Ad.) where it was observed that people are disturbed not so much by events as by the views which they take of them. The implications of this observation are first that situations, like objects in the visual world, are better viewed from some angles than from others, and secondly that people have a degree of choice in the point of view they adopt. Further, the cognitive theory of emotional disorders postulates reciprocal interactions between the cognitive and other systems, as per the simple cognitive behavioural model displayed below.

http://www.ptsdforum.org/images/cbtmodel.gif
CBT uses the emphasis upon breaking out of negative chains via the cognitive and behavioural ports of entry. It is also acceptable to break negative chains through the physiological port (exercising) or the emotional port (playing your favourite music). Whilst CBT concentrates on the two primary ports of entry into your mind, the other two are also used in conjunction often with smaller applications to improve functional areas, for example, use of the physiological port with exercise to help break the chain of depression.

Looking now at the more refined model used by most therapist when using CBT to treat PTSD patients, the below image depicts the comprehensive cognitive contextual model of human behaviour to locate the refined cognitive behaviour in a biological interpersonal milieu, and as detailed further on, outlining the processes you will often endure during detailed CBT therapy with a counsellor / therapist.

http://www.ptsdforum.org/images/cbtmodela.gif
Suitability for CBT

Because you think your ready for change, this does not necessarily reflect if your total surroundings are not ready for the therapy, as the therapy itself requires a great deal of time and effort outside of counselling, to practice new skills and techniques required for change. If a woman for example was living within a women's refuge, then this would not make the idealistic environment for the practice of the new learning theories and techniques to successfully allow improvement within the sufferer.

CBT Structured Counselling

During CBT it is proposed that you will move between the four stages of change, which are:

1. pre-contemplative
2. contemplative
3. action
4. relapse

These stages will occur and be structured for personal change within the general outline of CBT sessions, which are:

Session 1: Elicit the account of trauma. Rational discussion for targeting the account of the trauma, avoidance and alienation and involvement of significant other. Assigned homework.

Session 2: Review account of trauma, avoidance and alienation. Elaboration of worst moments, identification of saboteurs ie. drinking, drugs, pain, literacy and remedial strategies. Tackling anger. Rationale for tackling co-morbid disorders.

Session 3: Review account of trauma, alienation, avoidance and anger. Engaging with traumatic material and feared situations without being overwhelmed. Review remedial strategies. Re-authoring the account of the trauma and its effects, cognitive restructuring ie. yes... but... (DeCatastrophising).

Session 4: Review homework set, living in the land of approach and immobilising saboteurs. Managing shifts in mood and pain.

Session 5: Stocktaking, review of MOOD records. Introduction to faulty information processes. Weaning off safety behaviours. Connecting and communicating with others.

Session 6 - 7: Stepping around prejudice against self. Reassessment and review of thought records, Mood management and assigned tasks.

Session 8 - 11: Cover any outstanding issues. Distillation of personal protocol to be used in the event of relapse.

Session 12: One month follow-up, review of skills, fine tuning and formal reassessment.

The above is a synopsis only containing the basic outline of what CBT therapy contains. Within each session is then further refined, more specific and detailed information pertinent to each individual, trauma and case.

Realistic Timeline for CBT and Healing

CBT has a realistic expectation for a minimum timeline of 1 - 12 months, as outlined below. This outline can, and most likely will change to suit each individual’s specific needs. For example, if a sufferer has relationship breakdowns during therapy, a death in the family, struggles to achieve set tasks, has severe anger problems, or fails to push themselves beyond comfortable. These general life and impact of trauma aspects will certainly play a significant role within the healing process, thus the time of the healing process.

• 1 - 3 months in CBT sessions
• 3 - 6 months in follow-up, retraining and reassessment sessions
• 6 - 12 months recovery to refine skills and learning techniques

By no means after CBT will you be cured, however; what you should have is a fairly stable and balanced focus on life, your relationship, control of your symptoms, and be capable to certainly do more as you once used too, without the symptom outbreaks. Some may be capable of working, some may only be capable of volunteer work, and some may not be capable of working again. Each person varies vastly to their specific trauma and how they have taken it within them.