Cognitive behaviour therapy Incorporating therapy into general practice

Background Cognitive behaviour therapy is a talking therapy that looks at the connections between our emotions, thoughts and behaviours within the context of specific circumstances and symptoms. Objective This article describes cognitive behaviour therapy, its evidence base and applications. Pathways for further training for general practitioners in cognitive behaviour therapy are described. Discussion Cognitive behaviour therapy is an effective treatment for mild to moderate depression, generalised anxiety disorder, panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, and childhood depressive and anxiety disorders. At its simplest, it can take the form of an exercise prescription, teaching relaxation techniques, assistance with sleep hygiene, scheduling pleasurable activities and guiding the patient through thought identification and challenge. With some basic training in the area, GPs are well placed to provide basic cognitive behaviour therapy treatments, particularly to patients at the mild end of the spectrum of mental health disease, as they already know their patients well and have a therapeutic alliance with them. In some cases, this may be all that is needed; however, patients who have more complicated issues or more severe symptoms may require specialist psychiatrist or psychologist referral.