What has these ingredients: hibiscus fruit, safflower, red cabbage, black carrot, radish, lemon and blue-green algae?
“Only Smarties have the answer” is the answer. The ingredients are the natural colourings used to make Nestlé Smarties.
At the UK CBT Register, the therapists come in six different flavours, but you can’t tell this by looking at the register. Indeed, the BABCP does not even have this information in its database.
As an aside, the site’s tag line “The complete UK register of accredited BABCP CBT and AREBT therapists” is deliberately misleading. If you enter your post code and press the Search button, you do not get a complete listing of accredited therapists in your area.
You only get a listing of therapists who have paid an extra fee to the BABCP. Although the database does contain all accredited therapists, and you can find them if you already know their surnames, it does not show you them in the other search results.
The phrase “accredited BABCP CBT…therapists” is deliberately misleading too. There are perfectly good CBT therapists who are accredited by other organizations, and perfectly good CBT therapists who are not accredited by anyone.
So, while I support the CBT Register and recommend it, I remain dismayed that it deliberately sets out to mislead the public in these ways.
The hidden flavours of CBT are as follows:
- Guided self-help using general-purpose workbooks, teaching you techniques for forcing yourself to be happy and good, and putting the blame on you if the techniques don’t work.
- Old fashioned “first wave” behaviour therapy, aimed at suppressing your symptoms without examining why you have those symptoms.
- Conventional CBT, based on a collaborative formulation that explains the underlying causes of your symptoms, and a treatment plan (which very likely includes some behavioural work) to address those underlying causes (not just to address your symptoms directly).
- “Evidence-based” (“second wave”) treatment that treats your diagnosis, not you as a person, based on academic theories about the possible causes of your symptoms.
- Various modern “third wave” approaches aimed at providing distraction from your symptoms so that you become less aware of them, but not actually addressing your symptoms or their underlying causes — for example: DBT, mindfulness, acceptance and commitment therapy, and others.
- Rational-emotive behaviour therapy (REBT), a therapy closely related to CBT but which does not address underlying causes.
Unlike choosing a Smartie, when you can see the colours, you have to choose a therapist blind.
It’s not as bad as that, really. You can ask therapists some simple questions to establish what CBT flavour you are likely to get from them. Here are some suggested questions:
1. Is there a workbook for the course of treatment? If the answer is “Yes” then the treatment is probably guided self-help, not CBT.
2. Will the treatment address all my symptoms directly? If the answer is “Yes” then the treatment is probably behaviour therapy, not CBT.
3. Is all the treatment directly supported by scientific evidence? If the answer is “Yes” then the treatment is probably diagnosis-based, not CBT.
4. Is it important for me to learn new techniques to use on myself? If the answer is “Yes” then the treatment is probably distraction-based, not CBT.
5. Will I have a completely individual treatment plan for me personally? If the answer is “Yes” then the treatment might be REBT or CBT.
6. Will I be able to understand how I became ill in the first place? If the answer is “Yes” then the treatment is very likely CBT.
As an aside, it occurs to me when writing these questions that I have never been asked them, or anything like them, either by prospective patients looking for a therapist, or by other professionals intending to make a referral.
Question 3 is a trick question for therapists, unfortunately. Current BABCP rules require therapists to use only “evidence-based” approaches. Good CBT practice requires therapists to put the individual patient first, not some academic theory. This means that some genuine CBT therapists will feel obliged to lie. They’ll answer “Yes” to this question because they know it’s the politically correct answer. I don’t know how you get around that.
Why use the CBT Register?
If you think this gives a poor impression of the BABCP, it’s meant to. The BABCP is run by training organizations for the benefit of training organizations. It is not even run for the benefit of CBT therapists, and certainly not for the benefit of patients.
Even so, the BABCP’s CBT Register probably has the greatest concentration of competent CBT therapists. Therefore it’s probably the best place to start looking for a CBT therapist, just as long as you use appropriate caution and ask the right questions.
If you don’t ask the right questions, it’s like trying to pick your favourite colour of Smartie by choosing one blindfold.