Cognitive behavioural therapy (CBT) in Greenwich

What is CBT?

Cognitive behavioural therapy, or CBT, is a structured talking therapy that looks at the links between thoughts, feelings, physical sensations and behaviour, and helps you change patterns that keep a problem going.

Rather than spending long periods examining your childhood or the distant past, CBT starts with what is happening now: the situations that trigger difficult feelings, the thoughts that run through your mind in those moments, and the things you do (or avoid doing) as a result. A CBT psychologist works with you to map out this cycle, then helps you test new ways of responding to it.

Sessions tend to be collaborative rather than one-directional. You and your psychologist agree what to focus on, review progress from one week to the next, and build a shared understanding, known as a formulation, of why a problem has developed and what is keeping it going. Between sessions, you might keep a simple thought record, try a behavioural experiment, or practise a skill such as slowing down breathing or gradually facing a situation you have been avoiding.

When it helps

CBT has one of the largest evidence bases of any talking therapy, which is why it tends to be offered as a first option for a wide range of common difficulties. People come to CBT for generalised anxiety, social anxiety, panic attacks, health anxiety, obsessive compulsive disorder, low mood and depression, and for stress and burnout that has built up over months rather than weeks. It is also used to work on sleep difficulties, low self-esteem and unhelpful patterns of worry or rumination.

CBT tends to suit people who want a practical, hands-on approach and who are prepared to try things out between sessions rather than only talking within the room. It is not the right fit for everyone or every difficulty, and a psychologist will discuss with you whether it, or a different approach, makes more sense for what you are dealing with.

What to expect

A course of CBT usually opens with an assessment, where your psychologist asks about your current difficulties, your history and what you would like to change. From there, you and your psychologist build a formulation together: a working explanation of the thoughts, feelings, behaviours and physical sensations that connect to keep the problem in place.

Each session has a loose structure. You will typically set an agenda together, review how the previous week went, work on a specific skill or piece of thinking, and agree what to practise before the next appointment. This might include noticing and challenging unhelpful thoughts, gradually approaching situations you have been avoiding, adjusting behaviours that unintentionally maintain a problem, or building in structure around sleep, activity or worry time.

CBT is generally a time-limited therapy, with a course of sessions rather than an open-ended commitment, and progress is reviewed regularly so you and your psychologist can agree when you are ready to finish or whether further sessions would help.

The evidence for CBT

CBT is one of the most researched therapies available and is recommended by the National Institute for Health and Care Excellence (NICE) as a treatment option for depression and for several anxiety disorders, including generalised anxiety disorder, social anxiety disorder, panic disorder, obsessive compulsive disorder and health anxiety. This guidance reflects a large body of clinical trials comparing CBT with other treatments and with no treatment at all.

Research on remote and video-based CBT has also grown substantially, and outcomes for online CBT are broadly comparable to therapy delivered in person for many common difficulties. That evidence is part of why online delivery is a genuine option rather than a compromise.

Working with us

We are clinical psychologists working with adults across Greenwich and south east London, seeing people online rather than in a consulting room. Sessions take place by secure video call, which means you can have therapy from home, from work, or wherever suits you, without factoring in travel to central Greenwich, Blackheath or further afield in Lewisham or New Cross.

Every psychologist offering CBT here is trained to deliver it to a recognised clinical standard, and sessions follow the same structured, formulation-led approach whether they happen online or in a room. We will update this site as the practice develops.

Frequently asked questions

How soon might I notice a difference with CBT?

Some people notice early shifts within the first few weeks, particularly around understanding why a problem has developed and what keeps it going. Lasting change usually takes longer, since it depends on practising new responses between sessions rather than on insight from the room alone.

Does CBT mean I have to think positively about everything?

CBT centres on noticing thinking patterns that are unhelpful or inaccurate, such as assuming the worst outcome will happen, and testing whether a more balanced or evidence-based thought fits the situation. Positive thinking on its own is not the mechanism of change.

Can CBT still help with a problem I’ve had for years?

Yes, CBT is regularly used for long-standing difficulties as well as recent ones. The length of time a problem has been present does not rule out CBT, though a longer-standing pattern may mean working through it takes more sessions and more repetition of new skills.

What if I struggle to complete the exercises between sessions?

Tell your psychologist rather than skipping past it. Struggling with between-session practice is common and usually points to something useful, such as the task being too big a step, unclear, or clashing with a busy week, and it can be adjusted together.

Is it possible to have CBT by video call rather than in person?

Yes. All sessions here take place online by secure video call, and the same structured approach, agenda, formulation and between-session practice applies whether the therapy happens on screen or in a room. Working this way also means practising new skills in the environment where you actually need to use them, such as at home.

How many sessions does a typical course of CBT involve?

The number of sessions varies with the difficulty being worked on and how it responds to treatment, and your psychologist will discuss a likely course of sessions with you as part of assessment and review it as therapy progresses.