Cognitive behavioural therapy (CBT) is a structured, evidence-based talking therapy that helps people identify and change unhelpful patterns of thinking and behaviour that are maintaining psychological difficulties. It is one of the most widely researched and effective psychological treatments available, and is recommended by NICE for anxiety, depression, PTSD, and many other conditions commonly experienced by cardiac arrest survivors.
How CBT works
CBT is based on the principle that how we think about a situation affects how we feel emotionally and how we behave, and that these responses can become locked into self-reinforcing cycles. For example, a survivor who believes that any physical exertion is dangerous may avoid all activity (avoidance behaviour), which reduces their fitness and increases anxiety, which reinforces the belief. CBT helps identify these patterns, test them against evidence, and develop more balanced and helpful responses.
CBT for cardiac arrest survivors
CBT can address many of the psychological difficulties experienced after cardiac arrest, including:
- Fear of recurrence: examining the evidence, developing realistic appraisal of risk, gradual reintroduction of avoided activities
- Post-traumatic stress disorder: trauma-focused CBT directly processes traumatic memories
- Anxiety and hypervigilance: reducing sensitivity to bodily sensations through education and graded exposure
- Depression: behavioural activation and challenging negative thought patterns
- Adjustment difficulties: developing coping skills and processing significant life change
How CBT is delivered
CBT is typically delivered in 8 to 20 weekly sessions, either individually or in a group. It can also be delivered online or through guided self-help. Sessions involve work between appointments: keeping thought records, testing beliefs in real situations, and practising new skills.
Access
CBT is available through NHS Talking Therapies (formerly IAPT), by GP referral, or privately. Some cardiac rehabilitation programmes include CBT-based components.
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