Making sense of

cognitive behaviour
therapy (CBT)

1 1
2
Making sense of cognitive behaviour therapy
What is cognitive behaviour therapy? 4

What's the history of CBT? 5

What's so important about negative thoughts? 6

How does this kind of problem start? 6

What form does treatment take? 7

How else does it differ from other therapies? 9

What kind of people benefit? 9

Why do I need to do homework? 11

How effective is it? 11

How does CBT work? 12

How can I find a therapist? 14

Can I learn CBT techniques by myself? 15

Cognitive behaviour therapy in action 16

Useful organisations 18

References 21

Further reading and order form 22

3
 Making sense of
cognitive behaviour therapy

CBT is a short-term talking treatment that has a highly

practical approach to problem-solving. It aims to change
patterns of thinking or behaviour that are behind people’s
difficulties, and so change the way they feel. This booklet
is for anyone interested in knowing more about CBT. It
explains who and what it's for, and how to find a therapist.

What is cognitive behaviour therapy?

Cognitive behaviour therapy (CBT) describes a number of therapies
that all have a similar approach to solving problems, which can
range from sleeping difficulties or relationship problems, to drug
and alcohol abuse or anxiety and depression. CBT works by
changing people's attitudes and their behaviour. The therapies
focus on the thoughts, images, beliefs and attitudes that we
hold (our cognitive processes) and how this relates to the way
we behave, as a way of dealing with emotional problems.

An important advantage of CBT is that it tends to be short, taking

three to six months for most emotional problems. Clients attend
a session a week, each session lasting either 50 minutes or an
hour. During this time, the client and therapist are working
together to understand what the problems are and to develop
a new strategy for tackling them. CBT introduces them to a set
of principles that they can apply whenever they need to, and
which will stand them in good stead throughout their lives.

CBT is a combination of psychotherapy and behavioural therapy.

Psychotherapy emphasises the importance of the personal meaning
we place on things and how thinking patterns begin in childhood.
Behavioural therapy pays close attention to the relationship
between our problems, our behaviour and our thoughts.

4
What's the history of CBT?
In the 1960s, a US psychiatrist and psychotherapist called
Aaron T. Beck observed that, during his analytical sessions, his
patients tended to have an 'internal dialogue' going on in their
minds, almost as if they were talking to themselves. But they
would only report a fraction of this kind of thinking to him.

For example, in a therapy session the client might be thinking

to him- or herself: 'He (the therapist) hasn't said much today. I
wonder if he's annoyed with me?' These thoughts might make
the client feel slightly anxious or perhaps annoyed. He or she
could then respond to this thought with a further thought:
'He's probably tired, or perhaps I haven't been talking about
the most important things'. The second thought might change
how the client was feeling.

Beck realised that the link between thoughts and feelings was
very important. He invented the term 'automatic thoughts' to
describe emotion-filled or 'hot' thoughts that might pop up in
the mind. Beck found that people weren't always fully aware
of such thoughts, but could learn to identify and report them.
If a person was feeling upset in some way, the thoughts were
usually negative and neither realistic nor helpful. Beck found
that identifying these thoughts was the key to the client
understanding and overcoming his or her difficulties.

Beck called it cognitive therapy because of the importance it

places on thinking. It's now known as CBT because the therapy
employs behavioural techniques as well. The balance between
the cognitive and the behavioural elements varies among the
different therapies of this type, but all come under the umbrella
term cognitive behaviour therapy. CBT has since undergone
successful scientific trials in many places by different teams,
and has been applied to a wide variety of problems.
5
 What's so important about negative
thoughts?
CBT is based on a 'model' or theory that it's not events themselves
that upset us, but the meanings we give them. If our thoughts
are too negative, it can block us seeing things or doing things
that don't fit – that disconfirm – what we believe is true. In other
words, we continue to hold on to the same old thoughts and
fail to learn anything new.

For example, a depressed woman may think, 'I can't face going
into work today: I can't do it. Nothing will go right. I'll feel awful.'
As a result of having these thoughts – and of believing them –
she may well ring in sick. By behaving like this, she won't have
the chance to find out that her prediction was wrong. She might
have found some things she could do, and at least some things
that were OK. But, instead, she stays at home, brooding about
her failure to go in and ends up thinking: 'I've let everyone down.
They will be angry with me. Why can't I do what everyone else
does? I'm so weak and useless.' So, that woman probably ends
up feeling worse, and has even more difficulty going in to work
the next day. Thinking, behaving and feeling like this may start
a downward spiral. This vicious circle can apply to many
different kinds of problems.

How does this kind of problem start?

Beck suggested that these thinking patterns are set up in
childhood, and become automatic and relatively fixed. So, a
child who didn't get much open affection from their parents
but was praised for school work, might come to think, 'I have
to do well all the time. If I don't, people will reject me'. Such a
rule for living (known as a 'dysfunctional assumption') may do
well for the person a lot of the time and help them to work hard.

6
But if something happens that's beyond their control and they
experience failure, then the dysfunctional thought pattern may
be triggered. The person may then begin to have 'automatic'
thoughts like, 'I've completely failed. No one will like me. I
can't face them'.

CBT acts to help the person understand that this is what's going
on. It helps him or her to step outside their automatic thoughts
and test them out. CBT would encourage the depressed woman
mentioned earlier to examine real-life experiences to see what
happens to her, or to others, in similar situations. Then, in the
light of a more realistic perspective, she may be able to take
the chance of testing out what other people think, by revealing
something of her difficulties to friends.

Clearly, negative things can and do happen. But when we are

in a disturbed state of mind, we may be basing our predictions
and interpretations on a biased view of the situation, making
the difficulty that we face seem much worse. CBT helps people
to correct these misinterpretations.

What form does treatment take?

CBT differs from other therapies because sessions have a structure,
rather than the person talking freely about whatever comes
to mind. At the beginning of the therapy, the client meets the
therapist to describe specific problems and to set goals they want
to work towards. The problems may be troublesome symptoms,
such as sleeping badly, not being able to socialise with friends,
or difficulty concentrating on reading or work. Or they could be
life problems, such as being unhappy at work, having trouble
dealing with an adolescent child, or being in an unhappy marriage.

7
 These problems and goals then become the basis for planning
the content of sessions and discussing how to deal with them.
Typically, at the beginning of a session, the client and therapist
will jointly decide on the main topics they want to work on this
week. They will also allow time for discussing the conclusions
from the previous session. And they will look at the progress
made with the 'homework' the client set for him- or herself
last time. At the end of the session, they will plan another
assignment to do outside the sessions.

Doing homework
Working on homework assignments between sessions, in this
way, is a vital part of the process. What this may involve will
vary. For example, at the start of the therapy, the therapist
might ask the client to keep a diary of any incidents that
provoke feelings of anxiety or depression, so that they can
examine thoughts surrounding the incident. Later on in the
therapy, another assignment might consist of exercises to cope
with problem situations of a particular kind.

The importance of structure

The reason for having this structure is that it helps to use the
therapeutic time most efficiently. It also makes sure that
important information isn't missed out (the results of the
homework, for instance) and that both therapist and client think
about new assignments that naturally follow on from the session.

The therapist takes an active part in structuring the sessions to

begin with. As progress is made, and clients grasp the principles
they find helpful, they take more and more responsibility for the
content of sessions. So by the end, the client feels empowered
to continue working independently.

8
Group sessions
CBT is usually a one-to-one therapy. But it's also well suited
to working in groups, or families, particularly at the beginning
of therapy. Many people find great benefit from sharing their
difficulties with others who may have similar problems, even
though this may seem daunting at first. The group can also be
a source of specially valuable support and advice, because it
comes from people with personal experience of a problem. Also,
by seeing several people at once, service-providers can offer help
to more people at the same time, so people get help sooner.

How else does it differ from other therapies?

CBT also differs from other therapies in the nature of the
relationship that the therapist will try to establish. Some therapies
encourage the client to be dependent on the therapist, as part
of the treatment process. The client can then easily come to see
the therapist as all-knowing and all-powerful. The relationship
is different with CBT.

CBT favours a more equal relationship that is, perhaps, more

business-like, being problem-focused and practical. The therapist
will frequently ask the client for feedback and for their views about
what is going on in therapy. Beck coined the term 'collaborative
empiricism', which emphasises the importance of client and
therapist working together to test out how the ideas behind
CBT might apply to the client's individual situation and problems.

What kind of people benefit?

People who describe having particular problems are often the
most suitable for CBT, because it works through having a specific
focus and goals. It may be less suitable for someone who feels
vaguely unhappy or unfulfilled, but who doesn't have troubling
symptoms or a particular aspect of their life they want to work on.

9
 It's likely to be more helpful for anyone who can relate to CBT's
ideas, its problem-solving approach and the need for practical
self-assignments. People tend to prefer CBT if they want a more
practical treatment, where gaining insight isn't the main aim.

CBT can be an effective therapy for the following problems:

• anger management
• anxiety and panic attacks
• child and adolescent problems
• chronic fatigue syndrome
• chronic pain
• depression
• drug or alcohol problems
• eating problems
• general health problems
• habits, such as facial tics
• mood swings
• obsessive-compulsive disorder
• phobias
• post-traumatic stress disorder
• sexual and relationship problems
• sleep problems

There is a new and rapidly growing interest in using CBT (together

with medication) with people who suffer from hallucinations and
delusions, and those with long-term problems in relating to others.

It's less easy to solve problems that are more severely disabling
and more long-standing through short-term therapy. But people
can often learn principles that improve their quality of life and
increase their chances of making further progress. There is also a
wide variety of self-help literature. It provides information about
treatments for particular problems and ideas about what people
can do on their own or with friends and family (see p. 14).
10
Why do I need to do homework?
People who are willing to do assignments at home seem to get
the most benefit from CBT. For example, many people with
depression say they don't want to take on social or work activities
until they are feeling better. CBT may introduce them to an
alternative viewpoint – that trying some activity of this kind,
however small-scale to begin with, will help them feel better.

If that individual is open to testing this out, they could agree to

do a homework assignment (say to meet a friend at the pub for
a drink). They may make faster progress, as a result, than someone
who feels unable to take this risk and who prefers to talk about
their problems.

How effective is it?

CBT can substantially reduce the symptoms of many emotional
disorders – clinical trials have shown this. In the short term, it's
just as good as drug therapies at treating depression and anxiety
disorders. And the benefits may last longer. All too often, when
drug treatments finish, people relapse, and so practitioners
may advise patients to continue using medication for longer.

When patients are followed up for up to two years after therapy

has ended, many studies have shown a marked advantage for
CBT. For example, having just 12 sessions of CBT can be as
helpful in tackling depression as taking medication throughout
the two-year follow-up period. This research suggests that CBT
helps bring about a real change that goes beyond just feeling
better while the patient stays in therapy. This has fuelled
interest in CBT.

11
 Comparisons with other types of short-term psychological therapy
aren't quite so clear-cut. Therapies such as inter-personal therapy
and social skills training are also effective. The drive is now to
make all these interventions as effective as possible, and also,
perhaps, to establish who responds best to which type of
therapy.

Limitations
CBT is not a miracle cure. The therapist needs to have
considerable expertise – and the client must be prepared to be
persistent, open and brave. Not everybody will benefit, at least
not to full recovery, in a short space of time. It's unrealistic to
expect too much.

At the moment, experts know quite a lot about people who

have relatively clear-cut problems. They know much less about
how the average person may do – somebody, perhaps, who
has a number of problems that are less clearly defined.
Sometimes, therapy may have to go on longer to do justice to
the number of problems and to the length of time they've
been around. One fact is also clear, though. CBT is rapidly
developing. All the time, new ideas are being researched to
deal with the more difficult aspects of people’s problems.

How does CBT work?

CBT is quite complex. There are several possible theories about
how it works, and clients often have their own views. Perhaps
there is no one explanation. But CBT probably works in a number
of ways at the same time. Some it shares with other therapies,
some are specific to CBT. The following illustrate the ways in
which CBT can work.

12
Learning coping skills
CBT tries to teach people skills for dealing with their problems.
Someone with anxiety may learn that avoiding situations helps
to fan their fears. Confronting fears in a gradual and manageable
way helps give the person faith in their own ability to cope.
Someone who is depressed may learn to record their thoughts
and look at them more realistically. This helps them to break the
downward spiral of their mood. Someone with long-standing
problems in relating to other people may learn to check out
their assumptions about other people's motivation, rather than
always assuming the worst.

Changing behaviours and beliefs

A new strategy for coping can lead to more lasting changes to
basic attitudes and ways of behaving. The anxious client may
learn to avoid avoiding things! He or she may also find that
anxiety is not as dangerous as they assumed.

Someone who’s depressed may come to see themselves as an

ordinary member of the human race, rather than inferior and
fatally flawed. Even more basically, they may come to have a
different attitude to their thoughts – that thoughts are just
thoughts, and nothing more.

A new form of relationship

One-to-one CBT brings the client into a kind of relationship they
may not have had before. The 'collaborative' style means that they
are actively involved in changing. The therapist seeks their views
and reactions, which then shape the way the therapy progresses.
The person may be able to reveal very personal matters, and to
feel relieved, because no-one judges them. He or she arrives at
decisions in an adult way, as issues are opened up and explained.
Each individual is free to make his or her own way, without
being directed. Some people will value this experience as the
most important aspect of therapy. 13
 Solving life problems
The methods of CBT may be useful because the client solves
problems that may have been long-standing and stuck. Someone
anxious may have been in a repetitive and boring job, lacking
the confidence to change. A depressed person may have felt
too inadequate to meet new people and improve their social
life. Someone stuck in an unsatisfactory relationship may find
new ways of resolving disputes. CBT may teach someone a
new approach to dealing with problems that have their basis in
an emotional disturbance.

How can I find a therapist?

This may be the hardest bit. It's possible to get CBT on the NHS
in some places, and the NHS Mental Health Service is developing
fast. But in many areas this is patchy. Some counsellors and
psychologists offer CBT under the NHS. Some nurses, doctors,
occupational therapists and clinical psychologists working in
community mental health teams can also provide CBT. Some
NHS Trusts will have specialist therapy services.

Your GP may be in the best position to give you information about

local services. However, waiting lists tend to be long and it's
not easy to find practitioners who have good training. There
aren't many private practitioners yet, although many private
hospitals employ CBT therapists.

There is no legal requirement for therapists to register and be

approved, but the British Association of Behavioural and Cognitive
Therapy has a register of its members. Therapists on the register
have to present detailed information on their training and
experience, supported by a qualified practitioner. They have to
agree to conditions of ethical practice, to include supervision and
continuing professional education. A copy of this register can be
obtained from the BABCP. (See Useful organisations, on p. 18.)
14
There are practitioners working within the UK using other
cognitive behaviour treatments. These include Kelly's 'Personal
Construct Therapy' and Albert Ellis' 'Rational Emotive Therapy'.
These therapies have not received so much scientific attention
and they have not developed particular methods for specific
problems in the same way.

Can I learn CBT techniques by myself?

Since CBT has a highly educational component, much use is made
of reading material in individual therapy and this has been
expanded into a large self-help literature over recent years. (See
References, on p. 21 and Further reading, on p. 22.) Researchers
haven't paid much attention, so far, to whether these books can
be helpful. There is one study of The feeling good handbook
(see p. 21), which they found effective for alleviating depression.
This suggests that it could be beneficial for other problems, in
the same way, although this will depend on the severity of the
problem and how long it's been going on.

A recent development is using interactive CD-Rom programmes,

which can be accessed via your GP or other service-providers.
Some of these are very high quality. Some people may prefer
them to seeing a therapist, particularly as a first step. They can
help with devising relevant activities, and monitor your progress
in graphical form, which may be encouraging. They may well
come to be more freely available for self-help use.

15
 Cognitive behaviour therapy in action

Mike is a 38-year-old gay man who had suffered disabling bouts

of depression, on several occasions in his life, which caused him
to make several career changes. He twice tried to commit suicide.
He also suffered from a great deal of anxiety and stress, had some
drink problems and found it difficult to control his temper,
especially when drinking.

Mike was referred for CBT after a typical episode was triggered
by stress at work. At his first meeting with his therapist, Mike
already knew what he wanted to work on. He had a great sense
of failure over his history of depression and what he called his
lack of success in his career ('I've really messed up'). He was
anxious about his job prospects. He felt unattractive and was
worried about ageing and about further losing his physical
appeal. He felt his angry impulses were in danger of getting
out of control.

In therapy, Mike learned to monitor his actions and his emotional

responses. He began to plan activities that gave him a boost
and to deal with situations that he had avoided through fear.
He learned to identify when he was being extreme or biased in
his thinking. He became good at examining his emotion-driven
thoughts and reasoning them out so that he got things into
proper perspective.

His mood noticeably improved, and he began to tackle longer-

standing problems. He began looking at job prospects, by planning
a more realistic choice of career, and sending in applications. He
established a more equal relationship with his partner. He dealt
with social situations, without demanding attention and special
treatment from friends. Mike had to face up to problems that
were difficult to take on board, such as his perfectionism and
the unreasonable demands he made on other people. But Mike
was highly motivated by the crisis in his life to find alternatives.
16 This is what he wrote towards the end of his therapy:
'I have had many painful episodes of depression in my life, and
this has had a negative effect on my career and has put
considerable strain on my friends and family. The treatments I
have received, such as taking antidepressants and psychodynamic
counselling, have helped to cope with the symptoms and to
get some insights into the roots of my problems.

CBT has been by far the most useful approach I have found in
tackling these mood problems. It has raised my awareness of
how my thoughts impact on my moods. How the way I think
about myself, about others and about the world can lead me
into depression. It is a practical approach, which does not
dwell so much on childhood experiences, whilst acknowledging
that it was then that these patterns were learned. It looks at
what is happening now, and gives tools to manage these
moods on a daily basis.

The work has moved on to look at deeper beliefs, which can

dominate one's life and cause loads of problems. For example,
I have found that I have a strong entitlement belief [a belief
that he is entitled to expect certain things from other people].
This is characterised by low frustration tolerance, anger, and
inability to control impulses or be told what to do. It has been
a revelation to look back on one's life and see how this pattern
has dominated a lot of what I have done. CBT has given me a
feeling of being more in control of my life. I am now coming
off medication and, with the support of my therapist and
partner, I am learning new ways of being in the world. The
challenge remains to change these thoughts and behaviours.
It will not happen overnight.'

Mike is a man who has applied himself very actively to change.

As this quotation reveals, CBT offered him much more then the
'quick' fix that it is sometimes portrayed as giving.
17
 Useful organisations

Mind
Mind is the leading mental health organisation in England and
Wales, providing a unique range of services through its local
associations, to enable people with experience of mental
distress to have a better quality of life. For more information
about any mental health issues, including details of your
nearest local Mind association, contact the Mind website:
[Link] or Mindinfoline on 0845 766 0163.

Association for Cognitive Analytic Therapy

3rd Floor, South Wing, Division of Academic Psychiatry
St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH
tel. 020 7928 9292
web: [Link] or [Link]
Information about Cognitive Analytic Therapy, developed by
Dr Anthony Ryle. Information and help in finding private or
NHS therapists

Association for Rational Emotive Behaviour Therapy

PO Box 39207, London SE3 7XH
tel. 0114 271 8699, fax: 020 8293 1441
web: [Link]
Maintains a register of professionally trained Rational Emotive
Behaviour Therapists and Counsellors

British Association for Behavioural and Cognitive

Psychotherapies (BABCP)
The Globe Centre, PO Box 9, Accrington BB5 0XB
tel. 01254 875 277, fax: 01254 239 114
email: babcp@[Link] web: [Link]
Promotes the development of the theory and practice of
behavioural and cognitive psychotherapies. Can provide details
of accredited therapists. Full directory of psychotherapists
available online
18
The British Psychological Society
St Andrews House, 48 Princess Road East, Leicester LE1 7DR
tel. 0116 254 9568, fax: 0116 247 0787
email: mail@[Link] web: [Link]
Publishes a directory of chartered psychologists across the UK, who
may practice CBT. Available on the web and in public libraries

Centre for Personal Construct Psychology

The Sail Loft, Mulberry Quay, Falmouth TR11 3HD
email: fransella@[Link] web: [Link]
Information and resources on Personal Construct Psychology

Depression Alliance
35 Westminster Bridge Road, London SE1 7JB
tel. 0845 123 2320, fax: 020 7633 0559
email: information@[Link]
web: [Link]
Support and understanding to anyone affected by depression

First Steps to Freedom

1 Taylor Close, Kenilworth, Warwickshire CV8 2LW
helpline: 01926 851 608, tel./fax: 01926 864 473
email: [Link]@[Link] web: [Link]
Offers help to those who suffer from phobias, panic attacks,
general anxiety and obsessive-compulsive disorders

National Phobics Society

Zion Community Resource Centre, 339 Stretford Road
Hulme, Manchester M15 4ZY
helpline: 0870 7700 456, fax: 0161 227 9862
email: nationalphobic@[Link]
web: [Link]
A national registered charity run by sufferers and ex-sufferers
of anxiety disorders
19
 No Panic
93 Brands Farm Way, Randlay, Telford, Shropshire TF3 2JQ
helpline: 0808 808 0545, email: ceo@[Link]
web: [Link]
Runs local self-help groups and produces a range of leaflets,
information, audio and video cassettes

OCD Action
Aberdeen Centre, 22–24 Highbury Grove, London N5 2EA
tel. 020 7226 4000, fax: 020 7288 0828
email: obsessive-action@[Link]
web: [Link]
A national charity for people with obsessive-compulsive disorder
(OCD) and the related disorders such as body dysmorphic disorder
(BDD), compulsive skin picking (CSP) and trichotillomania.

Oxford Cognitive Therapy Centre

Psychology Deparment, Warneford Hospital, Oxford OX3 7JX
tel: 01865 223 986, fax: 01865 226 411, web: [Link]
Aims to provide cognitive therapy training and other resources to
NHS and other professionals, voluntary organisations, and clients

Triumph Over Phobia (TOPUK)

PO Box 344, Bristol BS34 8ZR
tel. 0845 600 9601, email: triumphoverphobia@[Link]
web: [Link]
A national network of structured self-help groups. Helpline for
people experiencing anxiety disorders

United Kingdom Council for Psychotherapy (UKCP)

167–169 Great Portland Street, London W1W 5PF
tel. 020 7436 3002, fax: 020 7436 3013
email: ukcp@[Link]
web: [Link]
20 Regional lists of psychotherapists are available free
Useful websites

[Link]
Calipso produces mental health training materials for healthcare
professionals, and self-help materials, including CDs

[Link]
The Beck Institute for cognitive therapy and research

[Link]
Aaron T. Beck's Home Page

[Link]
Association for the Advancement of Behavior Therapy

[Link]
The International Association for Cognitive Psychotherapy

[Link]
European Association for Behaviour and Cognitive Therapies

[Link]
The Albert Ellis Institute

References
The feeling good handbook D. D. Burns (Penguin 1990)
Love is never enough A. T. Beck (Penguin 1988)
Mind over mood: a cognitive therapy treatment manual
for clients D. Greenberger, C. A. Padesky (Guilford 1995)
Reinventing your life J. E. Young, J. S. Klosko (Plume 1994)
Treatment choice in psychological therapies and counselling:
evidence-based clinical practice guidelines (The DOH 2001)
21
 Further reading and order form

The anger control workbook: simple, innovative techniques

for managing anger and developing healthier ways of relating
M. McKay, P. Rogers (New Harbinger Press 2000) £14.99
The assertiveness workbook: how to express your ideas and
stand up for yourself at work and in relationships R. J. Paterson
(New Harbinger Press 2000) £12.99
Climbing out of depression: a practical guide for sufferers
S. Atkinson (Lion Publishing 1993) £7.99
Depression: the way out of your prison (3rd ed) D. Rowe
(Brunner-Routledge 2003) £9.99
How to assert yourself (Mind 2003) £1
How to cope with panic attacks (Mind 2004) £1
How to cope with the stress of student life (Mind 2003) £1
How to deal with anger (Mind 2003) £1
How to improve your mental wellbeing (Mind 2004) £1
How to increase your self-esteem (Mind 2003) £1
How to look after yourself (Mind 2004) £1
How to restrain your violent impulses (Mind 2002) £1
How to stop worrying (Mind 2004) £1
The Mind guide to managing stress (Mind 2003) £1
The Mind guide to relaxation (Mind 2004) £1
Overcoming anxiety H. Kennerley (Robinson 1997) £7.99
Overcoming depression P. Gilbert (Constable 2000) £7.99
Overcoming low self-esteem M. Fennell (Robinson 1999) £7.99
Overcoming panic D. Silove, V. Manicavasagar (Robinson 1997) £7.99
Overcoming social anxiety and shyness G. Butler (Robinson 1999)
£7.99
Overcoming traumatic stress C. Herbert, A. Wetmore (Robinson
1999) £7.99
Overcoming childhood trauma H. Kennerley (Robinson 2000) £7.99
Understanding anxiety (Mind 2003) £1
Understanding depression (Mind 2004) £1
Understanding mental illness (Mind 2004) £1
Understanding obsessive-compulsive disorder (Mind 2002) £1
Understanding phobias (Mind 2002) £1
22
For a catalogue of publications from Mind, send an A4 SAE
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 Mind works for a better life for everyone
with experience of mental distress
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For details of your nearest Mind association and of local services contact Mind’s helpline,
MindinfoLine: 0845 766 0163 Monday to Friday 9.15am to 5.15pm. Speech-impaired or
Deaf enquirers can contact us on the same number (if you are using BT Textdirect, add the
prefix 18001). For interpretation, Mindinfoline has access to 100 languages via Language Line.

Scottish Association for Mental Health tel. 0141 568 7000

Northern Ireland Association for Mental Health tel. 028 9032 8474

This book was written by Ruth Williams

First published by Mind 2001 © Mind 2004

ISBN: 1-903567-20-3
No reproduction without permission
Mind is a registered charity No. 219830

Mind (National Association for Mental Health)

15-19 Broadway
London E15 4BQ
tel: 020 8519 2122
fax: 020 8522 1725
web: [Link]

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