What is the CBT Skills Group Program?
The Cognitive Behavioural Therapy (CBT) Skills Groups are open to all BC residents with a valid Canadian health card number. The course is designed for adult patients (17.5 years and up) who want to learn practical tools to improve their mental health.
This eight-week educational program is a course that helps people with a variety of mental health conditions, such as anxiety, depression and stress-related disorders. It uses evidence-based therapies to teach people to recognize, understand and manage patterns of feeling, thinking and behaving. The purpose is to become more conscious of their choices as they respond to life stressors, and explore options for living a fuller, richer life, more aligned with what they value most.
What Groups Do We Offer?
The CBT Skills Group Program is proud to offer different groups that explore a variety of concepts and skills to support you to self-manage your mental health. Everyone who is referred to the program is offered our level 1 groups, which include CBT Skills Foundations and Raising Resilient Kids. Once you complete a level 1 group (i.e. attend at least 6 out of 8 sessions) you qualify for level 2 groups, which delve deeper into concepts for continued learning.
Everyone is on their own learning journey and will become comfortable with the course content at their own pace. We encourage participants to repeat the CBT Skills Foundations group until they are familiar with most of the concepts and skills.
LEVEL 1: CBT Skills Foundations
These groups introduce the foundational concepts of Cognitive Behavioural Therapy (CBT), weaving in aspects of mindfulness, emotion regulation and Acceptance and Commitment Therapy over an 8-week series. You will learn these concepts and apply practical skills in your daily life, with the aim of identifying which ones are most helpful to manage your stress and symptoms.
Specific CBT Skills Foundations groups are designated for defined populations, in addition to the general groups:
(1) Women only
This group is a space for participants who identify as women and would like to participate in a group comprised of only women.
(2) Groups for new parents
This group is for participants with young children (4 years old and younger), to promote specific skill sharing helpful in this phase of life.
LEVEL 1: Raising Resilient Kids
Raising Resilient Kids groups are for parents with kids 0-5 years old. In this group, we teach skills to prepare and support you in raising a secure, resilient child based on the best evidence from child development, mindfulness, attachment, and reflective parenting. You will learn how to be curious of your child’s inner world, navigate conflict, normalize distress, and manage not only your child’s but also your own big emotions and behaviors. We will also teach you how to create a secure home base to support your child’s development. This is a preventative care program designed to strengthen caregiver-child relationships and does not require any diagnosis of a child mental health disorder.
LEVEL 2: CBT Skills Building Blocks
Once you have completed a CBT Skills Foundations group (i.e., attended at east 6 out of 8 sessions) you qualify for CBT Skills Building Blocks groups that further explore skills and concepts you have learned in the Foundations. Only participants who qualify for these groups will be emailed about these offerings.
An Introduction to Mindfulness
In this 8 week course, you will be introduced to a variety of mindfulness and compassion practices to support your wellbeing. Each session will be 1 hour and 45 minutes long and will include an opportunity to check in with the group, try different forms of mindfulness practice in session, share about your experiences in small groups, and explore how mindfulness may fit into your daily life. The emphasis will be on experiential learning and each session will include one longer practice (about 15-20 min in length typically) and several shorter practices. The course will be of most benefit to you if you are able to try some daily home practice between sessions. In contrast to Mindfulness Based Cognitive Therapy, this series includes lovingkindness, compassion and gratitude cultivation practices along with mindful awareness practices.
Mindfulness-based Cognitive Therapy
In this 8-week course, you will be introduced to mindfulness-based cognitive therapy skills for managing anxiety and depression.
CBT Skills for Insomnia
Most of us have experienced periods of difficulty with insomnia. The goal of this course is to help participants acquire a better understanding of sleep in general, of insomnia, and the obstacles which can interfere with restorative sleep. We will discuss the structure of sleep and the ways in which you may be able to more successfully manage any difficulties you experience.
You will be asked to complete a weekly bedtime sleep diary and morning sleep log to help you to keep track of what skills you are able to successfully apply and the benefits you, hopefully, begin to experience.
Booster Groups are Building Block groups that delve deeper into specific areas that were taught in the CBT Skills Foundations course. In these groups, you will be encouraged to take more responsibility for learning and applying skills, with more home practice exercises and participation in small group discussions. These courses span 4 weeks with each session being 1 hour 30 minutes in length.
Booster Group - Avoidance: Procrastination & Perfectionism
The goal of this course is to help you understand how avoidance ‘works’, using material from the Foundations course. In particular, the False Promise of Avoidance will be discussed, as it applies to procrastination and perfectionism. We will work with the premise that avoidance is a move away from feelings (discomfort/fear). For example, procrastination allows one to avoid boredom, frustration, shame or even anger. Perfectionism will be examined as the flip side of procrastination, simply a different way of avoiding potential negative consequences. At the end of this course, you will hopefully be able to more accurate identify the feelings you hope to avoid and to examine the costs and benefits of such a response. We will use SMART goal setting as one technique to change unhelpful habits.
Booster Group - Cognitive Change
The overall goal of this course is to help participants understand, label and modify cognitive distortions. The concept of Core Beliefs will be reviewed and incorporated into the discussion. You will have time in small groups of 2 or 3 to refer back repeatedly to the Triangle of Experience, reminding oneself of the interactions between thoughts, feelings and behaviors. It is important that you have enough time to learn about ‘untwisting’ distortions and to practice this skill in small groups. By the end of Session 4, you will, hopefully, have more confidence in your ability to identify and modify distortions.
Booster Group - Values
The goal of this course is to help participants identify and prioritize personal values, clarified as: ‘What’s Important To You – At This Time’. The Triangle of Experience will form the basis for discussion, especially as the group moves into the discussion of obstacles: (what gets in the way of moving towards a value or a goal: thoughts, feelings and behaviours. Incorporating the concept of Core Beliefs and Cognitive Distortions is important in helping participants understand this area. Participants will work together in small groups and use tools including Smart goals and the pros and cons grid to take steps in the direction of what you identify as a priority value to focus on for the course.
Booster Group - Self-compassion
This course offers an opportunity for you to learn ways to evaluate your own ability for self-compassion. We will use the Triangle of Experience to identify thoughts, feelings and behaviour which contribute to one’s difficulty practicing self compassion. This course reviews the many benefits of practicing self compassion and offers suggestions for strengthening your ability to take better care of your own needs.
What is CBT?
Cognitive Behavioural Therapy (CBT) helps you become more aware of patterns of thinking (cognitions), feeling (emotions) and behaving. With awareness, you become aware of ways you can relate differently to your thoughts, or choose intentionally to create new thoughts and behaviours that will better support your mood. Focusing on your present-day life, you experiment with approaching challenges in ways that are more flexible and more likely to bring about positive change.
The CBT Skills groups draw from CBT and from other evidence-based therapies, including mindfulness and acceptance-based therapies, to teach you new ways of working in your life. You will learn about how the mind works, the nature of thoughts, the function of emotions, and the interconnection of thoughts, feelings and behaviours. You will practice various skills that help you remain in the present moment, where you can more often respond thoughtfully and in ways that will be supportive of your well-being. You will be introduced to practices that encourage self-compassion and self-acceptance.
Does CBT skills work?
Cognitive Behavioural Therapy (CBT) has been extensively researched in a wide range of psychiatric disorders, in both individual and group settings. In a broad summary of the literature (Butler et al., 2006), CBT was found to be an effective treatment for depression, general anxiety disorder, panic disorder, social phobia, post-traumatic stress disorder, obsessive compulsive disorder and other disorders. CBT can also improve outcomes when delivered in conjunction with medication, which is especially helpful when depression is more severe. For those who have had depression in the past, participating in CBT can be protective against having a future episode (Segal et al., 2002).
The CBT Skills program is not comprehensive CBT, but rather focuses on the education and skills aspects of CBT. Although we do not have a research program to assess outcomes rigorously, our quality improvement measuring indicates trends that are consistent with what is seen in the literature related to CBT treatments: those with anxiety and depression tend to experience a significant reduction in symptoms. Many participants have found CBT beneficial for managing mental health, as a stand-alone treatment, or in conjunction with medications or individual therapy.
For more information on the outcomes of the CBT Skills Program as assessed from 2015-2018, see this article in the BCMJ article.
What about us?
The CBT Skills Groups Society is a non-profit society formed by a small and passionate team of family physicians and psychiatrists, the Board of Directors, and the staff (Christine Tomori, Executive Director, Heather Eadie, Program Coordinator, and Anya Phillip and Maxine Thornton, Administrative Assistants). We operate now with to the ongoing support of the physician facilitators and thanks to a partnership with Island Health.
The CBT Skills Group program was first developed thanks to a grant from the Shared Care Committee, a joint collaborative committee of the Doctors of BC and the Ministry of Health. The Victoria Division of Family Practice was also a key supporter of the pilot, and Divisions of Family Practice continue to be integral in bringing the program to new communities. The Vancouver Division of Family Practice (Justin Ho, Anya Phillip) is a key partner for our current expansion.
This proven program continues to expand and grow in response to the needs of communities from across BC. As of August 2021, we are able to accept patients from across BC to attend any of our virtual groups. We continue to develop specialized groups as we hear calls for more in-depth learning or specific interests.
As of September 2021, we are partnering with the Shared Care Committee and the UBC Office of Continuing Professional Development to support physicians in BC to take the course, to better support their own health and those of their patients. We will also train more physician facilitators as part of this program, so that physicians can offer the groups online and eventually in-person, across BC.
Thank you to everyone to has helped us make it possible to offer an effective, accessible option for providers and participants who are looking to improve their lives through learning.
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