Can wellbeing initiatives such as befriending, arts and crafts or gardening be just as beneficial as a talking therapy like CBT? On the one hand, demand is constant and CBT has boomed, within the NHS and beyond. But on the other hand, doubts have started to be raised, and it’s now believed cognitive behavioural therapy, or CBT, can be negative or even damaging to some patients. Discovering these reports recently, I wanted to learn more – about why CBT might prove unhelpful, and what might be positive alternatives.
Maybe the most interesting report I found was a 2014 review by the Cochrane Group, which compared CBT’s impact with other, more informal and everyday approaches, such as befriending. It concluded that these alternatives could be equally beneficial. To me, that suggests that what many patients seek is the gift of time, of connection, of stimulus, of sharing, and that these can be of profound benefit in themselves.
Yes, the human brain is massively complex, and so is the variety of individual thought patterns. But within that complexity, there are also common threads, and the simplest, most instinctive experiences can be the most positive.
CBT can be wonderful: recharging, setting thoughts in new directions, enabling and encouraging. It too gives time and space for sharing and connection, only it focuses that time and space on issues, difficulties, problems. For some that can feel intimidating or oppressive. For others, it’s just what they need. CBT addresses thought patterns head on, so it can be concrete and specific where wellbeing initiatives might feel too vague. Sometimes suggesting befriending or art to someone can look like you’re brushing aside whatever they may be going through. But they are flexible alternatives, and they won’t ask you to change how you think. Instead they open up time and space in a different way, giving perspective.
Then there’s life coaching as opposed to therapy or counselling. I offer life coaching, as well as being an art for wellbeing practitioner. Life coaching is more of a shared experience, setting goals together as you encourage someone to discover and think more about themselves and how they live – not giving answers.
I like to compare and contrast the different ways that visual art can benefit wellbeing too – whether it’s used to express thoughts and emotions directly, or rather as an escape, a refuge, a stimulus, for rest, calm, fun, respite. Confronting issues head on, or recharging – or combining the two. Expressive art can feel negative and fuel overthinking or depression, like CBT. But it can also encourage someone to think through an issue in a new and creative way. Non-expressive art on any theme can feel irrelevant, but can also root someone in life and shine a light.
For any intervention, there’ll be doubters and naysayers. ADHD is one issue where doubt is being cast on the use of CBT. A 2024 University of Nottingham study identified negative experiences for a majority of 46 people with ADHD surveyed, with reports of feeling inadequate or distressed. One theory may be that CBT lags behind the rate at which people with ADHD think, and that’s where the very flexibility of other initiatives such as mindful gardening or painting could prove more absorbing, even as a balance with CBT.
What stands out is the need to experiment with an open mind, to see what helps any one of us as an individual. And not to assume that therapy will always be more beneficial than practical, tangible experiences. But it isn’t about either/or.
Medley 