How does cognitive behavioural therapy in Turkish work online? CBT principles for Turks abroad, session structure and techniques for daily life.
Cognitive behavioural therapy (CBT) is a structured, research-supported therapy approach used for anxiety, depression, panic, sleep problems and many other areas. For Turks living abroad, it is possible to access this approach in the country where they live; however, examining your thoughts and feelings in a foreign language can sometimes be difficult. Cognitive behavioural therapy in Turkish aims to apply CBT's methods in your mother tongue and with attention to cultural context. In this article we look at the basic logic of CBT, how it works when it is delivered online and in Turkish, the thought patterns commonly met abroad, and some techniques you can try on your own.
What Is Cognitive Behavioural Therapy in Turkish?
The basic idea of CBT is this: what affects us is not only the events we go through, but how we interpret them. Our thoughts, feelings, bodily reactions and behaviours are connected to one another. A change in one also affects the others.
Say your manager at work sends a short reply to your email. If the thought "They're not happy with me, I'm going to lose my job" crosses your mind, you feel anxious, your heart speeds up and perhaps you avoid your manager that day. If, in the same situation, you think "They must be very busy", you will most likely stay calmer. The event is the same; the interpretation is different.
CBT aims to notice these interpretations, assess how realistic they are, and develop more helpful ways of thinking and behaving. In doing so it:
- Focuses on the present and on problems here and now, while also taking into account the influence of the past on today.
- Is structured: Sessions proceed around a particular agenda and goals.
- Is collaborative: Client and therapist work like a team.
- Aims to build skills: The goal is for the client, in time, to be able to think like their own therapist.
- Includes work between sessions: What is learned is applied in daily life.
For more information on the general principles of CBT, you can look at the article what is cognitive behavioural therapy.
What Is CBT Used For? Which Signs Should You Look Out For?
CBT is an approach used across a wide range of difficulties. Among the issues that Turks living abroad often seek help for are the following:
- Constant worry, tension and "what if" thoughts
- Panic attacks and fear of bodily symptoms
- Unhappiness, lack of motivation, feelings of worthlessness
- Loneliness abroad and avoidance of social situations
- Sleep problems
- Perfectionism and burnout at work
- Difficulty controlling anger
- Obsessive thoughts and repetitive behaviours
- Symptoms that continue after a traumatic event
Experiencing the symptoms on this list does not in itself mean a diagnosis. How long the symptoms have continued and how much they affect your daily life are important in deciding what kind of support is needed. A definitive assessment should be made by a specialist.
The Place of Mother Tongue and Culture in CBT
CBT's methods are universal; but the person and the context in which they are applied are always specific. Thoughts are built in language. The sentences a person says to themselves are often shaped by the language they learned in childhood and the phrases they heard from their family.
For example, a person's inner critical voice may speak in Turkish phrases such as "Elâlem ne der?" ("What will people say?"), "Sen zaten hep böylesin" ("You're always like this") or "Ayıp olur" ("It would be shameful"). It is possible to translate these sentences into another language, but in translation they sometimes lose their emotional weight. Working in your mother tongue can make it easier to catch these automatic thoughts exactly as they are.
Cultural context matters too. In Turkish families, the concepts of family loyalty, respect for elders, hospitality, shame and honour are strong. In CBT these values are not treated as "wrong thinking". The aim is to notice the rigid rules that squeeze you unnecessarily and cause pain while keeping hold of your values. For example, the rule "I can never say no to my family" can be loosened into "I love my family, and I can express my boundaries with love too".
CBT recognises that beneath automatic thoughts lie deeper "intermediate beliefs" and "core beliefs". Beliefs such as "I must always sacrifice myself to be loved" or "If I make a mistake, I am worthless" often form in childhood, within the family and in our own language. The experience of migration can reactivate these beliefs: feeling inadequate in a new country can strengthen an old "I'm not good enough" belief. For some people, examining these layers in their mother tongue can be a more natural process.
The article why therapy in your mother tongue matters gives detailed information on this. Of course, there are also specialists in the country where you live who offer high-quality CBT; therapy in your mother tongue is an option that does not have to replace these services and can be considered alongside them.
Thought Patterns Often Seen Abroad
CBT has certain thought patterns called "cognitive distortions". Everyone experiences them from time to time, but when they are repeated often they are ways of thinking that increase emotional strain. The following examples are common among those living abroad:
- Mind reading: "My colleagues are making fun of me because of my accent."
- Catastrophising: "If I lose this job, everything is over, I'll have to go back to Turkey and that would be a huge failure."
- All-or-nothing thinking: "Either I'll adapt completely here or I'll never belong."
- "Should" statements: "I must be strong, I must never upset my family."
- Personalisation: "My mother's illness is because I left."
- Discounting the positive: "I learned the language, but that's nothing, everyone learns it."
Noticing these thoughts is the first step towards changing them. Even writing a thought down lets you look at it from a little distance.
How thought patterns affect the family and relationships
These thought patterns affect not only a person's inner world; they also spill over into family and couple relationships. A mother who lives by the rule "I must be strong" may not be able to tell her partner she is tired, and this accumulated burden may one day come out as anger. A father who thinks "If my children fail here, it will be my fault" may start checking their homework and grades constantly. Children also learn by observing their parents' ways of thinking. Seeing how a parent copes with anxious thoughts shows the child a way of regulating their own emotions. For this reason, the skills learned in CBT can often benefit not just the individual but the whole family.
CBT Techniques You Can Try on Your Own
The following techniques are simple practices often used in CBT that you can also try on your own. They do not replace therapy; but they can show you how the approach works.
1. Thought record
When you go through a difficult moment, fill in these columns:
- Situation: What happened? Where, and with whom?
- Automatic thought: What went through your mind at that moment?
- Emotion: What did you feel and how intense was it? (Give it a score between 0 and 100)
- Evidence: What supports this thought and what does not?
- Alternative thought: What might a more balanced perspective be?
- New emotion intensity: How intensely do you feel now?
2. Behavioural activation
In periods of unhappiness a person usually does less, and the less they do, the more the unhappiness grows. To break this cycle, plan a small activity every day that may do you good or give you a sense of achievement. For example, a twenty-minute walk, calling a friend in Turkey, cooking a dish you love. After doing the activity you planned, rate your mood. After a few weeks you can see which activities do you more good and arrange your weekly plan accordingly.
3. Graded exposure for anxiety
If there is a situation you avoid, such as making a phone call in the local language, break it into small steps. Start with a written message, then make a short phone call, then move on to a longer call. At each step, observe your anxiety decreasing over time. Take the steps at your own pace; the aim is not to force yourself, but to replace avoidance with small but regular encounters.
4. Worry time
For worries that run through the day, set aside a fifteen-minute "worry time" at a particular hour each day. When a worry comes during the day, make a note and tell yourself "I'll think about this in my worry time." This technique can help limit worry spreading uncontrollably through the day.
5. Problem solving
If you are facing a real problem, such as an official procedure or a job search, clarify the problem, write down possible solutions, weigh up the pros and cons of each, choose one and plan the first small step. After carrying it out, evaluate the result; if it did not work, that is not a failure but an opportunity to try the next option on the list. Problem-solving skills can help you feel less helpless in the face of the bureaucratic and practical difficulties met in a new country.
6. Behavioural experiment
One way to test whether a thought is true is to run a small experiment. For example, if you think "If I greet my neighbours, they'll find it strange", first rate how strongly you believe this thought. Then greet a neighbour every day for a week and note what happens. At the end of the week, look at the results and rate your belief in the thought again. Experiments will not always turn out as you expect; but every result helps you get to know reality better.
The aim of CBT is not "thinking positively" but being able to think more realistically and more flexibly.
When Should You Seek Professional Support?
Techniques you apply on your own may be enough in some situations; in others, the guidance of a specialist is needed. You may consider seeking professional support in the following situations:
- If symptoms last longer than two weeks and affect your daily life
- If the methods you have tried on your own are not working
- If you avoid certain places or situations because of panic attacks or intense anxiety
- If there are marked changes in your sleep, appetite and energy
- If your relationships and working life are being negatively affected
If you have thoughts of harming yourself or ending your life, call the emergency number of the country you are in: 112 in EU countries, 911 in the USA and Canada, 999 or 112 in the United Kingdom, 000 in Australia. Online therapy is not an emergency intervention service; in situations of serious risk, local emergency services and local psychiatric services are necessary. Where a medication assessment may be needed, it is also recommended that you see a psychiatrist where you live.
How Does Cognitive Behavioural Therapy in Turkish Work in Online Therapy in Your Mother Tongue?
Online CBT is based on the same principles as face-to-face CBT. The difference is that sessions are held by video. Thought records, worksheets and homework can be shared on screen or kept by the client in their own notebook.
The process of cognitive behavioural therapy in Turkish generally consists of the following stages:
- Assessment: In the first sessions, the difficulties you are experiencing, how long they have continued, your migration story, and your family and sources of support are discussed.
- Case formulation: How the problem started, what keeps it going, and how the thought-feeling-behaviour cycle shows up in you are mapped out together.
- Goal setting: Measurable and achievable goals are set. For example, "Attending a social event outside the home twice a week."
- Intervention stage: Methods such as thought records, behavioural experiments, graded exposure, problem solving and relaxation techniques are used.
- Relapse prevention: Towards the end of therapy, a plan is prepared for maintaining the skills learned and for difficult periods.
The frequency and length of sessions are decided together according to your needs. A suitable time is chosen taking the time difference into account. A quiet room, headphones and a secure internet connection are enough. Payment is made online; pricing is in TL and payment by international card is possible. For insurance reimbursement, you need to check the insurance conditions in the country where you live. For more information, you can look at the online therapy and Turks living abroad pages.
Frequently Asked Questions
How long does cognitive behavioural therapy in Turkish take?
The length varies according to the problem, the goals and the person's needs. CBT is generally a time-limited, goal-focused approach; progress is reviewed together at regular intervals.
Is online CBT as effective as face-to-face CBT?
Research shows that for many problems, CBT delivered online can give results close to those of face-to-face sessions. Even so, the most suitable method for each person is determined by your needs and preferences.
If my Turkish isn't very good, can I still have CBT in Turkish?
Yes. Many second- or third-generation people find it easier to talk about some subjects in Turkish and others in the language of the country where they live. Switching languages during a session, or saying a word in another language, is natural.
Is it compulsory to do homework between sessions?
It is not compulsory, but it is an important part of CBT. Work between sessions carries what you have learned into daily life. Homework is decided together in a way that suits your time and circumstances.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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