A CBT approach to Eco-Distress: Results and lessons from a single case study

ntroduction: The climate and ecological crises have severe implications for planetary and human health. Eco-distress is one impact, and describes a range of often painful thoughts and feelings that arise alongside increasing aware of the realities of the threats we face. It is thus both a rational response and a painful experience. CBT therapists need to consider the best ways of working with clients reporting eco-distress.
Methods: This single case experimental design describes the experiences of a 34-year-old British woman who presented to therapy with eco-distress associated with anxiety and low mood. A Cognitive Behavioural formulation was co-developed, from which a treatment protocol was followed. Seven on-line CBT sessions were completed, with a six-week follow up. Levels of anxiety, depression and climate emotions were assessed at baseline, each session and at follow ups.
Results: Symptoms of anxiety and low mood improved. Improvement was seen in some clusters of eco-emotions, but not others. Qualitative feedback indicated a high level of satisfaction with outcome, including a belief that attempting to completely remove eco-distress was unhelpful and unrealistic, and the patient’s relationship to their eco-distress was changed, from something undesirable, to an important sign of their humanity and care for the world.
Conclusion: Adapting existing models of CBT for working with eco-emotions is a potentially helpful approach. Important considerations for this way of working are discussed, including what a successful outcome means. Implications for future research is considered.