Cognitive behavioral therapy (CBT) can help you identify and replace negative or damaging behaviors learned in your past. It can be helpful to people with various mental health conditions.
Cognitive behavioral therapy (CBT) is a treatment approach that helps you recognize negative or unhelpful thought and behavior patterns.
CBT aims to help you identify and explore the ways your emotions and thoughts can affect your actions. Once you notice these patterns, you can begin learning how to change your behaviors and develop new coping strategies.
CBT addresses the present and focuses less on the past. However, therapy is not a one-size-fits-all. Understanding how CBT can help you cope with stressors may help you determine if it’s the best fit for you.
CBT is largely based on the idea that your thoughts, emotions, and actions are connected.
It examines how life experiences shape your worldview and self-perception, which can influence the way you think and behave. In other words, the way you think and feel about something can affect what you do.
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Typical treatment often involves the following:
- learning new problem-solving skills
- learning how to face fears and challenges
- recognizing how inaccurate thinking can worsen problems
- gaining confidence and a better understanding and appreciation of your self-worth
- using role play and calming techniques when faced with potentially challenging situations
It’s a flexible approach that can be accommodated to your needs. For example, you may choose to meet with your therapist virtually or in person.
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With time, the skills you learn in therapy can be applied directly to everyday life. These skills can help you cope with challenging issues during the course of therapy and beyond.
Subtypes
There are various forms of therapy that fit under the CBT umbrella. These subtypes include:
- Exposure therapy: This type of therapy involves slowly introducing anxiety-inducing activities or situations into your life for measured periods of time. This subtype can be particularly effective for people who deal with phobias or obsessive-compulsive disorder (OCD).
- Dialectical behavior therapy (DBT): DBT incorporates things like mindfulness and emotional regulation through talk therapy in an individual or group setting. This subtype can be particularly effective for people who live with borderline personality disorder (BPD), eating disorders, or depression.
- Acceptance and commitment therapy (ACT): ACT is a therapy that involves learning to accept negative or unwanted thoughts. This subtype may be particularly effective for people who experience intrusive thoughts or catastrophic thinking.
- Mindfulness-based cognitive therapy (MBCT): MBCT uses mindfulness techniques and meditation along with cognitive therapy. This subtype can be particularly effective for people who live with post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD).
- Rational emotive behavior therapy (REBT): REBT is the original form of CBT and focuses on negative thought patterns and how they influence issues with emotions or behaviors. This subtype can be particularly effective for anything from anxiety, depression, and sleep issues to addictive behaviors and more.
CBT is one of the most studied therapy approaches. In fact, many experts consider it to be the best treatment available for a number of mental health conditions, such as:
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Positive symptoms are symptoms that are added to your current baseline abilities rather than taken away from them. For instance, you may experience sights and sounds that don’t actually exist.
However, more research is needed to determine the efficacy of using CBT to treat negative symptoms, such as low motivation and social isolation.
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The review emphasizes gaps in research on using CBT to treat eating disorders. More research is needed, and caution should be used. Especially since research is limited on its efficacy for anorexia nervosa.
But you don’t need to have a specific mental health condition to benefit from CBT. It can also help with:
Some people even turn to CBT for help coping with chronic health issues like irritable bowel syndrome, chronic fatigue syndrome, and fibromyalgia.
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Therapy can challenge you emotionally. It often helps you get better over time, but the process can be difficult.
For example, a large study of people between the ages of 11 and 21 indicates that CBT treatment offers long-term results in reducing anxiety disorder symptoms. At follow-up, nearly 4 years after completing therapy, more than half of the participants in the study no longer met the criteria for anxiety.
While CBT can be helpful for many people, it does not work for everyone. Consider speaking with your therapist about other types of therapy that may better support you.
CBT involves the use of many varied techniques. Your therapist will work with you to find the ones that work best for you.
The goal of these techniques is to replace unhelpful or self-defeating thoughts with more encouraging and realistic ones.
These are some of the most popular techniques used in CBT:
- SMART goals: SMART stands for goals that are specific, measurable, achievable, realistic, and time-limited. Your therapist may work with you to set SMART goals and work toward them.
- Guided discovery and questioning: Your therapist can help you challenge unhelpful thoughts and consider different viewpoints. They may do this by questioning how you view yourself or a stressful situation.
- Journaling: You might be asked to write down negative beliefs that come up during the week and the positive ones you can replace them with.
- Self-talk: Your therapist may ask what you tell yourself about a certain situation or experience. They will then challenge you to replace negative or critical self-talk with compassionate, constructive self-talk.
- Cognitive restructuring: This involves examining any cognitive distortions affecting your thoughts and beginning to unravel them. Cognitive distortions may include black-and-white thinking, jumping to conclusions, or catastrophizing.
- Thought recording: In this
technique , you’ll record thoughts and feelings experienced during a specific situation, then come up with unbiased evidence supporting your negative belief and evidence against it. You’ll use this evidence to develop a more realistic thought. - Positive activities: Scheduling a rewarding activity each day can help increase overall positivity and improve your mood. Some examples might be buying yourself fresh flowers or fruit, watching your favorite movie, or having a picnic lunch at the park.
- Situation exposure: This involves listing situations or things that cause distress in order of the level of distress they cause and slowly exposing yourself to them until they lead to fewer negative feelings.
- Systematic desensitization: Similar to situation exposure, systematic desensitization involves learning relaxation techniques to help you cope with your feelings in a difficult situation.
Homework is another important part of CBT, regardless of the techniques you use. Just as school assignments help you practice and develop the skills you learned in class, therapy assignments can help you become more familiar with the skills you’re developing.
This might involve more practice with skills you learn in therapy, such as replacing self-criticizing thoughts with compassionate ones or keeping track of unhelpful thoughts in a journal.
Beginning therapy can seem overwhelming. It’s OK to feel nervous about your first session. You might wonder what the therapist will ask. You may even feel anxious about sharing your difficulties with a stranger.
CBT sessions tend to be very structured, but your first appointment may look a bit different.
Here’s a high-level look at what to expect during that first visit:
- Your therapist will ask about the symptoms, emotions, and feelings you experience. Emotional distress often manifests physically, too. Symptoms such as headaches, body aches, or stomach upset may be relevant, so it’s a good idea to mention them.
- They’ll also ask about the specific difficulties you’re experiencing. Feel free to share anything that comes to mind, even if it doesn’t bother you too much. Therapy can help you cope with any challenges you experience, large or small.
- You’ll go over general therapy policies, such as confidentiality, and talk about therapy costs, session length, and the number of sessions your therapist recommends.
- You’ll talk about your goals for therapy or what you want from treatment.
Feel free to ask any questions you have as they come up. You might consider asking:
- about trying medication along with therapy, if you’re interested in combining the two
- how your therapist can help if you’re having thoughts of suicide or find yourself in a crisis
- if your therapist has experience helping others with similar concerns
- how you’ll know therapy is helping
- what will happen in the other sessions
In general, seeing a therapist you can communicate and work well with will help you get the most out of your therapy sessions. If something doesn’t feel right about one therapist, it’s perfectly OK to see someone else. Not every therapist will be a good fit for you or your situation.
Consider visiting our resource page for steps you can take to find a therapist that fits your needs.
CBT is often considered the
- psychodynamic therapy
- behavioral therapy
- humanistic therapy
Learn more about their similarities and differences below.
| Types of therapy | Therapeutic approach | Useful for addressing |
|---|---|---|
| Cognitive behavioral therapy (CBT) | how to identify harmful patterns and beliefs that negatively affect you | • mood disorders • anxiety and phobias • eating disorders • substance use disorder • OCD • insomnia |
| Psychodynamic therapy | examining emotions, relationships, and thought patterns to explore the connection between your subconscious mind and actions | • depression • anxiety • eating disorders • somatic symptoms • substance use disorder |
| Behavioral therapy | often focused on current issues, action-oriented approaches are offered to change behavioral responses that cause you distress | • anxiety • phobias • substance use disorder • ADHD • OCD • other behavioral issues |
| Humanistic therapy | often focused on your day-to-day life, observing how your individual worldview affects the choices you make and how you can develop true self-acceptance | • self-esteem issues • effects of trauma • depression • relationship issues • feelings of worthlessness |
The type of therapy that works best for you will depend on several factors. Consider visiting our guide on different types of therapy to explore which one may best suit your needs.
Online therapy options
Read our review of the best online therapy options to help find the right fit for you.
What does a cognitive behavioral therapist do?
Typical CBT treatment involves identifying personal beliefs or feelings that negatively affect your life and learning new problem-solving skills. Your therapist will help you gain confidence and better understand and appreciate your self-worth. They’ll also support you in facing your fears and learning to use calming techniques during challenging situations.
There are a number of techniques your therapist might use during a session, but some of the most popular involve:
- setting achievable goals
- practicing cognitive restructuring
- journaling
- undergoing situation exposure
A cognitive behavioral therapist will often assign homework to help you practice the skills you learn in therapy, such as replacing self-criticizing thoughts or journaling.
What are some cognitive behavioral interventions?
There are a number of interventions or techniques used during CBT.
All cognitive behavioral interventions share a number of general characteristics, including:
- therapist-client collaboration
- an emphasis on environment-behavior relations
- a time-limited and present focus
Common CBT techniques include:
- thought recording and journaling
- exposure therapy
- role-playing
What can I expect in CBT?
CBT focuses on finding ways to change current thought patterns and behaviors that negatively affect your life. It provides you with tools to solve problems you’re currently going through.
While you and the therapist should set specific goals, the general aim of CBT is to reframe negative thoughts into positive feelings and behaviors.
CBT can last weeks or months. Some people have one session each week and six to 20 sessions in total. However, the number of sessions you have and how often you have them will depend on what you and your therapist have agreed is best for you.
Sessions are flexible and offered in various formats. You can attend in-person sessions that are either individual or group. Some people even get CBT online or via phone.
What are examples of cognitive behavioral therapy?
Examples of CBT techniques might include the following:
- Exposing yourself to situations that cause anxiety, like going into a crowded public space.
- Journaling about your thoughts throughout the day and recording your feelings about your thoughts.
- Engaging in mindfulness meditation, where you tune into the thoughts that come into your mind and let them pass without judgment.
- Looking at overwhelming tasks in a new way by breaking them up into smaller, more manageable sections.
- Scheduling activities that make you nervous or give you anxiety.
- Role-playing to practice social skills or improve your communication skills.
What is the goal of CBT?
People come to therapy for a variety of reasons, so the individual goal will vary by person. With CBT, the ultimate goal is to focus on the relationship between thoughts, feelings, and behaviors.
Through therapy, exercises, and homework, a therapist encourages people to recognize and gain control over their automatic thoughts and to learn ways to change their behaviors. As a result, a person may feel better, leading to a more positive cycle between these three things.
CBT may be a good therapy choice if you’re looking for something that focuses on your current problems rather than those that happened in the past.
CBT is a short-term therapy that requires active involvement. Meeting with a therapist can help you identify your therapy goals and discover whether CBT or its subtypes are the right choice for your particular situation.
If CBT isn’t what’s best for you, there are other types of therapy that may be a better fit. Reach out to a doctor or a licensed mental health professional for help navigating the options.