What Is Cognitive Behavioral Therapy (CBT) and How Does It Work?

What Is Cognitive Behavioral Therapy?

Cognitive-behavioral therapy (CBT) is a type of psychotherapy treatment that teaches people how to recognize and change harmful or troubling thought patterns that affect their behavior and emotions.

Cognitive-behavioral therapy focuses on modifying automatic negative thinking that can exacerbate emotional problems, sadness, and anxiety. These irrational negative thoughts have a negative impact on one’s mood.

CBT identifies these thoughts, challenges them, and replaces them with more objective, realistic ones.

Types of Cognitive Behavioral Therapy

CBT is a term that refers to a variety of strategies and approaches for dealing with ideas, emotions, and behaviors. Structured psychotherapies and self-help resources are examples of this. CBT is used in a number of different types of therapeutic treatments, including:

  • Cognitive therapy: The goal of cognitive therapy is to discover and change ineffective or erroneous thought patterns, emotional responses, and behaviours.
  • Dialectical behavior therapy (DBT): is a type of psychotherapy that focuses on thoughts and behaviours while also embracing techniques like emotional regulation and mindfulness.
  • Multimodal therapy: Behaviour, affect, sensation, imagery, cognition, interpersonal aspects, and drug/biological considerations are all included in multimodal therapy.
  • Rational emotive behaviour therapy (REBT): Identifying illogical thoughts, aggressively challenging these beliefs, and finally learning to recognise and change these thought patterns are all part of rational emotive behaviour therapy (REBT).

Where each style of cognitive-behavioral therapy has its own technique, they all aim to change the underlying thought patterns that cause psychological suffering.

Behaviour, affect, sensation, imagery, cognition, interpersonal aspects, and drug/biological considerations are all included in multimodal therapy.


CBT is about more than just recognizing thought patterns; it’s about applying a variety of tactics to help people overcome them. Journaling, role-playing, relaxation techniques, and mental distractions are some of the approaches that can be used.

1. Identifying Negative Thoughts

Learning how ideas, feelings, and situations might contribute to maladaptive behaviors is critical. The approach can be challenging, especially for persons who have trouble with introspection, but it can eventually lead to self-discovery and insights, which are crucial to the therapy process.

2. Practising New Skills

It’s critical to begin practicing new abilities so that they can be applied in real-life circumstances. A person with a substance use disorder, for example, can begin practicing new coping skills and rehearsing methods to avoid or deal with social situations that could lead to relapse.

3. Goal-Setting

Setting goals can be a helpful tool in recovering from mental illness and making adjustments to improve your health and quality of life.

A therapist can assist you with goal-setting skills during CBT by teaching you how to identify your goal, differentiate between short- and long-term goals, develop SMART (specific, measurable, achievable, relevant, time-based) goals, and focus on the process rather than the end result.

4. Problem-Solving

Learning problem-solving skills can assist you in identifying and resolving issues that occur from both large and small life pressures, as well as reducing the negative effects of psychological and physical sickness.

In CBT, problem-solving usually involves five steps:

  1. Identifying an issue is the first step.
  2. Making a list of potential solutions
  3. Considering the advantages and disadvantages of each feasible solution
  4. Choosing a solution to put into action
  5. Putting the plan into action

5. Self-Monitoring

Self-monitoring, also known as diary work, is a crucial aspect of CBT that entails keeping track of your actions, symptoms, and experiences over time and sharing them with your therapist.

Self-monitoring can help your therapist get the information he or she needs to provide you with the best treatment possible. Self-monitoring, for example, for those with eating disorders may entail keeping track of eating behaviors as well as any thoughts or sensations that came with eating that meal or snack.

What CBT Can Help With

Cognitive behavior therapy is a short-term treatment that teaches people to focus on their current thoughts and ideas.

CBT is used to address a variety of issues, including:

CBT has been shown to assist patients to manage the following issues in addition to mental health issues:


CBT is based on the idea that thoughts and feelings have a significant impact on one’s behavior. 1 A person who spends a lot of time worrying about plane crashes, runway accidents, and other aviation tragedies, for example, may avoid flying.

Cognitive behavior therapy aims to teach people that, while they may not be able to control every part of their environment, they can manage how they understand and respond to it.

The following fundamental advantages of CBT are well-known:

  • It enables you to adopt healthy thought patterns by recognising the negative and frequently unrealistic beliefs that diminish your sentiments and moods.
  • It’s a good short-term treatment choice; for example, you can observe results after five to twenty sessions.
  • It has been demonstrated to be useful in the treatment of a wide range of maladaptive behaviours.
  • It is frequently less expensive than other forms of therapy.
  • It has been found to be successful both online and in person.

It’s appropriate for people who don’t need psychotropic drugs one of the most important advantages of cognitive-behavioral therapy is that it aids in the development of coping skills that may be used now and in the future.


CBT was developed in the 1960s as a result of psychiatrist Aaron Beck’s observations that certain ways of thinking related to emotional difficulties. Beck coined the term “automatic negative thoughts” and devised the cognitive therapy procedure to address them.

Whereas previous behavior therapies concentrated almost entirely on associations, reinforcements, and punishments to change behavior, the cognitive approach focused on how ideas and feelings influence behavior.

  • Cognitive behavioural therapy is now one of the most well-studied types of treatment, having been proven to be beneficial in the treatment of anxiety, depression, eating disorders, insomnia, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and drug use disorder.
  • CBT is the most well-researched eating disorder treatment.
  • CBT has been shown to benefit those with insomnia as well as those with a general medical condition that prevents them from sleeping, such as pain or mood disorders like depression.
  • The effectiveness of cognitive behavioural therapy in treating symptoms of depression and anxiety in children and adolescents has been clinically demonstrated. 
  • CBT assisted persons with anxiety and anxiety-related illnesses, such as obsessive-compulsive disorder and post-traumatic stress disorder, according to a 2018 meta-analysis of 41 research.
  • 12 CBT has a lot of evidence behind it when it comes to treating substance use disorders. It can help you gain self-control, avoid triggers, and establish coping methods for everyday stressors.

CBT is one of the most investigated types of therapy, in part because it focuses on very precise goals with quantifiable outcomes.

Things to Consider

During the course of cognitive-behavioral therapy, clients may face a number of difficulties.

1. Change Can Be Difficult

Some patients first claim that while they are aware that certain thoughts are not rational or healthy, simply being aware of them does not make it simple to change them.

2. CBT Is Very Structured

Other treatments, such as psychoanalytic psychotherapy, tend to focus more on underlying unconscious resistances to change than cognitive-behavioral therapy. 14 It is frequently best suited for clients who prefer an organized and concentrated approach in which the therapist frequently acts as an instructor.

3. People Must Be Willing to Change

Individuals must be willing to devote time and effort to evaluate their ideas and feelings in order for cognitive behavioral therapy to be effective. Although self-analysis and homework can be challenging, they are an excellent way to learn more about how interior moods influence external action.

4. Progress Is Often Gradual

In most circumstances, CBT is a gradual procedure that helps a person change their behavior in little steps. Someone suffering from social anxiety, for example, would begin by visualizing anxiety-inducing social scenarios.

They may then begin practicing discussions with friends, family, and strangers. The process appears less overwhelming and the goals appear easier to achieve by gradually working toward a larger goal.

How to Get Started

For a variety of psychiatric disorders, cognitive behavior therapy can be a useful treatment option. Consider the following actions if you or someone you care about might benefit from this type of therapy:

  • Consult with your physician: and/or check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a licensed professional in your area.
  • Contact your health insurance: Check with your health insurance to check if CBT is covered and, if so, how many sessions per year are covered.
  • Expect your initial experience to be similar to a doctor’s appointment: Filling out documentation including HIPAA papers, insurance information, medical history, current medications, a questionnaire about your symptoms, and a therapist-patient service agreement should be similar to what you’d expect at a doctor’s appointment. You’ll most likely fill out these documents online if you’re in online counselling.
  • Be prepared to answer questions: Prepare to discuss what brought you to therapy, your symptoms, and your background, including your childhood, schooling, work, relationships (family, romantic, and friends), and current living circumstance.

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