What Is Cognitive Behavioral Therapy?

Often, when people think of therapy, they think of the same thing: a therapist sitting and listening to a patient talk about their past. However, many people don't realize that there is a wide variety of available therapy treatments. One of the most popular and effective forms of therapy is called cognitive behavioral therapy.

What is cognitive behavioral therapy?

While many people think of therapy as diving into deep childhood issues and repressed memory, Cognitive behavioral therapy definition focuses on finding solutions today instead of processing the root cause of where psychological issues or behavioral patterns are coming from. This link between negative thoughts and negative behavioral responses is known as successive approximation, and it's why difficult situations can cause people to react in organic and sometimes explosive ways. 

CBT targets that link and tries to build positive thoughts to encourage realistic responses and improved problem-solving skills. This form of therapy, significantly influenced by psychiatrist Aaron Beck, has been developed over several decades, with input from clinical trials and countless scientific studies.

The Mayo Clinic describes CBT as “a common type of talk therapy (psychotherapy) (the patient) works with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking to view challenging situations more clearly and respond to them more effectively."

CBT strategy works by helping patients understand how negative thoughts and negative emotions impact behavior. While our thoughts may be based on our experiences and past (such as our childhood), CBT strategies work to find a solution for the here and now rather than focusing on negative feelings of the past. 

CBT for various mental health conditions

CBT can treat a vast number of mental health challenges and mental illnesses. Some of these mental health conditions include anxiety disorders, post-traumatic stress disorder (PTSD), panic disorders, depression, substance use disorders, borderline personality disorder (BPD), and eating disorders, among others. Here are some of the studies behind the effectiveness of commonly diagnosed disorders. 

PTSD

Cognitive behavioral therapy has shown significant effectiveness in treating symptoms of PTSD by helping individuals identify and challenge cognitive distortions associated with their trauma. Through cognitive restructuring, a core CBT technique, therapists and clients work together to identify irrational beliefs and automatic negative thoughts that contribute to the person's psychological distress. Additionally, CBT for PTSD often incorporates relaxation training techniques, such as progressive muscle relaxation, to help manage the emotional responses triggered by trauma-related cues.

Eating disorders

In treating eating disorders, CBT focuses on changing maladaptive behaviors and thoughts related to food, body image, and self-worth. Therapists might use behavioral experiments to challenge the negative influence of particular behaviors and thoughts on the person suffering from an eating disorder. Cognitive restructuring can also help address spontaneous negative thoughts about body image and eating, promoting healthier coping strategies.

Anxiety disorders

For anxiety disorders, including panic disorder and social anxiety disorder, CBT might aim to reduce symptoms by teaching individuals to practice mindfulness and stay engaged in the present moment rather than being overwhelmed by fear. Techniques such as exposure therapy combined with response prevention allow individuals to confront their fears in a controlled manner, which may help reduce avoidance behaviors. Cognitive behavioral therapists might also focus on relaxation training to help manage physical symptoms of anxiety.

Obsessive-compulsive disorder

CBT for OCD primarily involves the use of exposure and response prevention (ERP), in which the therapist and client work together to expose the person to situations that trigger their compulsions without engaging in the same behavior. This approach may help break the cycle of compulsions and obsessive thoughts. Cognitive techniques focus on identifying and challenging the irrational beliefs and ideas that fuel OCD symptoms. By practicing these strategies, individuals learn to cope with life stressors and emotional triggers without resorting to compulsive behaviors.

Other negative patterns in thought and behavior can also be treated with CBT; for example, many people find CBT to help them learn stress management, improve coping skills, and enhance overall emotional health.

How CBT techniques are carried out

While cognitive behavioral therapy examples will vary based on your needs and mental health professional, there is a similar outline involved with each patient. Overall, CBT is a short-term therapy, which means that the number of sessions is already pre-determined based on the patient’s course of treatment. Within CBT, other therapies (such as cognitive processing therapy) are also an option. 

The first step in CBT is to identify negative thought patterns and mental illness symptoms that you want to address with your CBT therapist. This could be dealing with grief from the loss of a loved one, anger after a divorce, anxiety, depression, or even symptoms from other diagnosed mental health disorders. You will likely spend your first few sessions going over your emotional challenges and problematic behavior patterns so that your licensed mental health professional can develop a treatment plan. CBT strategies such as role-playing, exposure therapy, guided discovery, and talking through specific problems of daily life are often employed to help your therapist understand your exact symptoms and issues to target.

After that, your counselor will ask questions about your emotional difficulties. Questions will help get you talking and processing your thoughts about the topic. This is effective in helping you to identify any negative thoughts that you have in your head. This could include talking about your own experiences, relationships with people, or events you have experienced in your life. Your counselor may also give you homework assignments, such as journaling daily about your thoughts, implementing positive self-talk, and other forms of homework. Journaling can be a particularly great way to keep thought records that you can reference in future therapy sessions.

According to CBT Psychology, therapists often use worksheets during CBT to help a person develop positive feelings and coping mechanisms. Worksheets can serve as a therapist’s guide for the patient, even when the patient isn’t communicating at that moment. Exercises such as mindfulness meditation and writing exercises, like journaling, can help promote helpful behaviors to recover and ease past emotional trauma, medical illness, and other mental illnesses. Essentially, CBT is meant to encourage behaviors that modify core beliefs about oneself and one’s own life.

Once you've been able to identify negative thought patterns, you will start to see how those thoughts can often form a self-fulfilling prophecy and affect your emotions or behavior. This will teach you how to reshape and reprogram those thoughts into ones that will be more helpful for your situation and in your life. CBT can play a part in improving many mental health conditions, including anxiety, depression, and substance use disorders.

What to expect from your first session

When you meet with your counselor at first, they will need to take some time to get to know you and your situation. They may ask about your physical health and if you have any past experiences or challenges with mental health or mental illness symptoms, as well as if you have a medical condition like diabetes or chronic pain. Questions can help identify what form of psychological treatment will be the best for you or if you’ll need a combination of treatments and CBT techniques. 

This might not all happen in one therapy session, as cognitive reframing takes time. The more open you are with your counselor from the start, the easier it will be to get the needed information to start moving forward with your treatment plan. 

How to get the most out of CBT

CBT, like all forms of therapy, can be difficult and emotional to work through. By working with your counselor, you are learning how to think differently about situations that may have been very hurtful in your life. If you stick with the plan that your counselor provides you, you can find relief and experience long-lasting changes. To get the most out of your cognitive behavioral therapy sessions, there are several core principles to keep in mind.

• You must be willing to be honest. If you can't be honest during your sessions, CBT is not likely to work for you. 

• Follow through on the work that is given to you. If you want to see results from your cognitive behavioral therapy session, you’ll need to do what your therapist is telling you to do. This step is called behavior activation, and it is critical to your treatment success. For instance, if your counselor wants you to keep a journal until your next session, it’s probably part of their treatment strategy, and it’s in your best interest to do it. 

• Be willing to stick with it. Even though some forms of therapy may help you achieve results faster than others, there is no such thing as instant results. How many sessions you will need for treatment depends on the issues you’re working on and your timeline. Make your treatment a priority, and make sure to stick with your program to the very end of treatment!

• Don't be afraid to ask questions. You must be involved in this process throughout. If you have questions about why your counselor wants you to do something, or you aren't seeing the results you were expecting, it's okay to talk to your therapist about it. There may be some changes that your therapist can make to your treatment plan to help you better achieve your goals.

• Some people find therapy to be most effective in conjunction with psychiatric medications. You may wish to consider working with a psychiatrist or healthcare professional who can prescribe medications for mental health symptoms.

How to find a CBT provider 

There are many ways to find a behavioral provider. When you begin psychological therapy, whether it's CBT or another form, it's important that you feel comfortable with your therapist and their clinical practice. If you are uncomfortable, you are likely to have a difficult time opening up about personal things. This can cause a delay in your results, or you may see no improvement at all in your thought patterns or negative thoughts. 

If it seems that your counselor isn’t engaged or actively listening to you, don’t be afraid to find a new one- especially if you’ve been seeing someone for a while without results. The whole purpose of your therapy session is to improve your mental health. 

If you don’t know where to begin, you can ask for a referral from your doctor or your health insurance company. You can also ask friends and family for a personal recommendation for a counselor. You'll be surprised at how many people you know have been to therapy before. It can be helpful to have a personal recommendation, but remember that this is not a 100% guarantee that their therapist is going to be a good fit for you as well.

You can also try finding a therapist by doing a simple online search. Make sure that you check the online reviews from past clients, and don't be afraid to call and schedule an appointment to speak with them about your treatment.

When you’ve narrowed your list or found a therapist you want to work with, make sure you check their credentials. You also want to look for a therapist who is experienced with CBT treatment plans. While all licensed therapists should be familiar with cognitive behavioral therapy techniques, not all therapists will be experienced in using them.