What Is Cognitive Behavioral Therapy?

By BetterHelp Editorial Team|Updated May 26, 2022
CheckedMedically Reviewed By Tonia Cassaday , LISW

Suppose three women had been friends since they were children. One of the women was diagnosed with anxiety when she was a teenager. Another of the women had a family and a demanding job, and the stressors of life caused her to drink alcohol to excess. The third woman had recently lost her husband due to a car accident. All three women sought professional clinical help in resolving their issues, whether that be through in-person or online therapy services. In having a conversation over coffee one morning, they discovered a fascinating similarity between them. Even though they were all dealing with different issues and they were seeing different therapists, they were all receiving the same type of treatment: cognitive behavioral therapy (CBT). While their mental and emotional concerns are distinctly different, the appropriate treatment modality in clinical psychology is exactly the same.

cognitive behavioral therapy can help for people living with depression, anxiety, and many other mental health challenges

The fact that all three women were receiving the same type of treatment is more than a coincidence. Cognitive behavioral therapy is a form of psychological treatment that’s effective for a wide range of mental health conditions and disordersMayo Clinic lists some of the disorders that CBT is appropriate for are:

  • Depression
  • Anxiety disorders
  • Drug and alcohol use
  • Marital problems
  • Eating disorders
  • PTSD
  • Phobias
  • Sleep disorders
  • Obsessive-compulsive disorder (OCD)
  • Bipolar disorders
  • Schizophrenia
  • Sexual disorders

If we go back to our example of the three friends, you’ll notice that two of them were dealing with specific diagnoses: one with lifelong anxiety and one with substance use. The third woman was going through the process of grief after the loss of her husband. While her reason for seeing a therapist isn’t related to a diagnosable mental health condition (such as a panic disorder), cognitive behavioral therapy is an appropriate treatment for her condition, which can improve with time. This is significant because CBT therapy is one of the therapeutic approaches that is effective for a wide variety of needs that don’t have any connection to mental health disorders.

Cognitive Behavioral Therapy (CBT) is a type of therapy where a psychotherapist or therapist uses a structured process to help their clients quickly become aware of negative or inaccurate thinking patterns so they can better cope and respond to them in a more effective manner. One of the benefits of behavior therapy is that it generally requires fewer sessions than other approaches, and patients usually notice improvement after the first few sessions. The evidence for cognitive behavior therapy is strong. Considered the "gold standard" of therapy today, as determined by this study, CBT creates positive effects through its reframing, so the client can continue to benefit from it beyond the therapy session. So what is CBT, and what are common CBT techniques?

Is CBT Effective?

Numerous research studies, clinical trials, and peer reviewed studies have shown that cognitive behavioral therapy leads to a notable improvement in how people function, emotional regulation, and their quality of life. In fact, the cognitive behavior therapy approach has proven to be as effective as or more effective than other psychological therapy or psychiatric medications. In clinical practice, CBT is a highly common psychological treatment.

Researchers have made many advances around cognitive behavior on the basis of research and clinical practice and these new methods have produced meaningful change. CBT therapists apply these techniques, sometimes in combination with other therapies, and sometimes prescribe medications, to treat their patients.

What Are The Principles Of CBT?

Besides having a specific structure, APA lists the core principles that form the basis of cognitive-behavioral therapy:

  • Psychological concerns are at least partly based on faulty or unhelpful thought patterns.
  • Disorders or conditions are at least partly based on patterns of unhelpful behaviors that are learned.
  • People who deal with psychological disorders or conditions can learn better coping strategies that will relieve their symptoms and lead to happier, healthier lives.

The premise behind CBT is to get people to change their thinking patterns bit by bit. During the course of counseling, clinicians work with clients to help them learn to recognize distortions in their thinking that are causing problems in their lives and perhaps influencing mental illness. Once clients can accomplish this, the therapist can help them reevaluate and apply their new thinking patterns to their lives.

CBT utilizes problem-solving skills to help clients better understand their behavior and the motivation behind it and how to implement coping strategies to address difficult situations. The process helps them to increase their confidence in their responses to others, and increase the use of healthy coping mechanisms.

Some therapies add another component of CBT in treating certain conditions which are helping clients to change their behavioral patterns. Behavioral strategies may assist individuals in how to face their fears rather than avoid them, use role-playing in anticipation of their interactions with others, and learn to relax their bodies and calm their minds. Eating disorders, anxiety disorders, substance use disorders, and mood disorders can all be improved by healthier thinking patterns from cognitive behavioural therapy.

Cognitive Behavioral Therapy for Emotional Disorders

Emotional challenges often accompany various mental illnesses and life’s challenges, as well. Cognitive-behavioral therapy is shown to help individuals improve their ability to manage their emotions because it helps them learn new techniques for how to cope with stressful situations, in addition to reframing negative thoughts. Cognitive behavior therapy sessions can help people improve their relationships and communication, reframe negative thoughts, cope with physical illnesses, manage chronic physical symptoms, overcome emotional trauma, practice healthy coping skills, and prevent a relapse of mental illness. 

What Are the Risks Associated with CBT?

There aren’t any significant risks in pursuing CBT. At the same time, if it’s the approach that your clinician feels will be best for you, you may want to be aware that certain sessions may make you feel emotional or even uncomfortable.

Try not to worry about that too much; it’s part of the process. Cognitive-behavioral therapy is a process that works to help you explore your experiences and emotions, which often include painful feelings. Don’t be surprised if during or after a challenging session you cry, get upset, or feel angry, though you should not feel psychological distress from Cognitive Behavioral Therapy CBT. Sometimes you’ll leave a session feeling mentally and emotionally drained. These are actually good signs for a response, because they validate the fact that you’re able to start releasing these painful emotions, which is a vital part of the healing process for adults. This is especially true for a part of CBT called exposure therapy for people who live with fear and anxiety. In this approach, the clinician exposes their client to the things they’re afraid of in small doses. While the exposure approach causes stress or anxiety initially, over time, it helps people overcome their fears by helping them face them. However, your therapist should also teach you relaxation techniques that you can use to self soothe after a session. 

Because these types of issues can be debilitating, it’s important to work with a licensed therapist who will help you make forward progress without causing mental or emotional setbacks.

How Long Will CBT Take?

In most cases, CBT works over the short term. People often feel the benefits of their therapeutic sessions after 5 to 20 sessions. Your therapist will talk with you early on about what your therapeutic goals are and make sense of what you want to achieve. How many sessions you’ll need depends on the reason that you reached out initially, the severity of your symptoms, how much stress you’re under, how long you’ve been dealing with your disorder of the situation, and other unique factors. If you are an active participant in your treatment, you're likely to see significant results. 

Consider that everyone is an individual and they all heal within their own timeframes. The length of time for your therapy will depend, in part, on how quickly you make progress. Cognitive behavioral therapy often works best when you have strong support from family members and friends, which can also have a bearing on the length of your treatment.

What Level of Confidentiality Can I Expect from My Therapist?

For the most part, your therapy sessions with your clinician are highly confidential. You should be aware that counselors are required to break confidentiality under certain situations. If you are participating in a session and you disclose that there is an immediate threat of safety to you or someone else, your therapist may be required by law to report it to the state or federal authorities.

These types of situations are typically limited to threatening to immediately take your own life or harm yourself in some other way or make threats of harming or taking the life of another person. (Note: If you or someone you know is experiencing thoughts about harming others or taking your life or theirs, do not hesitate to reach out for help at 1-800-273-8255 today.) Another exception to the confidentiality rule is when a session reveals that the client has abused a child or vulnerable adult, or who is unable to safely care for themselves. (Note: If you or someone you know has been abused or is perpetrating abuse, reach out for help at 1-800-799-7233.)

What You Can Expect from CBT

The expectation of CBT isn’t necessarily to cure your disorders or the concerns that motivated you to seek professional mental health help with a counselor. If that’s what you’re expecting, you may find that you’re disappointed. It’s important to come to terms with exactly how cognitive behavioral therapy can help you. The thoughts and feelings you are experiencing may or may not go away, but what you gain from cognitive behavioral therapy is the power to cope in a healthier manner, which may give you a better outlook on yourself and your life.

The reality is that CBT works better for some people than others. You are a central component to the success of your therapy. The psychological treatment of CBT will work best for you when you fully engage in the process with your mental health professional. You’ll likely have better results when you can come to an agreement with your therapist about the major issues that you’re dealing with and how to tackle them. This way, you won't be using up your energy on the wrong challenges.

Much of whether your sessions will truly be helpful to you depends on whether you’re able to be open and honest in sharing your thoughts and feelings, especially when it’s something that is hard. That doesn’t mean that you have to spill your every thought, experience, and emotion from the first session. You’re bound to uncover fears, painful emotions, or embarrassment during your sessions. When these uncomfortable feelings come to the surface, it’s the right time to communicate to your therapist that you’re struggling with them, so your therapist can help you find a way to express them. Bringing attention to the situation will help a lot.

Fortunately, you don’t have to decide whether CBT is right for you.

What you can do to help yourself is to seek professional help by scheduling an appointment with a licensed therapist who can help diagnose your issues and determine the best course of treatment which may include cognitive behavioral therapy or another therapy modality entirely better able to successfully meet your needs.

Online therapy cbt services offer you the privacy to speak about your well-being with mental health experts and psychologists who are trained to help you through mental health challenges, like self-esteem, anger, depression, anxiety, and more. Online counseling is growing in popularity with members, as it offers more options, privacy, and flexibility vs. traditional sessions in an office. A service like BetterHelp can help you take the next step in your life, helping you make positive changes in your day-to-day world.

Frequently Asked Questions

What does cognitive behavioral therapy do?

CBT is a type of talk therapy where a psychotherapist or therapist uses a structured treatment strategy or process to help their clients quickly become aware of negative or inaccurate thinking patterns so they can better cope and respond to them in a more effective manner. 

What are some cognitive behavioral therapy techniques?

Some examples of cognitive behavioral therapy techniques include: homework assignments to test new thought patterns and self talk, unlearning patterns of unhelpful behaviors, and learning coping skills that will help relieve symptoms associated with psychological disorders. Couples can also use CBT to boost their communication skills, increase positive relationship behaviors, and learn about assumptions that may be impacting each partner.

What is cognitive behavioral therapy give an example?

An example of CBT as mentioned above could be to treat a substance use disorder stemming from chronic pain. This could be done by developing a treatment plan with your therapist, attending group sessions to understand the struggles those in a similar situation go through, ensuring you are self monitoring your behavior, learning stress management techniques that could help with triggers to use different substances, and more. 

What are the 5 steps of CBT?

The 5 steps of CBT according to the APA are write down the upsetting situation, identify the most upsetting feeling you had in the situation, identify your thoughts about the situation that are underlying your upsetting feelings, evaluate the accuracy of your upsetting thought, and make a decision about whether your thought is accurate or not.

What are the 4 steps of cognitive restructuring?

The 4 steps of cognitive restructuring are making your automatic thoughts conscious, evaluate which thoughts are rational and which ones are not, identify why the problematic thoughts are problematic in the first place, and replace these irrational thoughts with a more rational thought. 

Can you learn CBT on your own?

One of the goals of CBT is to practice the teachings of your therapist, so learning CBT on your own is possible. While some may feel this is a better way to protect their health information, BetterHelp and similar online counseling platforms do an excellent job at ensuring health information is kept safe so privacy settings are always on and health insurance does not need to be involved. In addition, you can enroll easily online and have sessions by chat, phone, or video.

What are 3 basic principles concepts of CBT?

The three basic principles of CBT are identification, recognition, and management. 

According to the American Psychological Association, the three core principles of CBT in the United States are:

1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking

2. Psychological problems are based, in part, on learned patterns of unhelpful behavior

3. People suffering from psychological problems (panic disorders, eating disorders, post traumatic stress disorder, bipolar disorder, etc) can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives. 

What are the three main goals in cognitive therapy?

Three main areas in CBT include promotion of self-awareness, self-talk, and emotional intelligence by learning how to understand healthy vs unhealthy emotions, learning self-control techniques to identify and challenge distorted thinking, and preventing future distress by changing core beliefs. 

How can I practice CBT at home?

There are many ways to practice CBT at home, they all depend on what your goals are and what you are hoping to accomplish. For more information on getting involved in CBT practices, you can visit the Society of Clinical Psychology. 

What is the cognitive triangle?

The cognitive triangle is a diagram that depicts how our thoughts, emotions, and behaviors are all connected to one another and how they end up influencing one another. 

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