What Is Cognitive Behavior Therapy?

Updated August 27, 2020

Medically Reviewed By: Tonia Cassaday

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. 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 issues are distinctly different, the appropriate treatment is exactly the same.

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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 issues and other types of problems. Mayo Clinic lists some of the disorders that cognitive-behavioral therapy is appropriate for are:

  • Depression
  • Anxiety disorders
  • Alcohol and drug abuse
  • 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 women friends, you’ll notice that two of them were dealing with specific diagnoses—one with lifelong anxiety and one with substance abuse. 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, cognitive behavioral therapy is an appropriate treatment for her condition, which should improve with time. This is significant because cognitive behavioral therapy is effective for a wide variety of issues 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 types of therapy.

Is Cognitive Behavioral Therapy (CBT) Effective?

Numerous research studies have shown that cognitive-behavioral therapy leads to a notable improvement in how people function and their quality of life. In fact, this type of therapy has proven to be as effective or more effective than other psychological therapy or psychiatric medications.

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Researchers have made many advances around cognitive behavior on the basis of research and clinical practice and these new methods have produced meaningful change.

What Are the Principles of Cognitive Behavioral Therapy?

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

  1. Psychological problems are at least partly based on faulty or unhelpful thought patterns.
  2. Psychological problems are at least partly based on patterns of unhelpful behaviors that are learned.
  3. People that deal with psychological problems can learn better coping strategies that will relieve their symptoms and lead to happier, healthier lives.

The premise behind cognitive behavioral therapy is to get people to change their thinking patterns. During the course of therapy, clinicians work with clients to help them learn to recognize distortions in their thinking that are causing problems in their lives. Once clients can accomplish this, the therapist can help them reevaluate and apply their new thinking patterns to their lives.

Cognitive-behavioral therapy 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.

Some therapies add another component of cognitive-behavioral therapy 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.

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. Therapy sessions can help people improve their relationships and communication, cope with physical illnesses, manage chronic physical symptoms, overcome emotional trauma, and prevent a relapse of mental illness.

What Are the Risks Associated with Cognitive Behavioral Therapy?

There aren’t any significant risks in pursuing cognitive behavioral therapy. At the same time, if it’s the type of therapy 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.

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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. Sometimes you’ll leave a session feeling mentally and emotionally drained. These are actually good signs because they validate the fact that you’re able to start releasing these painful emotions which is part of the healing process. This is especially true for a part of cognitive behavior therapy called exposure therapy for people that struggle with fear and anxiety. In this type of therapy, the clinician exposes their client to the things they’re afraid of in small doses. While exposure therapy causes stress or anxiety initially, over time, it helps people overcome their fears by helping them face them.

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

How Long Will Cognitive Behavioral Therapy Take?

In most cases, cognitive behavioral therapy works over the short term. People often feel the benefits of their therapeutic sessions after five to twenty sessions. Your therapist will talk with you early on about what your therapeutic goals are. How many sessions you’ll need depends on the reason that you scheduled therapy, 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.

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 therapists 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. Another exception to the confidentiality rule is when a therapy session reveals that the client has abused a child or vulnerable adult, or who is unable to safely care for themselves.

What You Can Expect from Cognitive Behavioral Therapy

The expectation of cognitive behavioral therapy isn’t necessarily to cure your disorders or the issues that motivated you to seek therapy. 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. Your problems may or may not go away, but what you gain from cognitive behavioral therapy is the power to cope with your problems or situations in a healthier manner, which will give you a better outlook on yourself and your life.

The reality is that cognitive behavioral therapy works better for some people than others. You are a central component to the success of your therapy. Cognitive-behavioral therapy will work best for you when you fully engage in the process. You’ll likely have better success when you can come to an agreement with your therapist about the major issues that you’re dealing with and how to tackle them.

Much of whether your therapy 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 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 help you express them.

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Fortunately, you don’t have to decide whether cognitive behavioral therapy is right for you.

What you can do to help yourself is to seek professional help by scheduling an appointment with a licensed therapist that can help diagnose your issues and determine the best course of treatment which may include cognitive behavioral therapy or some other appropriate treatment.


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