What Is Cognitive Behavioral Therapy?

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Cognitive behavioral therapy, or CBT, is a therapeutic approach used to treat mental illness. CBT can be an effective treatment for many concerns, from anxiety to trauma to eating disorders.

Some experts call CBT the “gold standard” of treatment for its high levels of research and effectiveness.

With CBT, a trained mental health professional provides specific guidance and steps to follow during a limited number of sessions. It usually includes homework.

The steps are based on the idea that thoughts and behavior are connected, and that by changing faulty or incorrect thinking to more helpful thoughts, unhealthy behaviors can also change. CBT also involves adopting behaviors that lead to healthier ways of coping.

Client meeting with a therapist to discuss their mental health.

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What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is rooted in the idea that most emotional and behavioral reactions come from our way of thinking about ourselves and the world around us.

CBT can be used to treat a number of different mental health problems. It was first developed as a general approach to change thoughts and behaviors.

Over time, CBT has been developed to include specific approaches for various types of mental illness. For example, TF-CBT is a trauma-focused CBT approach, and CBT-E is specific to those with eating disorders. Regardless of the condition, however, the steps to following CBT are generally the same.

CBT Steps

CBT usually lasts anywhere between five and 20 sessions. The first step in the CBT process is identifying the conditions and challenges being experienced. A general discussion will allow the therapist to understand the nature of the problem and its impact or level of disruption.

The second step involves thinking through the feelings that each issue brings, along with the behaviors that occur in response to the issue.

Next, a therapist helps identify faulty thinking or unhelpful thoughts. This may mean noticing thoughts that are illogical outside of the therapy session.

Finally, negative or unhealthy thoughts are challenged and changed to more realistic, healthy ones. This step may also include changing behaviors that reinforce or encourage negative thinking.

What Are Unhealthy Thoughts?

An example of faulty thinking would be saying to yourself, “I always fail math tests. I’m so stupid.” As a result of this thinking, you might change your behavior to giving up on studying or trying to do well, because you don’t see the point in doing so.

With CBT, this thinking would be challenged, and new behaviors would be encouraged to bring out healthier thoughts and more useful behaviors.

Changing Thought Patterns and Behaviors

One of the main features of CBT is helping people understand when their thinking is faulty, incorrect, or illogical. The idea is to guide people toward their own conclusions to encourage their ability to recognize when these thought patterns emerge and eventually how to intervene to change them without assistance.

Another key component of CBT is looking at unhealthy behaviors and changing them to responses that encourage and support healthy ways of coping. For example, drinking alcohol in response to feeling inadequate in social situations would be challenged through CBT and then changed to a healthier way of responding when related thoughts or feelings emerge.

Journaling or other activities are also often assigned to work on outside of the therapy session to help identify patterns and reinforce new behaviors.

When Is CBT Used?

One of the benefits of using CBT is that it can generally be effective for many different complaints and mental health concerns. CBT can also assist in quickly being able to identify and notice faulty thinking and unhelpful behaviors, which allows for a quicker path to healing.

CBT Is One of the Most Common Types of Treatment

One study found that 67% of social workers use CBT as their main form of treatment in therapy.

CBT is used when thought patterns are at the root of the complaint. In order for CBT to be effective, the person seeking treatment must take an active role in recognizing and changing their way of thinking, and they must be willing to help drive the treatment.

How Does CBT Help?

Cognitive behavioral therapy as a treatment method has been highly researched. One of the reasons CBT is so helpful is that it provides clear steps to follow to encourage healthy changes.

CBT can be used as a complete approach to treatment where all of the steps are followed and the therapy sessions are terminated once all steps have been worked through.

CBT can also be used as part of another treatment approach to help point out illogical thinking. For example, in the course of treatment, a person may state, “I’m a terrible friend.”

The therapist would then challenge that thinking by asking for examples where the person demonstrated being a good friend, by asking the person to change the sentence into a more accurate statement, and/or by encouraging new behaviors that support being a good friend.

These are all elements of a CBT approach.

CBT Incorporates Patient Involvement

Another reason CBT is so effective is that it asks the person seeking treatment to be an active participant in the healing process. The individual and the therapist work together to identify problem areas, the approach to addressing those concerns, and any adjustments that should be made along the way. This helps by:

  • Helping people to see that they are experts on their own lives
  • Empowering them to see how they can change unhealthy thoughts to develop healthier behaviors and responses
  • Teaching them to recognize when thoughts and beliefs are illogical or unhelpful and when to make changes

Research shows that the more a person can be involved in the treatment, the more likely the person will see ongoing improvements.

Summary

Cognitive behavioral therapy can be a very effective treatment method for many mental health concerns. The key to CBT working is to be open and honest in therapy and to approach the sessions as a joint effort with the therapist.

CBT takes people through a series of steps that can last between five and 20 therapy sessions, depending on the person, situation, and issues. During CBT, a person is asked to examine and identify thoughts that are faulty or illogical and replace them with more helpful ones. A therapist also helps to identify healthy behaviors to cope with any ongoing concerns.

CBT can be used on its own in treatment, or it can be combined with other treatment methods, including other therapeutic approaches and medication.

A Word From Verywell

If you’re struggling with a mental health concern, CBT could be an effective way to help you work through the issues you’re facing. Though CBT can be helpful for many people, the most important thing in therapy is finding someone who is qualified and who you feel comfortable working with and opening up to.

If you are interested in trying CBT in therapy, talk to your therapist about it. Remember that as hard as it may be, being open and honest in therapy will lead to feeling better more quickly, regardless of the treatment method.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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