Everything You Need To Know About CBT
Cognitive Behavioral Therapy (CBT) is one of the most famous and used forms of psychotherapy. It is also widely researched and thankfully, available. Today, CBT is used for anxiety, depression, or everyday stress, and many more difficulties.
CBT offers practical tools that can help clients think differently, feel better, and change behaviors that no longer serve them.
In this article, we’ll explore what CBT is, how it works, and what types of conditions it can treat. We will cover everything you need to know about CBT.
The Basics of Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a short-term and goal-oriented form of psychotherapy. It is effective for a wide range of emotional and psychological difficulties. In its essence, CBT is based on the concept that our thoughts, emotions, and behaviors are deeply interconnected. If we identify and challenge unhelpful patterns in our thinking, we can change the way we feel and behave, even if situations that we encounter don’t change externally.
The point of CBT is not to “think positively” or ignore or avoid difficult emotions. Instead, it’s about becoming aware of the thoughts that drive our emotions and behaviors. Furthermore, CBT encourages people to learn to evaluate thoughts more realistically and gradually shift their responses in healthier directions.
Cognitive Behavioral therapy is collaborative, structured, and present-focused. This makes it a good fit for people who want to develop practical coping skills and see measurable progress over time, as therapy moves forward.
What Is CBT?
CBT has its foundations dating back to the 1960s. Psychiatrist Aaron Beck noticed that his patients with depression often had negative automatic thoughts that distorted reality. They tended to ruminate and run in “circles” with their negative thinking patterns, maintaining their depression with it.
In relatively the same time, psychologist Albert Ellis also worked on his Rational Emotive Behavior Therapy (REBT), which focused on disputing irrational beliefs. Together, these approaches laid the foundation for modern CBT.
In its core, CBT has a simple idea: our thoughts, feelings, and behaviors are all connected. If you can change how you think, you can change how you feel and what you do.
Here’s an example:
Situation: You don’t get a reply to a text you sent.
Thought: “They’re ignoring me. I must have done something wrong.”
Feeling: Anxious, rejected.
Behavior: You avoid reaching out again and withdraw socially.
Now imagine a different thought: “They’re probably busy and will reply later.” That thought is more balanced, and you’re less likely to feel distressed or act out of fear.
CBT aims to help people recognize the automatic thoughts, like the first example, examine the evidence for and against them, and replace them with more helpful perspectives. Over time, this can lead to lasting changes in emotional responses and daily behavior, as automatic thoughts are examined and adjusted.
How CBT Works
CBT usually lasts between 6 and 20 sessions, depending on the particular issue or the difficulties that the person experiences. Sessions focus on current challenges rather than delving deeply into the past. While history and background are acknowledged and explored, the main emphasis is on how your current thinking patterns affect your mood and behavior. Since thought patterns are more or less constant, current events and thinking about them reflect preexisting thinking patterns.
Here’s how CBT typically works in practice, as explained by the American Psychological Association:
Assessment and Goal Setting
In the first few sessions, the therapist works with the client to understand their main concerns, identify patterns of thinking and behavior, and set specific goals for therapy. For example, a goal might be “reduce panic attacks to once per week” or “improve confidence in social situations.”
Identifying Cognitive Distortions
Once they set goals, the therapist supports the client as they recognize cognitive distortions, i.e., automatic thought patterns that are unhelpful, irrational, or biased.
Some common distortions include:
All-or-nothing thinking: Seeing things in black-and-white terms (“If I fail this, I’m a total failure”).
Catastrophizing: Expecting the worst possible outcome (“If I make a mistake, I’ll lose my job”).
Personalization: Blaming yourself for things outside your control (“If I worked more, the inflation wouldn’t have affected me”).
Mind reading: Assuming others are thinking negatively about you (“I didn’t ask him how his family is going, he must be thinking that I’m a heartless and selfish person”).
Once identified, these distortions are explored and challenged, trying to identify if there is objective evidence about those thoughts, or if any alternative explanations can be found for the results.
Behavioral Techniques
Changing negative thought patterns is just one part of CBT. From there, CBT uses behavioral directions to support emotional change. These might include:
Behavioral experiments: Trying new behaviors to test out beliefs. For example, someone who fears rejection might practice starting a conversation with a coworker.
Exposure therapy: Gradual and repeated exposure to feared situations, often used for anxiety and phobias.
Activity scheduling: Planning enjoyable or meaningful activities to combat avoidance and low mood.
Problem-solving training: Learning systematic ways to approach and manage stressful situations.
Homework and Practice
One of the defining features of CBT is its homework and self-practice between sessions. Self-work outside of sessions might include writing down automatic thoughts in a journal, practicing a new skill, or facing a feared situation. By working on these skills outside the therapy room, clients build confidence and reinforce their progress, understanding that they’ve made a step forward and building confidence to exercise what they’ve learned in therapy, without the help of the therapist.
If you want to learn more about Cognitive Behavioral therapy basics and some real-life examples, head over to our practical overview.
What Conditions CBT Can Treat or What Can CBT Help With
CBT is one of the most versatile psychotherapy modalities and is effective for a wide range of mental health conditions. Numerous studies have been done on the effectiveness of CBT. It is now recognized as one of the most effective treatments for a variety of mental health conditions. Here are some of the most common ones:
Anxiety Disorders
CBT is considered the gold standard treatment for anxiety disorders. This includes:
Generalized Anxiety Disorder (GAD)
Panic Disorder
Social Anxiety Disorder
Phobias
CBT for anxiety disorders helps clients reduce worry, fear, and negative thought patterns by cognitive restructuring, reinterpretation of physical symptoms, gradual exposure to anxious situations, and relaxation training.
Depression
When treating depression, CBT helps people identify the negative thought patterns (e.g., hopelessness, self-criticism) that contribute to rumination and low mood.
Through behavioral activation and changes like scheduling activities that provide a sense of pleasure or achievement, clients can start breaking the cycle of withdrawal and inactivity that often maintains depression.
Post-Traumatic Stress Disorder (PTSD)
CBT for PTSD involves trauma-focused interventions, like cognitive processing therapy or prolonged exposure to triggering situations.
These methods help people safely process traumatic memories and reduce avoidance, flashbacks, and hyperarousal. Relaxation techniques, on the other hand, serve as tools for better stress and trigger management.
Obsessive-Compulsive Disorder (OCD)
For OCD difficulties, CBT has a specialized form called Exposure and Response Prevention (ERP).
With ERP, the client is gradually exposed to feared thoughts or situations while preventing the compulsive behavior that normally follows. This form of exposure therapy helps clients better manage both their obsessive thoughts and their compulsive actions.
Eating Disorders
CBT is used to help individuals with anorexia, bulimia, and binge eating disorder.
For eating disorders, CBT helps clients identify distorted beliefs about body image, food, and self-worth. Behavioral techniques support changes in eating patterns and challenge perfectionism or control-related thinking.
Insomnia
CBT for insomnia (CBT-I) is a highly effective, non-medication modality that includes sleep hygiene education, cognitive restructuring of sleep-related anxieties, and behavior changes to improve sleep patterns.
Chronic Pain and Physical Health Issues
CBT can also help people cope with chronic conditions such as fibromyalgia, migraines, and irritable bowel syndrome.
When working with physical health issues, a CBT therapist can help clients address the emotional and cognitive aspects of chronic illness. With that, CBT techniques reduce the distress that may cause or promote physical issues and improve overall functioning and the body-mind connection.
Final Thoughts
Cognitive Behavioral Therapy is essentially a psychotherapy that aims to improve the mindset and automatic thought processes of clients, and with that, achieve behavior changes. But aside from that, CBT is a wonderful approach that gives clients a set of life skills. By learning to recognize how your thoughts influence your emotions and actions, you gain the power to respond to challenges with greater clarity, flexibility, and resilience.
If you’re curious about CBT, feel free to reach out and ask all the questions you may have. At EMDR Therapy Nashville, we are dedicated to helping clients with personalized treatment plans. The journey to changing your mind—literally and figuratively—begins with understanding how your thoughts shape your life.
Resources
Chand, S. P., Kuckel, D. P., & Huecker, M. R. (2023, May 23). Cognitive Behavior Therapy. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470241/#:~:text=Since%20then%2C%20it%20has%20been,substance%20abuse%2C%20and%20personality%20disorders.
What is Cognitive Behavioral Therapy? (n.d.). apa.org. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral therapy: A review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1