How does cognitive behavioral therapy work?

04 Dec 2019

Cognitive behavioral therapy, or CBT, is a short-term therapy technique that can help people find new ways to behave by changing their thought patterns.

Engaging with CBT can help people reduce stress, cope with complicated relationships, deal with grief, and face many other common life challenges.

CBT works on the basis that the way we think and interpret life’s events affects how we behave and, ultimately, how we feel. Studies have shown that it is useful in many situations.

More specifically, CBT is a problem-specific, goal-oriented approach that needs the individual’s active involvement to succeed. It focuses on their present-day challenges, thoughts, and behaviors.

It is also time-limited, meaning the person knows when a course will end, and they have some idea what to expect. Often, a course will consist of 20 one-to-one sessions, but this is not always the case.

It can also take the form of either individual or group sessions.

CBT is a collaborative therapy, requiring the individual and counselor to work together. According to the American Psychological Association (APA), the person eventually learns to become their own therapist.

Read on to find out more about what CBT involves and how it can help.

What is CBT?

CBT is a form of psychotherapy that focuses on how a person’s thoughts, beliefs, and attitudes affect their feelings and behaviors.

The APA note that CBT is based on a number of beliefs, including the following:

  • Unhelpful ways that people think can lead to psychological problems.
  • If people learn unhelpful behavior, this, too, can lead to psychological issues.
  • People can learn more beneficial ways of thinking and behaving.
  • New habits can relieve symptoms of mental and physical conditions and allow people to act in better ways.

Practitioners base CBT on the theory that problems arise from the meanings people give to events, as well as the events themselves. Unhelpful thoughts can make it difficult for a person to function confidently in different situations.

CBT can have a positive impact on how people feel and act and equip them with coping strategies that help them deal with challenges.

Research shows that CBT can offer support to people with depression, panic disorder, and various other health conditions. There is also growing evidence that it can help to relieve chronic pain.

CBT is a broad concept. Different types of CBT focus on various aspects of life. Some types address specific problems, for example, emotional or social challenges.

A course of CBT consists of a series of sessions, in which a counselor and an individual or group meet regularly and collaborate.

 What can you learn?

During a course of CBT, a person can learn to:

  • identify problems more clearly
  • develop an awareness of automatic thoughts
  • challenge underlying assumptions that may be wrong
  • distinguish between facts and irrational thoughts
  • understand how past experience can affect present feelings and beliefs
  • stop fearing the worst
  • see a situation from a different perspective
  • better understand other people’s actions and motivations
  • develop a more positive way of thinking and seeing situations
  • become more aware of their own mood
  • establish attainable goals
  • avoid generalizations and all-or-nothing thinking
  • stop taking the blame for everything
  • focus on how things are rather than how they think they should be
  • face their fears rather than avoid them
  • describe, accept, and understand rather than judge themselves or others

How do you learn?

Learning tools for CBT include:

  • regular one-to-one or group discussion sessions, or a combination of both
  • frequent feedback
  • role-playing activities
  • ways to calm the mind and body
  • gradually increasing exposure to things that cause fear
  • homework assignments
  • keeping a cognitive behavioral diary
  • practicing the skills learned to promote positive behavioral change and growth
What can it treat?

Therapists created the first CBT models around 50 years agoTrusted Source to treat depression. There are now models for treating a wide range of conditions, including:

  • panic disorder
  • post-traumatic stress disorder (PTSD)
  • generalized anxiety disorder (GAD)
  • insomnia
  • social phobia
  • childhood depression
  • anger
  • marital conflict
  • substance abuse and addiction
  • borderline personality
  • dental phobia
  • eating disorders
  • many other mental and physical conditions

Research has shown that CBT can reduce symptoms of health conditions than some other treatments are unable to relieve.

How does it work?

Some forms of psychotherapy focus on looking into the past to gain an understanding of current feelings. In contrast, CBT focuses on present thoughts and beliefs.

CBT can help people with many problems where thoughts and beliefs are critical. It emphasizes the need to identify, challenge, and change how a person views a situation.

According to CBT, people’s pattern of thinking is like wearing a pair of glasses that makes us see the world in a specific way. CBT makes us more aware of how these thought patterns create our reality and determine how we behave.

Changing distortions and perceptions

CBT aims to transform any ways of thinking and behaving that stand in the way of positive outcomes. For example, when a person has depression, their perceptions and interpretations become distorted.

A distorted view can make someone more susceptible to:

  • a negative mindset
  • jumping to conclusions
  • mistakenly seeing situations as catastrophic
  • seeing things as either good or bad with nothing in between

If people learn fearful or negative ways of thinking, they can start to think in this way automatically. CBT focuses on challenging these automatic thoughts and comparing them with reality.

If a person can change their way of thinking, their distress decreases and they can function in a way that is more likely to benefit them and those around them.

As the individual acquires new skills, it becomes easier for them to solve problems in a constructive way. This can reduce stress, help them to feel more in control, and reduce the risk of a negative mood.

An example: Dental phobia

A person with dental phobia, for example, fears going to the dentist because they believe they will experience severe pain or even death by having a dental procedure. This fear may have started with a previous negative experience, perhaps in childhood.

A CBT therapist can work with the person to address the faulty thinking which says “Because I had pain with a filling, all dental visits will be painful.”

Together, the client and the therapist can develop a plan to see dental treatment in a new way and overcome the fear.


CBT is a form of psychotherapy where a person learns to change their perceptions, and how they see things in their life. This can have a positive effect on behavior and mood.

CBT can help people with many problems, ranging from depression to chronic pain.

A counselor and client work together to identify goals and expected outcomes. The individual must be an active participant to benefit.

Anyone considering CBT should find a qualified professional. A doctor may be able to recommend CBT specialists locally.

Counseling and therapy can be costly, but self-help courses are also available.

In 2012, some researchersTrusted Source reported that an online self-help program for CBT was beneficial for people with chronic back pain. This could be promising as a cost-effective option for some people in the future.

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