What Is Cognitive Behavioral Therapy (CBT)?

Disorders that could benefits from cognitive behavioral therapy

Verywell / Daniel Fishel

In This Article

What Is Cognitive-Behavioral Therapy?

Cognitive-behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior and emotions.

Cognitive-behavioral therapy focuses on changing the automatic negative thoughts that can contribute to and worsen emotional difficulties, depression, and anxiety. These spontaneous negative thoughts have a detrimental influence on mood.

Through CBT, these thoughts are identified, challenged, and replaced with more objective, realistic thoughts.

CBT is about more than identifying thought patterns; it is focused on using a wide range of strategies to help people overcome these thoughts. Such strategies may include journaling, role-playing, relaxation techniques, and mental distractions.

Types of Cognitive Behavioral Therapy

CBT encompasses a range of techniques and approaches that address thoughts, emotions, and behaviors. These can range from structured psychotherapies to self-help materials. There are a number of specific types of therapeutic approaches that involve CBT:

  • Rational emotive behavior therapy (REBT) involves identifying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought patterns.
  • Cognitive therapy centers on identifying and changing inaccurate or distorted thinking patterns, emotional responses, and behaviors.
  • Multimodal therapy suggests that psychological issues must be treated by addressing seven different but interconnected modalities, which are behavior, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.
  • Dialectical behavior therapy (DBT) addresses thoughts and behaviors while incorporating strategies such as emotional regulation and mindfulness.

While each type of cognitive-behavioral therapy takes a different approach, all work to address the underlying thought patterns that contribute to psychological distress.

Uses

Cognitive-behavior therapy can be effectively used as a short-term treatment centered on helping people with a very specific problem. CBT is used to treat a wide range of conditions including:

Cognitive behavioral therapy is highly goal-oriented and focused, with the therapist taking a very active role. People work with their therapist toward mutually established goals. The process is explained in detail and people are often given homework to complete between sessions.

Impact

The underlying concept behind CBT is that thoughts and feelings play a fundamental role in behavior. For example, a person who spends a lot of time thinking about plane crashes, runway accidents, and other air disasters avoid air travel as a result.

The goal of cognitive behavior therapy is to teach people that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.

Cognitive behavior therapy has become increasingly popular in recent years with both mental health consumers and treatment professionals. Some reasons for this include:

  • By becoming aware of the negative and often unrealistic thoughts that dampen their feelings and moods, people are able to start engaging in healthier thinking patterns. 
  • CBT can be an effective short-term treatment option.
  • It can help people with certain types of emotional distress that don't require psychotropic medication.
  • It is empirically supported and has been shown to effectively help patients overcome a wide variety of maladaptive behaviors.
  • It is often more affordable than some other types of therapy.

One of the greatest benefits of cognitive-behavior therapy is that it helps clients develop coping skills that can be useful both now and in the future.

CBT Strategies

People often experience thoughts or feelings that reinforce or compound faulty beliefs. Such beliefs can result in problematic behaviors that can affect numerous life areas, including family, romantic relationships, work, and academics.

Identify Negative Thoughts

It is important to learn how thoughts, feelings, and situations can contribute to maladaptive behaviors. The process can be difficult, especially for people who struggle with introspection, but it can ultimately lead to self-discovery and insights that are an essential part of the treatment process.

Practice New Skills

It is important to start practicing new skills that can then be put in to use in real-world situations. For example, a person with a substance use disorder might start practicing new coping skills and rehearsing ways to avoid or deal with social situations that could potentially trigger a relapse.

Progress Gradually

In most cases, CBT is a gradual process that helps a person take incremental steps towards a behavior change. For example, someone with social anxiety might start by simply imagining anxiety-provoking social situations. Next, they might start practicing conversations with friends, family, and acquaintances.

By progressively working toward a larger goal, the process seems less daunting and the goals easier to achieve.

Potential Pitfalls

There are several challenges that people may run into during the course of cognitive behavioral therapy.

Change Can Be Difficult

Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simply becoming aware of these thoughts does not make it easy to alter them.

CBT Is Very Structured

Cognitive behavioral therapy doesn't tend to focus on underlying unconscious resistances to change as much as other approaches such as psychoanalytic psychotherapy. It is often best-suited for clients who are more comfortable with a structured and focused approach in which the therapist often takes an instructional role.

People Must Be Willing to Change

For cognitive behavioral therapy to be effective, the individual must be ready and willing to spend time and effort analyzing their thoughts and feelings. Such self-analysis and homework can be difficult, but it is a great way to learn more about how internal states impact outward behavior.

History

CBT emerged during the 1960s and originated in the work of psychiatrist Aaron Beck, who noted that certain types of thinking contributed to emotional problems. Beck labeled these 'automatic negative thoughts' and developed the process of cognitive therapy. 

Where earlier behavior therapies had focused almost exclusively on associations, reinforcements, and punishments to modify behavior, the cognitive approach addressed how thoughts and feelings affect behaviors.

Since then, CBT has emerged as an effective first-line treatment for a wide range of disorders and conditions.

CBT is one of the most researched types of therapy, in part because treatment is focused on highly specific goals and results can be measured relatively easily.

A Word From Verywell

Cognitive-behavior therapy can be an effective treatment choice for a range of psychological issues. If you feel that you might benefit from this form of therapy, consult with your physician and check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a professional in your area.

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Article Sources
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Additional Reading
  • Beck, J. S. Cognitive Behavior Therapy: Basics and Beyond. New York, NY: The Guilford Press; 2011.

  • Coull, G & Morris, PG. The Clinical Effectiveness of CBT-Based Guided Self-Help Interventions for Anxiety and Depressive Disorders: A Systematic Review. Psychological Medicine. 2011;41(11):2239-2252.