What is Cognitive Behavior Therapy?

Cognitive Behavior Therapy (CBT) is a form of psychotherapy that teaches people to become their own therapists. CBT is based on Dr. Aaron T. Beck’s Cognitive Model, which is the theory that the way individuals perceive a situation is more closely connected to their reaction than the situation itself. CBT is an evidence-based practice, which means that it has been scientifically tested. In fact, more than 2,000 studies have demonstrated that CBT is an effective treatment for many different health and mental health conditions.

In CBT treatment, trained therapists help clients identify distressing thoughts and evaluate how realistic these thoughts are. As clients become aware of their thoughts and are able to evaluate them, they feel better. CBT therapists also work with clients on solving problems, learning new skills, and setting and achieving meaningful goals. Although initially therapists and clients work together in session, therapists also empower clients by teaching them to evaluate their thoughts and practice their new skills on their own, outside of therapy.

When implemented correctly, CBT helps individuals get better and stay better.

Learn more about the history of CBT.

Dr. Judith Beck defines and discusses Cognitive Behavior Therapy (CBT).

How Does CBT Work?

CBT is based on the Cognitive Model which says that a person’s thoughts influence their behavioral, emotional, and physiological reactions to the situations in their lives.

When people are suffering from a mental health condition like depression or anxiety, they may feel negatively about themselves, others, the world, and the future. This can lead to patterns of unrealistic or unhelpful thoughts in their daily lives. These thoughts, in turn, can lead to unhelpful or maladaptive reactions, creating a feedback loop that can continuously reinforce underlying negative beliefs.

One of the goals of Cognitive Behavior Therapy is to interrupt that feedback loop by helping people evaluate their thoughts and think about the situations in their lives in more helpful ways. CBT therapists start by helping clients do this in session, but eventually teach clients to evaluate their thoughts on their own, outside of session.

How CBT Helps

CBT can help individuals with many health and mental health conditions learn lifelong skills to improve their lives and achieve their goals. But individuals don’t do this work alone. One of the most important aspects of CBT is the relationship between a client and their therapist, often called the therapeutic relationship. This relationship must be strong and collaborative for treatment to work.

CBT therapists work with each of their clients to set individual goals and to chart progress towards those goals. Therapists should also create what is called a “conceptualization” of each client, which helps them determine an individualized treatment plan for every client. Therapists should then explain the treatment plan, and any related skills and techniques, sometimes called interventions, to each client. If clients agree to the suggested interventions, then they work together with their therapists to learn these techniques and skills. Here are some of the most common techniques that therapists use to help clients feel better, cope with stress, improve their relationships, manage symptoms, and maintain their progress.

  • Identifying negative thoughts
  • Evaluating thoughts
  • Scheduling meaningful or pleasurable activities
  • Identifying values and aspirations
  • Setting goals and breaking goals down into small steps
  • Solving problems
  • Making decisions
  • Learning communication skills, including role-playing difficult conversations
  • Learning mindfulness skills
  • Tolerating distress, relaxation
  • Doing self-therapy between sessions, or after the conclusion of treatment

Specific Conditions CBT Can Help

What are CBT Sessions Like?

CBT treatment is tailored to each individual and is adapted to meet the needs of the client. A good CBT treatment plan carefully considers the client’s goals, values, presenting problems, symptoms, and demographics including culture, religion, language, sexual and gender identity and more. However, there are certain elements that are common to CBT treatment across a range of populations and settings. 

Does CBT Work?

CBT is the most extensively studied and widely practiced form of psychotherapy. When Dr. Aaron Beck developed CBT in the 1960s and 1970s, he knew he would need to demonstrate that his revolutionary treatment worked. In 1977, he and colleagues published the results of a landmark randomized clinical trial comparing CBT to anti-depressant medication. CBT became the first talking therapy demonstrated to be more effective than medication for the treatment of depression. In 1981, a UK-based research group published the results of a second study with the same findings.

Since then, more than 2,000 studies have demonstrated the efficacy of CBT for psychiatric disorders, psychological problems and medical problems with a psychiatric component.

Find a collection of research studies demonstrating the effectiveness of CBT in our research corner.

Types of Cognitive Behavior Therapy

Following on CBT’s demonstrated success, researchers and clinicians around the world have developed and tested a range of specialized treatments that build and expand on the theory behind CBT. Many of these treatments were designed to extend the benefits of CBT to special populations, diagnoses, or clinical settings. Here are some examples:

CBT protocols have also been developed for use in group settings, school settings, and medical settings such as primary care and hospital settings.

In addition, CBT has also inspired a range of other cognitive and behavioral-based therapies. These so-called “third wave therapies” include Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Cognitive Therapy (MBCT).

Things to Keep in Mind about CBT

It can be challenging: CBT believes that the way people get better is by making small changes in their lives every day. Don’t be surprised if you find yourself working on an “Action Plan” with your therapist. This collaborative plan will allow you to practice the new skills you’ve learned between sessions. Regular Action Plan completion is associated with better results in CBT.

It takes time: Although CBT is designed to be time-sensitive and clients often see improvement more quickly than with other types of therapy, you shouldn’t expect instantaneous results. Continuing to attend scheduled therapy sessions and completing your Action Plan between sessions will help you feel better faster.

Therapists and clients work together to make treatment effective: In CBT, the relationship between the therapist and the client is paramount. Therapists and clients work together to decide what to talk about in each session, how much time to devote to each issue being discussed, and what interventions would be most helpful.

Honesty is critical: Your CBT therapist should ask you regularly what you are finding helpful or unhelpful about treatment and whether there’s anything they may have gotten wrong. It’s important to be honest with your therapist. This is critical information that can help them improve their treatment plan and benefit you in the long run.

CBT sessions are highly structured: If you have tried other types of therapy, you may be used to a loose session structure, where you are encouraged to relate whatever is on your mind with minimal intervention by the therapist. CBT therapists maximize session time by structuring sessions to make sure that the client’s most pressing problems get solved and most important goals are met. If you are having difficulty adjusting to the structured nature of a CBT session, you should discuss this with your CBT therapist.

Sometimes CBT clients still need medication, and that’s okay: CBT is often used in tandem with medication, especially for more serious mental health conditions like bipolar disorder and schizophrenia. CBT can help you manage your medication and can facilitate open and honest conversations about medication preferences with your prescribing physician.

Finding a CBT Therapist

Clinical Services at Beck Institute  

Beck Institute’s expert clinicians can provide compassionate evidence-based treatment for psychological disorders and medical problems.    

Clinician Directory

Find a Beck Institute certified CBT clinician near you.