Since its development in the 1960s and 1970s, Cognitive Behavior Therapy (CBT) has been demonstrated to be effective in treating a wide range of mental health conditions, physical illnesses, and quality of life concerns. 

Before starting therapy, many people want to know how it works. They may have struggled with depression or anxiety for a long time, or tried other types of therapy without success, or tried taking medication. They wonder what makes CBT different, and how it could possibly help them. 

CBT is based on the idea that the way a person thinks about a situation can influence the way they feel and behave (perhaps even moreso than the situation itself). Here’s a commonly used example: you text a friend, but they don’t text you back. If you have the thought, “Maybe something terrible happened to them,” you might feel anxious, and text them and call them multiple times. But if you think, “They’re probably just really busy,” you’ll likely just feel neutral and continue to go about your day. 

When people are in distress, they often aren’t thinking in accurate or helpful ways. One important part of therapy is helping people identify their distressing thoughts and evaluate them. CBT therapists often do this by asking:  

What’s the evidence that this thought is true or not true or not completely true? 

Using the text message example, you probably wouldn’t be able to come up with any evidence that something terrible has happened to your friend, aside from the delay in response. On the other hand, in examining the evidence that the thought is not true, you might remember that your friend is usually in the car around this time of day, and they might not want to text and drive. Considering this other possibility might make you feel less anxious. 

When people are able to think about the situations in their lives in a more realistic and balanced way, they often feel better. 

This may seem like a small and inconsequential shift. But people have hundreds of thoughts every day. And if they are feeling distressed, inaccurate or unhelpful thoughts can come up over and over again. Helping clients learn to evaluate their own thoughts outside of therapy is paramount to CBT. CBT therapists believe that the way that people get better is by making small changes in their thinking and behavior every day. 

In addition to teaching cognitive (thinking) skills, CBT therapists also help clients solve problems, make decisions, and learn new skills they can use for the rest of their lives. Mindfulness and relaxation skills can help clients cope with strong emotions; communication skills can help them improve their relationships, or be more assertive; and organizational skills can help clients complete tasks, manage their time, and be more successful at school or at work. 

CBT therapists also help clients set meaningful goals, and work with them to overcome obstacles to achieving their goals. Oftentimes, when clients are working toward a meaningful goal, they feel empowered, and gain a sense of purpose. Unlike other therapies, CBT places less importance on the past and focuses more on the present and the future. Many clients find that they like the practical nature of the therapy and the focus on solving problems and working toward goals. Often, after only one or two sessions, clients find that they are able to have even a slightly better week; and many need only 6-12 sessions before they see significant improvement in their mood and functioning.