Therapy FAQ

Feeling Better with CBT and Other Behavior-Based Therapies

Many people feel self-conscious about what others think of them, especially in public spaces. But imagine feeling so worried about your perception that you can’t walk across campus. That was the experience of a college-aged client of Melissa Galica, a licensed professional counselor with Grow Therapy.  Eventually, they would need to work out where the […]

Grow Therapy therapist Gregorio (Greg) Lozano III LPC By Greg Lozano, LPC

Updated on Feb 15, 2024

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Many people feel self-conscious about what others think of them, especially in public spaces. But imagine feeling so worried about your perception that you can’t walk across campus. That was the experience of a college-aged client of Melissa Galica, a licensed professional counselor with Grow Therapy. 

Eventually, they would need to work out where the anxiety was coming from. But in the meantime, they needed her to be able to cross campus. That’s where cognitive behavioral therapy (CBT) came in. CBT is designed to help people tackle present, pressing problems, so that they can live healthier, more peaceful lives. 

Galica gave her a homework assignment, which is typical of CBT: get a fidget spinner. Next time you cross campus, play with the spinner to keep your hands and mind occupied. This helps to keep the thinking part of our brains from being taken over by our emotional part of the brain. 

“The next day, I get a text message that says, ‘That was so weird. It worked.’” Galica remembers. Changing the behavior actually helped change the client’s cognition. CBT isn’t magic — but it can make a meaningful difference in our day-to-day lives. 

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a type of talk therapy that’s about changing your thoughts, so that you can change unhealthy or unwanted behaviors. 

“Literally, it’s cognitive. We’re thinking about how you think,” says Galica. 

That’s the ultimate goal of CBT: building strategies to live healthier and more aligned with your personal values. People often start CBT when they’re stuck in thought and behavior patterns that they don’t want but can’t stop. For example, CBT can help address, resolve, or alleviate:

One of the very first cognitive things I may talk about with a client is ‘how are you sleeping?’ And if not, we need to focus on that first.

- Melissa Galica, LPC

If you’re considering CBT, you should know that it’s both problem-oriented and present-focused, according to an article from the Institute for Quality and Efficiency in Health Care. Here’s what this means:

Example: Imagine you’re doing CBT for an eating disorder. You and a therapist will identify unwanted behaviors and thoughts, and then begin understanding the beliefs underlying them. Together, you’ll begin replacing those beliefs with more recovery-focused ones. CBT therapists believe that when you can change the constructs, you can change the behaviors.   

Example: If you’re working on shutting down during difficult conversations with your partner, you and your therapist might consider why this happens. But CBT’s primary emphasis is to help you recognize and manage the behavior — shutting down — so that you can better navigate those conversations. 

Other Behavior-Based Therapies

CBT isn’t the only behavior-based therapy that can help people struggling with depression, anxiety, post-traumatic stress disorder (PTSD), and other mental health conditions. More behavior-based therapies include:

How Cognitive Behavioral Therapy Works

We all have cognitions (thoughts) and constructs (beliefs) that underlie them. These cognitions shape our behaviors — sometimes in good, helpful ways and sometimes in unproductive, unhealthy ways. 

Unfortunately, we’re not always aware of our unhealthy cognitions, much less the unhealthy beliefs behind them. This means we sometimes engage in unhealthy behaviors even when they harm us or we don’t want to do them. Galica compares these hidden, underlying beliefs to embers; unless put out, they could start another fire. 

“The elements that start the dumpster fire are still smoldering in the bin, and those things will reignite,” she says. 

CBT focuses on putting out the embers — in other words, getting to the root of someone’s problems. Researchers have actually found CBT is an effective treatment for depression, anxiety disorders, substance use problems, marital struggles, eating disorders, and severe mental illness, according to the American Psychological Association

Mental health professionals think CBT works well in these scenarios because:

Of course, all these benefits assume that you have a therapist who is safe and with whom you have good rapport. “First we have to decide if we like each other,” as Galica puts it. Then the work can start. 

What to Expect in a CBT Session

Preparing for your first session doesn’t have to be intimidating. In fact, it should be something you look forward. But what’s going to happen in this first session? Anxiety before therapy is common, but with a little research on the front end, you can prepare yourself for what happens during an initial therapy session and feel more confident going in.

You and Your Therapist Will Evaluate Your Readiness 

CBT can start in your very first therapy session — assuming you have a good client/therapist fit and the therapist believes you’re ready. “Unfortunately, when you start therapy, you think that means you want to change. That always tickles me,” says Galica. 

She’s referring to the reality that people coming to counseling often want their lives to change — but they may not feel ready to change the specific behaviors contributing to their problems. Together, you and your therapist will consider whether you’re ready for CBT work or if another type of therapy might be a better fit right now. 

You’ll Identify Unwanted Behaviors

You and your therapist will gather “data” on your problems and potential solutions, according to the Association for Behavioral and Cognitive Therapies. Galica starts by asking questions about her clients’ health, such as sleeping patterns, nutrition, and hydration. “One of the very first cognitive things I may talk about with a client is ‘how are you sleeping?’ And if not, we need to focus on that first,” she explains. 

You might also complete questionnaires or self-monitoring exercises to understand any mood changes, self-critical thoughts, or unwanted behaviors. These insights inform your treatment plan. 

Together, You Will Make a Plan

Every client’s plan is unique, tailored to their preferences, health history, concerns, support system, and personality. APA suggests that yours could include both thought strategies and behavior strategies. 

Strategies for changing your thinking patterns could include:

Strategies for changing your behavior patterns could include:

Your Therapist Will Hold You Accountable

CBT is about making changes, and your therapist will likely push you toward the goals you’ve decided on together. “It is my job in our relationship to hold you accountable,” says Galica. “You wanted to change that behavior, but you’re telling me that you’re doing the same thing. Why? What happened? What were you feeling?” These questions aren’t to blame or shame you. Instead, they’re about helping you better understand why you do the things you do—especially when you don’t want to do them. 

You May Have Homework

The goal of CBT is equipping you with new skills to use in your daily life. So, much of the work will actually happen outside of sessions as you practice the strategies. “The cool thing about this homework is that if you don’t do it, I still like you anyway, and you don’t get a grade,” says Galica. The homework is simply meant to help you practice incorporating CBT into your life and make the changes you want to make. 

Find a CBT Therapist With Grow Therapy

Cognitive behavioral therapy can help you finally break unwanted behavior patterns and start building healthy ones. CBT takes effort, patience with yourself, and honesty with others. But the results can reshape your life. 

At Grow Therapy, we offer both in-person and online mental health support, including CBT. Our platform helps match people like you to professionals who specialize in your needs and are available soon. 

FAQs

  • CBT stands for cognitive behavioral therapy.

  • CBT has been demonstrated to be an effective treatment for a range of mental health conditions, including depression, anxiety disorders, PTSD, eating disorders, and substance use problems.

  • While there aren't official types of CBT, various therapies incorporate CBT into their processes. For example, dialectical behavior therapy draws on CBT principles. Mindfulness-based cognitive therapy does, too. But, instead of helping people change their thoughts themselves (CBT’s approach), MBCT helps people change how they relate to their thoughts.

  • Cognitive behavioral therapy is one of the evidence-based treatments for depression. Researchers typically don’t subdivide it into types of CBT. Instead, a provider will partner with you in identifying the specific challenges you’re facing and potential solutions that could help.

  • Cognitive therapy is about challenging unhelpful or unhealthy thoughts. The therapist helps clients identify, process, and replace them with healthier ways of thinking. For example, your therapist might challenge you to think of alternative interpretations of a stressful social interaction. CBT adds a behavior change element — you’re challenging the unproductive thoughts that underlie certain behavior patterns. The goal is that you can change both.

  • The goal of CBT is unique to you and your treatment plan. Generally speaking, a CBT therapist aims to help you challenge thoughts, relieve symptoms, cope better, end generational patterns, and become more effective in your life.

About the author
Grow Therapy therapist Gregorio (Greg) Lozano III LPC Greg Lozano, LPC

Greg Lozano is a licensed professional counselor who specializes in working with individuals with severe mental illnesses such as depressive, bipolar, schizophrenia, and substance abuse conditions.

This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.

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