Therapy FAQ

What is Cognitive Behavioral Therapy (CBT) and How Does it Work?

Cognitive Behavioral Therapy (CBT) is a leading treatment option when it comes to addressing mental health concerns. Here, we delve into CBT’s principles, techniques, applications, and benefits to help you understand its suitability for mental health concerns.

therapist sean abraham By Sean Abraham, LCSW

Updated on May 12, 2024

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Mental health is a prevalent issue affecting millions worldwide. According to Mental Health America, nearly 50 million U.S. citizens experienced mental illnesses in 2022.

In light of this, more people are seeking the best treatment options — Cognitive Behavioral Therapy (CBT) being among the most common forms of treatment. 

Here, we’ll explore what CBT is and how it works to help determine if this therapeutic method is suitable for you or a loved one facing mental health concerns.

How CBT Works: Basic Principles and Techniques

The Centre for Addiction and Mental Health defines CBT as psychotherapy that focuses on helping people develop strategies for maintaining their health. It aims to assist people in identifying and changing the destructive and disturbing patterns that negatively influence their emotions and behaviors. CBT is about recognizing the influence of our experience on our understanding of the world around us and our thinking processes, as well as how those thinking processes then impact us emotionally and behaviorally.

According to Melissa Galica, a licensed professional counselor with Grow Therapy, “Cognitive behavioral therapy alters a person’s thinking patterns to positively impact their behavior. This proven therapy utilizes role-playing and exposure therapy techniques while equipping individuals with relaxation techniques to manage the anxiety associated with the addressed thoughts and behaviors.”

While treatments should be tailored to an individual’s specific problems, common principles and techniques are used in every treatment.

Basic Principles of CBT

The following are the underlying principles used in cognitive behavioral therapy:

Thought Pattern Recognition

A therapist focuses on understanding the patient better by identifying their thinking patterns and behaviors, as well as cognitive distortions, or thinking errors. They then challenge those thoughts to help people overcome irrational thinking patterns. They look at the patient’s life experiences — from childhood to adulthood and during therapy sessions, which helps to establish the most suitable support for the client.

Shared Therapeutic Relationship

A trustworthy relationship between a therapist and a patient is essential during CBT. It allows patients to feel safe as they express their situations. Creating rapport makes it easy for therapists to address patients’ situations from their angle, making the session more productive.

Focus on the Existing Problem and Set Goals

Identifying the patient’s problems and aligning them with their set goals fosters the effectiveness of the treatment session. Further, setting realistic and achievable goals is essential for patients to solve their problems.

Emphasizing the Present

CBT prioritizes addressing the current problems and situations that distress patients, encouraging patients to think about the current issues and live in the present.

Time-Constrained Sessions

CBT treatment is time-constrained based on the duration of each session and the number of sessions needed — typically 6-20 sessions. However, therapy sessions for patients with severe conditions may take several months to years.

Techniques Used in CBT

Cognitive behavioral therapy employs different techniques to help people overcome their problems. Common CBT techniques include the following:

Recognizing Negative Thoughts

CBT focuses on identifying negative thoughts, feelings, and situations that lead to maladaptive behaviors. While it may be challenging, discovering these thoughts enhances self-discovery and offers important insights into the treatment process.

Problem-Solving

In CBT, therapists help patients learn problem-solving skills that allow them to identify and prevent life stressors. In addition, these skills help patients to reduce the harmful impacts of their physical and psychological illnesses.

Setting Goals

Cognitive behavioral therapists encourage patients to set goals and strengthen their goal-setting skills to improve their health and life. This may involve helping them identify and set clear long and short term goals.

Relaxation Techniques

Cognitive behavioral therapy employs various relaxation and stress reduction exercises, including the following:

Journaling

Cognitive behavioral therapists use this technique to gather patients’ moods and thoughts. A therapist usually asks patients to write down their thoughts and feelings about their situation, whether positive or negative.

Journaling helps you to identify and understand your thoughts and emotional patterns, change, adapt, or cope with them.

Types of CBT: Variations and Applications

Mental health professionals use various types of CBT, depending on the issues addressed and the patient’s preferences. The common types of CBT therapies used include the following:

Dialectical Behavioral Therapy (DBT)

Dialectical behavioral therapy focuses on creating awareness and accepting patients’ situations while promoting change. In DBT, patients learn that their experiences are valid and must change positively to control their emotions and move forward.

The four major areas that DBT can assist with are Interpersonal Effectiveness, Emotion Regulation, Distress Tolerance, and Mindfulness. DBT effectively treats a range of mental health issues, including borderline personality disorders, suicidal thoughts, PTSD, and eating disorders. 

Rational Emotive Behavior Therapy (REBT)

Rational emotive behavior therapy helps patients to identify their irrational thoughts, challenge them, and recognize and change their thought patterns. REBT is based on the idea that thoughts about yourself or specific events, rather than external circumstances, influence your happiness.

Exposure Therapy

Exposure therapy focuses on confronting a patient’s fears and breaking the avoidance pattern. In exposure therapy, healthcare professionals create a secure environment to expose patients to the things or situations they fear and avoid. As a result, they develop courage and feel less vulnerable in such situations.

Multimodal Behavior Therapy

Multimodal behavior therapy uses different modalities — pharmacotherapy, behavioral interventions, and devices — to treat psychological issues like brain disorders. It focuses on treating the patient as a whole rather than focusing on specific symptoms.

Mindfulness Therapy

Mindfulness therapy combines CBT techniques and mindfulness to help patients learn and manage emotions and thoughts and relieve distress. It also allows patients to accept their self-being and disconnect themselves from their moods and thoughts.

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When to Use CBT: Mental Health Conditions and Problems

Cognitive behavioral therapy is an effective treatment method for mental illnesses and life problems. In particular, uses of CBT include treating the following conditions:

Anxiety and Depression

CBT focuses on preventing cycles that make you feel scared, anxious, or depressed, addressing each at their root.

Bipolar Disorders

CBT helps to identify and change unhelpful behaviors and thoughts linked with bipolar disorder. By replacing these thoughts with helpful ones, patients can modify their behaviors and have more control of their life.

Phobias

Cognitive behavioral therapy exposes patients incrementally and appropriately — through what’s known as exposure therapy — to their fears, commonly leading to decreased vulnerability and an increased sense of control.

Marital Problems

CBT helps couples to identify and change their relationship issues into positive goals. Further, it helps couples improve their trust, closeness, communication skills, and understanding..

Substance Use Disorders

Cognitive behavioral therapy allows those with addictions and substance abuse issues to identify their negative emotions, thoughts, and actions. When addicts understand their actions and feelings and how they lead to addiction, they can easily overcome their condition.

In addition, CBT can help people with post-traumatic stress disorder, chronic pain and panic disorders. Further, it is used to treat distortions, obsessive-compulsive disorder (OCD), and catastrophizing. 

When to Not Use CBT

There are instances where CBT is generally not helpful. This includes instances where an individual has any sort of traumatic brain injury and with those with cognitive delays or differences.

CBT vs. Other Forms of Psychotherapy

Understanding how CBT differs from other forms of psychotherapy is essential for making informed decisions about the treatment option.

CBT vs. Psychodynamic Therapy

CBT focuses on the present thoughts and behaviors that a person has, whereas psychodynamic therapy is a talk therapy that focuses on the unconscious thoughts and emotions of the past.

CBT vs. Interpersonal Therapy

CBT aims at changing the dysfunctional beliefs of social anxiety disorders and biased information processing. On the other hand, interpersonal therapy focuses on modifying troublesome interpersonal behavior patterns that feed social anxiety.

CBT vs. Humanistic Therapy

Cognitive behavioral therapy focuses on modifying specific thoughts and behavior patterns. Conversely, the humanistic approach focuses on the entire well-being of a patient. It helps patients develop a healthier and more robust sense of self.

CBT vs. Supportive Therapy

Supportive therapy allows patients to express their concerns, feelings, and thoughts and receive emotional support. However, CBT focuses on actively challenging and changing negative thoughts and patterns, providing coping skills without emotional support.

Benefits of Cognitive Behavioral Therapy

Galica says, “CBT aims to challenge and modify our negative thoughts and beliefs about ourselves, leading to changes in behavior and increased confidence and comfort in our lives.”

The following are some benefits of CBT: 

Boosts Self-Esteem

CBT disrupts and challenges the negative feelings and thoughts that could be caused by mental health conditions like depression. This helps to develop confidence in your abilities, boosting your self-esteem.

Improves Self-Awareness 

CBT allows you to understand the influence of negative thinking on behaviors and how to change such thoughts to positive ones.

Equips You with New Coping Mechanisms

By understanding how your feelings and thoughts influence behavior, you can develop practical coping tools to deal with such situations. For instance, you may develop evidence-based skills in mindfulness and journaling.

Prevents Relapse in Addiction Recovery 

Cognitive behavioral therapy identifies relapse triggers and provides effective strategies to overcome these triggers.

CBT and Medications: Combining Treatments

Cognitive behavioral therapy may bring better results if combined with medications. For instance, CBT is often used with antidepressants to treat different types of depression. Combining pharmacotherapy with CBT provides quick and permanent symptomatic improvement. Likewise, for those facing anxiety, antidepressants and antianxiety medications may reduce symptoms and offer relief. 

For those facing schizophrenia, antipsychotic medication is used to reduce the severity of the symptoms. However, CBT treats positive symptoms that don’t respond as well to medication. For instance, cognitive behavioral therapy treats hallucinations, delusions, and confusion. 

How to Find a Therapist for CBT

Finding the right therapist is the first step to your recovery. Galica says, “A therapist can help individuals recognize automatic thoughts and adopt a more balanced and practical thinking approach.” Have you ever avoided something simply because you feared appearing socially awkward? A therapist can assist in modifying such thoughts to enable the person to attend the event. Rather than thinking, “I’ll be too awkward,” they can reframe it to, “It’s natural to feel nervous when uncertain, and that’s all right,” or “People will judge me anyhow, but I’ll be fine.”

Here are tips to help you choose the right therapist for cognitive behavioral therapy:  

Understand Your Preferences

Finding a therapist who meets your needs is crucial. Because therapists practice different types of therapy, it’s essential to conduct due diligence to check which one offers what meets your needs. 

Check Their Accreditation

Not all therapists are licensed. So, check their credentials before you proceed with therapy. Additionally, you can confirm with licensing boards in your state if they have the proper licensure and if there are any complaints against them.

Research Online

Use online directories and search filters like Grow Therapy to find a therapist who meets your needs and preferences. Our filters let you find therapists in your area who accept your insurance. 

Seek Recommendations and Referrals

Seeking help from friends, family, or someone you trust can help secure a reputable CBT therapist. However, remember to settle with one who meets your needs as they may differ from other people’s needs. 

Schedule for an Initial Meeting

Meeting with a therapist before treatment helps you to gain more insight about them. During the meetings, you may ask about their education, licensure, and treatment approach.

Get a CBT Therapist

Whether you are facing anxiety, stress, depression, or other mental health issues, cognitive behavioral therapy can help. Although it may have limitations and challenges, CBT has numerous benefits that help to improve your well-being.

A therapist who offers CBT can help develop coping mechanisms that will help navigate your mental health concerns. At Grow Therapy, we make it easy for you to get a therapist that meets your preferences and needs.

Frequently Asked Questions

About the author
therapist sean abraham Sean Abraham, LCSW

Sean Abraham is a licensed clinical social worker who works with those who have struggled with substance use, depression, anxiety, loss, communication problems, student life, as well as other mental health concerns.

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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