Cognitive behavioural therapy is a talking therapy used to treat anxiety, depression, obsessive-compulsive disorder, addictions, phobias, and many other issues.
Therapists use different cognitive and behavioural techniques to help patients live happier, more fulfilling lives.
In this article, we explore how CBT works and the evidence to support it. We’ll also tell you how to find a qualified therapist and what to expect during treatment.
Table of contents
- What is Cognitive Behavioural Therapy?
- What is the theory behind CBT?
- When and how is CBT applied?
- What is the evidence to support CBT?
- What to expect as a CBT student?
What is Cognitive Behavioural Therapy?
Cognitive behavioural therapy (known as CBT) is an evidence-based psychotherapy treatment. It also happens to be the most widely practised mental health therapy.
It helps you identify maladaptive thoughts, emotional responses, and behaviours that may be affecting your mental health. The tools you learn in CBT help you notice and challenge your thoughts and behaviours and replace them with objectively helpful responses.
As you can imagine, it’s incredibly empowering!
What is the theory behind CBT?
CBT was developed in the 1960s by psychiatrist Aaron Beck after he realized people with depression displayed unhelpful ways of thinking.
The central theory behind CBT is that your thoughts influence your feelings and behaviours. Problems arise when you get stuck in a cycle of unhelpful thoughts and emotions. This can make you jump to conclusions, overreact, feel anxious or depressed, catastrophize, and develop black-or-white thinking.
CBT believes your emotional reactions and behaviours can improve by learning awareness and practising new coping tools.
When and how is CBT applied?
CBT is a confidential therapy guided by a mental health therapist in a one-on-one or group setting.
It doesn’t focus on past traumas but rather on how you think, feel, and behave in the present.
You learn helpful strategies to better respond to triggers and situations. For example, someone with a fear of flying may work to change their beliefs and develop confidence. This may include graded exposure using visualization exercises and mindfulness to reduce anxiety.
CBT is used in a broad range of situations
CBT is useful for managing various mental health conditions (and some physical health problems).
CBT may help with the following:
- Post-traumatic stress disorder
- Obsessive-compulsive disorder
- Eating disorders
- Social anxiety
- Bipolar disorder
- Personality disorders
- Irritable bowel syndrome
- Chronic pain
While it may not cure the conditions, it helps to improve your quality of life.
You don’t need to have a specific condition to benefit from CBT. It can help with relationship problems, life stress, divorce, grief, and low self-esteem.
CBT uses a range of cognitive and behavioural techniques
Here are some examples of CBT techniques:
- Goal setting
- Mental distraction
- Role-playing to solve problems and address fears
- Learning to observe your self-talk
- Cognitive restructuring to unravel unhelpful thought patterns
- Exposure therapy to slowly reintroduce yourself to activities that previously caused distress
- Self-care strategies to support your mood
- Mindfulness and breathing techniques for stress reduction
- Journaling to track behaviours, symptoms, and experiences
Homework is another aspect of CBT. The therapist may assign tasks between sessions to contribute to growth and change. For example, replacing negative self-talk with self-compassion.
What is the evidence to support CBT?
There is strong evidence to support the efficacy of CBT for emotional and behavioural problems.
A 2015 review found CBT is an effective treatment for anxiety disorders1.
Research suggests CBT may help to resolve acute depression and prevent relapses2. Combining CBT with medication also appears to be more effective than medication alone.
An NIH-published review3 found CBT is most effective for treating:
- Anxiety disorders
- Somatic symptom disorders
- Eating disorders
- Sleep problems
Interestingly, in-person and online CBT are equally effective for depression and anxiety.4
What can I expect as a CBT patient?
Starting therapy is understandably overwhelming. It’s normal to feel nervous about sharing personal issues with a stranger.
Here are some things you should know before starting CBT:
The CBT appointment
During your first appointment, the therapist will take a general health history, ask about your reasons for seeking therapy, and ask about your goals for the therapy sessions. They may also discuss current stressors in your life.
The therapist will explain how CBT works and the techniques used during therapy. This is the time to ask questions about their approach.
Once the therapist understands your challenges and goals, future CBT appointments will follow a structure. They will work with you to help you move forward with healthier thought patterns and behaviours.
Your therapist may also suggest you do homework between sessions, such as journaling, mindfulness, redirecting thoughts, and graded exposure.
Each session usually lasts an hour.
What qualifications must a Cognitive Behavioural Therapist have?
CBT therapists must have a bachelor’s degree in psychology (or a degree in social work, healthcare, or similar) and a postgraduate qualification in CBT. They also have to complete supervised clinical practice.
Qualified CBT therapists in the UK register with The British Association for Behavioural & Cognitive Psychotherapies (BABCP). This ensures they meet the minimum training requirements and are involved in continuing professional development (CPD).
How do I find a Cognitive Behavioural Therapist?
Firstly, consider whether you want one-on-one in-person, online, or group therapy.
You can ask your GP, friends, or family to recommend a therapist practising CBT.
We also encourage you to use our Treatwiser Practitioner Directory to connect with qualified therapists.
How much will it cost?
CBT is available on the NHS in the UK with or without a referral from a GP.
If you choose to pay for it privately, each session may cost between £40-£100. Many therapists also charge on a sliding scale for those with limited resources.
How many appointments will I need?
A course of CBT treatment is typically between 5-20 sessions, with each session spaced one or two weeks apart. Your therapist will work with you to determine how many sessions are necessary.
The goal is to teach you the skills necessary for success in day-to-day life after therapy.
What are the benefits and goals of CBT?
CBT helps you gain an awareness of your thought patterns and the knowledge to develop constructive coping skills.
This has a range of knock-on benefits, including:
- Better cognitive functioning
- A stable mood
- Fewer OCD compulsions
- Better problem solving
- Improved self-confidence and self-esteem
- Feeling calmer
- Better interpersonal skills
- Healthier emotional expression
- Greater control of your thoughts and feelings
- Lower stress levels
However, CBT is not a cure-all treatment. The skills you learn require practice and consistency.
Is CBT safe for everyone?
CBT is a drug-free, evidence-based therapy that’s generally safe for most people.
In some people, it may aggravate anxiety and trigger emotional responses. This is completely normal and usually resolves as you work through the issues.
Working with a trained therapist helps to minimise any risks.
Further CBT therapy information and resources
- Kaczkurkin & Foa. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci.
- Gautam et al. (2020). Cognitive Behavioral Therapy for Depression. Indian J Psychiatry.
- Hofmann et al. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res.
- Luo et al. (2020). A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. EClinicalMedicine.
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