Cognitive Behavioral Therapy

Developed in the 1960s by Aaron Beck, CBT has been well studied and found to be effective for many mental health disorders. It helps people deal with specific problems and learn healthier ways to think and act.

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What is CBT?

CBT is based on the idea that your thoughts, emotions and behaviour are linked. Inaccurate or negative thinking can lead to emotional distress and unhelpful behaviours that become a pattern.

For example, someone with anxiety may notice that their heart is beating fast and assume that they are having a heart attack (even though there are good and safe reasons for their hearts to beat faster). This mistake can trigger fear and panic and cause them to avoid social situations or other potentially dangerous situations.

The main thing that sets CBT apart from other types of therapy is that it involves a more active role for the client. Sessions often include exercises and homework, such as keeping a thought diary or replacing self-critical thoughts with more positive ones.

Identifying Problems

Cognitive behavior therapy is often the preferred type of psychotherapy to treat many different mental health issues, such as anxiety, depression and co-occurring disorders. It is particularly effective when it’s used in conjunction with other forms of treatment, such as antidepressants. During your first sessions, a CBT therapist will gather information about your condition and help you understand what’s contributing to your symptoms.

The mainstream cognitive behavioral therapies include rational emotive behavior therapy (REBT), cognitive therapy, dialectical behavior therapy, acceptance and commitment therapy, cognitive processing therapy, EMDR and other similar modalities.[4] Each has its own set of techniques that therapists use to identify maladaptive thoughts and behaviors.

It is important to monitor problems and symptoms to make sure that your therapy is working. This can be difficult, as our impressions about whether treatment is helping can be biased by our own thinking.

Observing Your Thoughts

In CBT, your therapist will encourage you to observe and become aware of your automatic thoughts. They might ask you to keep a thought log and write down irrational thoughts, and then provide you with unbiased evidence that contradicts these negative beliefs.

Your therapist will also help you to become aware of your negative self-talk, often called cognitive distortions, like black-and-white thinking or jumping to conclusions, and work with you on replacing these with more realistic, compassionate self-talk. In addition, therapists may use behavioral experiments to learn to tolerate anxiety (e.g. predicting something catastrophic will happen if you leave the house) and work with you on developing hierarchical tasks to reduce anxiety.

CBT is often paired with mindfulness meditation, such as the BetterSleep app’s guided meditations and curated sleep sounds. Practicing mindfulness helps you observe your thoughts from a distance, and refrain from judgment or interfering.

Reshaping Negative Thinking

As you work through cognitive behavioral therapy, your therapist will teach you ways to challenge and “test” negative thoughts. For example, if you are upset because you think your friend didn’t call, you can ask yourself questions like “is this really true?” and “why?” Your therapist can give you a list of useful questions to help you get started.

This is a key component of CBT, which incorporates the ideas of Aaron Beck and Albert Ellis, who developed Rational Emotive Behavioral Therapy (REBT). As you practice these skills, your helpful thinking will replace your inaccurate beliefs over time. This is a slow process, but it will help you change your emotional and behavioural responses. This is a common approach to treating many mental health disorders and may be combined with other treatments, including medications.

Practicing New Strategies

During CBT, you and your therapist will practice new skills that you can use in real-world situations. This includes coping strategies to help you reduce anxiety, role-playing difficult social situations or learning healthy self-talk.

You may also work on avoiding or changing certain behaviors that make your problems worse. For example, if you have an anxiety disorder and worry about plane crashes or runway accidents, CBT can teach you methods to help you calm down when you start thinking those thoughts.

As with all types of psychotherapy, Cognitive Behavioral Therapy (CBT) can take time and is typically done over a limited number of sessions (five to 20). Your therapist will monitor your progress in each session. They will also be able to identify any barriers that may be blocking your progress.