All Your CBT Questions Answered by Experts

Even if you’ve never worked with a therapist who specializes in Cognitive Behavioral Therapy (CBT), you’ve probably hear of this hugely popular form of therapy. CBT is the single most researched form of psychotherapy and it’s often referred to as the gold-standard psychological treatment. Of course, no one type of therapy is best for everyone, but CBT has been shown to improve a long list of mental health conditions and help clients overcome problems of all shapes and sizes.

Cognitive Behavioral Therapy is uniquely practical and solution-focused. The most defining characteristic of CBT is that it requires extensive collaboration between the client and the clinician and for the client to “do homework” between sessions. With CBT, the more you participate, the greater the rewards.

If you’re curious to learn more about the principal behind Cognitive Behavioral Therapy, the different types of CBT, and how it can be used to treat specific conditions like anxiety, depression, insomnia, anger issues, or ADHD, you’re in the right place.

Below, we provide concise answers to the most commonly asked questions about CBT. Want to dig even deeper? We’ve included links to trusted resources where you can learn more.

Who came up with Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) was developed by Dr. Aaron Beck in the 1960s at the University of Pennsylvania. Dr. Beck initially developed it as a treatment for depression after observing that his clients’ negative thought patterns contributed to their emotional difficulties. focusing on helping clients identify, evaluate, and modify these negative thought patterns.

Dr. Beck’s work revolutionized the field of psychotherapy by creating a more structured, time-limited approach that focused on current problems and teaches specific skills, (instead of focusing on unconscious factors alone).

What principle underlies Cognitive Behavioral Therapy?

The fundamental principle underlying (CBT) is that our thoughts, feelings, and behaviors are interconnected. The basic premise is that emotions are difficult to change directly, so CBT targets emotions by changing thoughts and behaviors that contribute to distressing emotions.

Cognitive Behavioral Therapy builds on the understanding that psychological problems are partly based on unhelpful thinking patterns and learned patterns of unhelpful behavior.

The CBT process is collaborative — it’s not the type of therapy where a provider mainly listens to a client talk. A CBT therapist teaches their client new skills and provides homework assignments for them to do between sessions.

What are the 5 components of Cognitive Behavioral Therapy?

CBT is a structured and clear process that’s proven to get results. It consists of the following five components:

1. Education about the cognitive model

Education involves helping clients understand how thoughts, feelings, and behaviors are interconnected and influence each other. Clients learn about the basic principles of CBT and how it can help address their specific concerns.

2. Cognitive restructuring

Cognitive restructuring focuses on identifying and modifying unhelpful thinking patterns. Clients learn to recognize automatic negative thoughts, challenge cognitive distortions, and develop more balanced, realistic ways of thinking.

3. Behavioral activation

Behavior activation involves engaging in planned activities that can improve mood and functioning. It's particularly important for depression and includes scheduling pleasant activities, setting goals, and gradually increasing activity levels.

4. Skills training

Skills training encompasses learning and practicing specific coping skills such as: problem-solving techniques, relaxation methods, communication skills, stress management strategies, and mindfulness practices.

5. Exposure and response prevention

Exposure and response prevention is the process of gradually facing feared situations or thoughts while learning to manage anxiety and resist unhelpful coping behaviors. It is particularly important for anxiety disorders and phobias.

What are the different types of Cognitive Behavioral Therapy?

There are several specialized types of CBT that have been developed to address specific conditions and therapeutic needs. All are evidence-based, meaning they are rooted in scientific research.

Rational Emotive Behavior Therapy (REBT)

Rational Emotive Behavior Therapy (REBT) focuses mostly on the present. The goal is to address attitudes, unhealthy emotions, and maladaptive behaviors that negatively impact how satisfied you feel with your life.

For example, an REBT therapist can help you work on processing anger, depression, anxiety, or guilt. They can also help you overcome behaviors like procrastination, addictive behaviors, aggression, disordered eating, and sleep disturbances. You can learn more about REBT here.

Dialectical Behavior Therapy (DBT)

Dialectical Behavioral Therapy combines cognitive behavioral techniques with mindfulness. DBT was initially designed for working with Borderline Personality Disorder (BPD); however, it is now shown to be effective in reducing depression, anxiety, disordered eating, addiction, bipolar, and self-harm. Get more information about DBT here.

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy was specifically adapted for treating different types of trauma and Post Traumatic Stress Disorder (PTSD). CPT is a manualized treatment completed over twelve (12) 50-minute individual counseling sessions where clinicians help educate clients on trauma while helping them to cope. Clients participate in regular practice assignments between sessions. You can get more info about CPT here.

Mindfulness-Based Cognitive Therapy (MBCT)

Mindfulness-Based Cognitive Therapy combines traditional CBT techniques with mindfulness practices, such as body scans, yoga, and meditation. It consists of eight, weekly, 2-3 hour sessions, including a day of mindfulness after the sixth session.

MBCT was originally developed for depression relapse prevention (e.g., people who are not in a phase of acute depression but have a history of depressive episodes), but has expanded to treat many other conditions, including anxiety, cancer, and chronic fatigue syndrome. Learn more about MBCT here.

Trauma-Focused CBT (TF-CBT)

Trauma-focused CBT was specifically designed for treating children, adolescents, and their families overcoming the negative effects of traumatic experiences. TF-CBT focuses on the trauma narrative, developing coping skills, and enhancing safety. Treatment typically spans 8-25 individual or family sessions. It is important to note that a PTSD diagnosis is not required, as TF-CBT addresses any and all trauma experiences. Learn more about TF-CBT here.

Reality Therapy (RT)

Reality Therapy is based on Choice Theory — the idea that people choose many of their behaviors in order to satisfy the following innate human needs:

• Self-preservation / survival
• Belonging / love
• Achievement / power
• Freedom / independence
• Fun / enjoyment

RT explores how individuals are responsible for their own behavior and how people can change and live more effective lives. Reality Therapy clinicians assist clients in identifying what they want and what they need — and then help their client to evaluate whether they can realistically attain what they want. This ultimately empowers clients to rethink how they invest their time and energy. Dive deeper into Reality Therapy here.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy incorporates Relational Frame Theory, as well as behavioral, cognitive, and mindfulness techniques to teach clients and clinicians to accept psychological suffering versus trying to eliminate it.

This empowering message has been shown to help individuals cope with a wide variety of issues that range from clinical conditions like depression and anxiety, behavioral changes related to health and wellness, relationship issues, social problems such as stigma or prejudice, and even climate change.

The benefits of ACT are as important for the clinician as they are for clients. For example, ACT has shown to be effective for clinician burnout. Learn more about ACT here.

What is socratic questioning in Cognitive Behavioral Therapy?

Socratic questioning in CBT is a therapeutic technique where the clinician asks open-ended questions to help clients examine their thoughts, assumptions, and beliefs more deeply through self-reflection and critical thinking. Rather than telling clients what to think, the clinician helps clients explore and evaluate their thoughts and beliefs in a systematic way, leading to new perspectives and understanding.

Questions might explore evidence for and against certain beliefs, examine alternative perspectives, or help clients consider the implications of their thoughts. The goal is to help clients reach their own conclusions and develop more balanced thinking patterns rather than having the therapist directly challenge or contradict their thoughts.

Some examples of socratic questioning in CBT:

• "How does this thought make you feel?"
• "Can you think of a situation where this belief might not be true?"
• "What would be a more helpful way to look at this situation?"
• "What is the worst that could happen if you didn't believe this thought?"
• "What evidence do you have that contradicts this belief?"

Does Cognitive Behavioral Therapy help anxiety?

Extensive research has shown CBT to be highly effective for various types of anxiety disorders. Studies consistently demonstrate its efficacy in reducing anxiety symptoms by helping people identify and challenge anxious thoughts and develop coping strategies.

The effectiveness has been demonstrated across different types of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. Success rates are particularly high when patients actively engage in the therapy and complete between-session homework assignments.

What are the goals of Cognitive-Behavioral Therapy in treating depression?

CBT for depression has several specific goals aimed at reducing depressive symptoms and preventing relapse:

• Identifying and challenging negative thought patterns that contribute to depression
• Developing healthy coping strategies to manage depressive symptoms
• Increasing engagement in pleasurable activities through behavioral activation
• Improving problem-solving skills to handle life stressors more effectively
• Building better relationships and social support networks
• Preventing relapse through maintenance strategies

With CBT, therapy for depression focuses on helping clients recognize how their thoughts affect their mood and behavior, and teaches them practical skills to make positive changes. Goals are typically set collaboratively between the clinician and client, with measurable objectives that can track progress throughout treatment.

How does Cognitive Behavioral Therapy help with sleep issues?

CBT helps with rest and sleep issues in several ways:

• Addressing thoughts that interfere with sleep (like racing thoughts or worry)
• Teaching specific relaxation techniques to prepare for sleep
• Establishing healthy sleep hygiene practices
• Challenging beliefs about sleep that may be unhelpful
• Developing consistent sleep routines
• Managing anxiety and stress that might interfere with rest
• Creating behavioral changes that support better sleep patterns
• Identifying and modifying habits that may disrupt sleep

A Cognitive Behavioral Therapist will help their client understand how their thoughts and behaviors affect their ability to rest and provide practical strategies to improve sleep quality and quantity. This might include cognitive techniques to address sleep-related anxiety and behavioral interventions to establish better sleep patterns.

Who is qualified to do Cognitive Behavioral Therapy?

CBT can be provided by several types of licensed mental health professionals:

• Licensed Clinical Psychologists
• Licensed Professional Counselors (LPC)
• Licensed Clinical Social Workers (LCSW)
• Licensed Marriage and Family Therapists (LMFT)
• Psychiatrists

When looking for a CBT provider, it’s key to make sure they have specific training and experience using CBT techniques. While various types of mental health professionals can deliver CBT, their approach might vary based on their background and training. Some providers take the extra step to become certified in CBT to demonstrate their expertise and competency.

How do professionals get certified in Cognitive Behavioral Therapy?

To become certified in CBT, clinicians typically need to provide a copy of their graduate degree transcript, state licensure, CBT certificate from accredited programs, and supervised clinical experience with CBT.

It’s best practice for clinicians to obtain traditional CBT training before pursuing specialized training (e.g., MCBT, TF-CBT, etc.). Reputable training programs include:

• National Association of Cognitive Behavior Therapists
• Academy of Cognitive and Behavioral Therapies
• Beck Institution of Cognitive Behavior Therapy

Does DIY Cognitive Behavioral Therapy work?

While self-guided CBT can be helpful for mild to moderate issues, research suggests it's most effective when combined with guidance of a licensed professional.

The benefits of DIY CBT:

• A starting point for those who can't immediately access counseling
• A useful supplement to professional treatment
• Helpful for maintaining gains after therapy ends
• Effective for mild symptoms that do not require the support of a professional

The limitations of DIY CBT:

• May not be sufficient for severe symptoms
• Lacks the objective perspective of a trained mental health professional
• Missing the therapeutic relationship that can enhance effectiveness
• May be harder to maintain motivation and accountability

A few CBT practices that are helpful to engage in at home include:

• Keeping thought records and mood diaries to track patterns in thinking and emotions
• Practicing relaxation techniques like deep breathing or progressive muscle relaxation
• Setting achievable goals and breaking them down into manageable steps
• Challenging negative thoughts using structured thought records
• Engaging in behavioral activation by scheduling pleasant activities
• Using structured problem-solving methods

Where can I get Cognitive Behavioral Therapy and does insurance cover it?

CBT is widely available in-person and online through licensed mental health professionals in private practice, mental health clinics and hospitals, university counseling centers, therapist-finding platforms like Alma, community mental health centers, and some primary care practices that have integrated mental health services.

As an evidence-based treatment, CBT with an in-network provider is typically covered by most insurance companies and plans. A formal diagnosis from a licensed mental health professional might be required in order to have your CBT therapy sessions covered by insurance.