Introduction

The Basics

What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) is a widely-used form of psychotherapy that focuses on identifying and changing negative thought patterns and behaviors. It's based on the idea that our thoughts, feelings, and behaviors are interconnected - when we change how we think about situations, we can change how we feel and act.

Goal

What is the goal of Cognitive Behavioral Therapy (CBT)?

The fundamental goal of Cognitive Behavioral Therapy (CBT) is to help people identify and change unhelpful patterns of thinking and behavior that contribute to their difficulties. Think of it like learning to be your own detective, you develop skills to investigate your thoughts, test their accuracy, and discover more helpful ways of viewing situations.

CBT aims to give you practical tools you can use even after therapy ends. It’s typically structured and time-limited, and is designed to teach skills you can keep using on your own.

Where it helps to get specific, CBT often includes skills like:

• Cognitive restructuring: spotting and challenging thinking traps
• Behavioral strategies such as behavioral activation, exposure, and experiments to test beliefs in real life
• Problem-solving and coping skills you can apply between sessions and after therapy ends

Uses

Who could benefit from Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) has strong research support for treating:

• Depression
• Anxiety disorders
• Panic disorder and phobias
• Post Traumatic Stress Disorder (PTSD)
• Eating disorders
• Addiction/substance use
• Sleep issues
• Many other mental health conditions (e.g., relationship concerns, OCD, coping with chronic pain, etc.).

It's often considered the gold standard treatment for a lot of mental health concerns.

Subtypes

Are there any subtypes of Cognitive Behavioral Therapy (CBT)?

Several specialized variations of Cognitive Behavioral Therapy (CBT) have been developed to target specific mental health concerns and populations. Examples include:

• Cognitive Processing Therapy (CPT): a structured treatment for PTSD and trauma, focused on changing trauma-related beliefs.
• Exposure and Response Prevention (ERP): the gold-standard CBT method for Obsessive-Compulsive Disorder (OCD), helping people face fears without engaging in compulsions.
• Dialectical Behavior Therapy (DBT): combines CBT with mindfulness and acceptance strategies to improve emotion regulation and reduce self-destructive behaviors.
• Cognitive Behavioral Analysis System of Psychotherapy (CBASP): designed for chronic depression, integrating interpersonal and behavioral strategies.
• Mindfulness-Based Cognitive Therapy (MBCT): blends CBT with mindfulness to prevent recurrent depression and reduce relapse risk.
• Trauma-Focused CBT (TF-CBT): tailored for children and adolescents who have experienced trauma, with strong caregiver involvement.

Each subtype retains CBT’s core structure, linking thoughts, feelings, and behaviors, while adapting techniques to fit the unique challenges of different conditions or populations.

Effectiveness

Origins

Who developed Cognitive Behavioral Therapy (CBT) and when?

Cognitive Behavioral Therapy (CBT) was developed in the 1960s by Aaron Beck, who was originally trained as a psychoanalyst. While treating depression, Beck noticed that his patients had recurring negative thought patterns that significantly influenced their emotions and behaviors. This observation led him to develop a more structured, present-focused approach that would become CBT.

The approach also incorporated behavioral principles from earlier work by researchers like Joseph Wolpe and Albert Ellis. Beck’s 1963 paper “Thinking and Depression” helped formalize a structured, time-limited model that drew on behavior therapy (e.g., Wolpe’s systematic desensitization) and was influenced by Ellis’s Rational Emotive Behavior Therapy (REBT).

Evidence Base

Is Cognitive Behavioral Therapy (CBT) evidence-based?

Cognitive Behavioral Therapy (CBT) is one of the most thoroughly researched psychotherapy approaches. Hundreds of clinical trials demonstrate its effectiveness across a wide range of conditions.

What makes CBT particularly compelling from a research perspective is that we can measure both its outcomes (symptom reduction) and its proposed mechanisms of change (shifts in thinking patterns).

Studies consistently show that when people learn to identify and modify problematic thinking patterns, their symptoms improve. This alignment between theory and evidence has helped establish CBT as a first-line treatment for many mental health concerns.

How It Works

Techniques Used

How does Cognitive Behavioral Therapy (CBT) work?

Cognitive Behavioral Therapy (CBT) works through a structured process of examining the connections between thoughts, feelings, and behaviors.

1. The therapist helps you identify automatic thoughts and core beliefs that might be contributing to your difficulties.
2. You learn to evaluate these thoughts objectively and develop more balanced perspectives.
3. Simultaneously, you work on changing behavioral patterns through structured exercises and real-world practice.

CBT is typically time-limited and skills-focused, with practice between sessions to help you apply tools in daily life.

What to Expect in a Session

What can I expect from a Cognitive Behavioral Therapy (CBT) session?

The Cognitive Behavioral Therapy (CBT) approach is very collaborative - you and your therapist work as a team to understand patterns in your thinking and behavior, then develop practical strategies to create positive changes in your daily life.

Here are some common activities and techniques you might encounter in a CBT session:

• Thought tracking and examination - You'll learn to identify negative or unhelpful thought patterns, write them down, and examine the evidence for and against these thoughts. For example, if you think “I'm terrible at my job,” you'd explore what evidence supports or contradicts this belief.
• Behavioral experiments - Your therapist might suggest small activities to test out feared situations or challenge avoidant behaviors. If you're anxious about social situations, you might practice making small talk with a cashier.
• Homework assignments - Between sessions, you might keep mood journals, practice relaxation techniques, or gradually expose yourself to situations you've been avoiding.
• Problem-solving techniques - You'll work together to break down overwhelming problems into manageable steps and develop concrete action plans.
• Cognitive restructuring - Learning to identify cognitive distortions (like all-or-nothing thinking or catastrophizing) and replace them with more balanced, realistic thoughts.
• Activity scheduling - Planning pleasant or meaningful activities, especially helpful for depression. This might involve scheduling things you used to enjoy or finding new activities that give you a sense of accomplishment.
• Relaxation and mindfulness exercises - Techniques like deep breathing, progressive muscle relaxation, or grounding exercises to manage anxiety and stress.

Treatment Length & Structure

How long does Cognitive Behavioral Therapy (CBT) take?

Traditional Cognitive Behavioral Therapy (CBT) typically runs for 12–20 weekly sessions, though this varies by person and concern.

Most sessions last about 45–60 minutes and follow a clear, collaborative structure to keep treatment focused and measurable.

Where it helps to be concrete, a typical CBT session often includes:

• Setting an agenda together for the hour
• Reviewing between-session work (“homework” / action plans)
• Practicing new skills or strategies in-session
• Assigning new practice for the coming week

This structured, time-limited, skills-focused approach helps ensure progress can be tracked and that tools are practiced between sessions so they stick.

Getting Care

Finding a Therapist

How do I find a therapist trained in Cognitive Behavioral Therapy (CBT)?

Alma’s directory has many therapists who are trained in Cognitive Behavioral Therapy (CBT), including: