What Is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is an effective treatment for many psychological disorders.

Cognitive Behavioral Therapy (CBT) is a short-term treatment that teaches clients specific skills. What makes CBT unique is that it focuses on the ways that a person’s cognitions (i.e., thoughts), emotions, and behaviors are connected and affect one another. Because emotions, thoughts, and behaviors are all linked, CBT allows for therapists to intervene at different points in the cycle.

CBT is the term used for a group of psychological treatments that are proven to be effective in treating many psychological disorders. Some people have a limited view of what psychological therapy is, perhaps because of the old-fashioned treatments shown on TV or in the movies. CBT is very different from this. It is usually a short-term treatment (i.e., often between 6-20 sessions, depending on what is being treated) that focuses on teaching clients specific skills. CBT focuses on the ways that a person’s cognitions (i.e., thoughts), emotions, and behaviors are connected and affect one another. Because emotions, thoughts, and behaviors are all linked, CBT allows for therapists to intervene at different points in the cycle.

Therapists differ regarding how much they emphasize behavioral and cognitive techniques in therapy. Some focus exclusively on behavioral or cognitive techniques, though most will use a combination of the two. Some common aspects of CBT are:

The therapist and client work together with a mutual understanding that the therapist has theoretical and technical expertise, but the client is the expert on themselves.
The therapist seeks to help the client discover that they are powerful and capable of choosing more helpful thoughts and behaviors.
Treatment is often short-term. Clients actively participate in treatment in and out of session. The skills that are taught in these therapies require practice. Therefore, homework is often included in therapy.
Treatment is goal-oriented to resolve present-day problems.
Therapy involves working step-by-step to achieve goals. The therapist and client develop goals for therapy together, and track progress toward goals throughout the course of treatment.

A more detailed discussion of cognitive and behavioral techniques is described below.

Cognitive Components of CBT

The basis of the cognitive component of CBT is the idea that thoughts can influence feelings, and that your emotional response is based on your interpretation of a situation. For example, imagine feeling shortness of breath and your heart racing. If these physical symptoms pop up while sitting quietly on a park bench, you might think that something is wrong with your body (“maybe I’m having a heart attack”) which would probably make you feel anxious (your emotion). In contrast, if you felt these same physical sensations while running on a treadmill, you would likely expect your heart to race, and would not consider it a result of a medical ailment. You probably would not feel fear or anxiety. In short, different interpretations of those same sensations lead to entirely different reactions and emotions.

Cognitive therapy suggests that many of our emotions are due to our thinking – the ways that we perceive or interpret our environments. Sometimes, these interpretations are not the only way of looking at the situation. For example, you might believe that an ambiguous text message means that you’re being rejected or pushed away, or that a funny physical sensation in your body means that you have some rare disease. Other people may set unrealistic expectations for themselves, or put all their focus on being accepted by others. These types of thoughts often lead to negative emotion, and they are not the only way to see a given situation.

In cognitive therapy, clients learn to:

Distinguish between thoughts and feelings.
Become aware of the ways thoughts can influence feelings.
Learn about thoughts that seem to occur automatically, without even realizing how they may affect emotions.
Evaluate critically whether these “automatic” thoughts and assumptions are accurate, or perhaps biased.
Develop the skills to notice, interrupt, and correct these unhelpful thoughts independently.

Behavioral Components of CBT

The behavioral aspects of CBT are derived from a wealth of research into how we learn. The two primary ways that we learn are by association (classical conditioning) and through consequences to our actions/reactions (operant conditioning).

Associative learning happens when two things occur closely together in time, so we pair them together. For example, if you are going through a stressful period in your life, you may feel anxious while riding a subway. Through pairing that anxious feeling with your commute, you may learn to associate the subway with anxiety or danger.

The other form of learning (operant conditioning) happens when a particular action is either increased or decreased by the consequences that come after. Let’s go back to the subway example above. When you have thoughts of riding the subway, you might feel anxious, so you might decide to avoid this mode of transportation. When you decide not to ride the subway, you feel relieved and your anxiety decreases. This avoidance of the subway is rewarded or reinforced by the relief you experienced. This increases the likelihood that you will avoid the subway in the future. Unfortunately, this avoidance behavior will also prevent you from learning that you could face your fears and successfully ride the subway.

CBT helps people try new ways of acting and reacting to both external situations and their internal experiences. These behaviors are chosen through collaboration with your therapist and thoughtful consideration to what would most improve your life. A therapist may help someone who is afraid of riding the subway by helping them to learn how their anxiety works, identify that they fear both their own anxiety and the subway, and help them develop a plan to systematically face their fears. The process by which you gradually face your fears, with the help of a skilled therapist, is a behavioral technique called “exposure therapy.” Through this process a new type of learning occurs in which you gradually overcome your fear of these situations. Research shows that through practice, we can replace unhelpful actions and reactions with healthy coping behaviors.

Psychological Symptoms

One of ABCT’s most important goals is to help increase public awareness and understanding of mental health difficulties. Please click on the links below to learn about psychological symptoms.

Fact Sheets about Symptoms

Psychological Treatments

Choosing the right treatment from a range of options can be an overwhelming task, especially if you are already suffering from psychological symptoms. ABCT provides resources to help the general public navigate through this confusion and make informed decisions as to their care or the care of a loved one. Please click on the links below to learn more about treatment.

Cognitive Behavioral Therapy is a type of treatment that is based firmly on research findings. It places emphasis on changing your cognitions (thoughts) or behaviors (actions) in order to effect change in how you feel. These approaches help people in achieving specific changes or goals.

Changes or goals might involve:

A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like reducing back pain or helping a person stick to a doctor’s suggestions.

Cognitive behavioral therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life. CBT is an effective treatment for individuals, parents, children, couples, and families. The goal of CBT is to help people improve and gain more control over their lives by changing behaviors that don’t work well to ones that do.

How to Get Help

If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website (www.abct.org) and click on “Find a CBT Therapist”

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.