Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a type of psychotherapy (talk therapy) that helps you notice and change unhelpful thoughts and behaviors. It focuses on how your thoughts influence how you feel and behave.

In CBT, you learn practical skills to handle stress and challenges. This may include practicing new ways of thinking or trying small exercises between sessions. CBT may help you manage mental health conditions or support you through difficult situations.

This common type of therapy is based on a few core principles:

• Mental health concerns are often linked to unhelpful ways of thinking.
• Concerns can also relate to learned behaviors that no longer help.
• Core beliefs about yourself and the world can affect how you feel and act.
• You can learn new coping skills to feel better and improve your emotional health.

CBT usually takes place over a limited number of sessions. You can use CBT on its own or with medication and other treatments. Your therapist will tailor therapy to your specific needs.

What conditions does cognitive behavioral therapy manage?

CBT commonly helps manage mental health conditions like anxiety and depression. It may also help with other mental and behavioral health conditions, including:

• Attention-deficit/hyperactivity disorder (ADHD) and executive functioning challenges, like planning, organization or focus
• Eating disorders
• Obsessive compulsive disorder
• Post-traumatic stress disorder (PTSD)
• Social phobia
• Substance use disorder

CBT is often used along with medication and other treatments for conditions like bipolar disorder, schizophrenia and some personality disorders.

It can also help you manage certain physical health conditions, especially when symptoms relate to stress or coping challenges, like:

• Chronic fatigue syndrome
• Fibromyalgia and other causes of chronic pain
• Insomnia
• Irritable bowel syndrome (IBS)
• Migraines

In addition, CBT can support you through everyday challenges and life changes, including:

• Divorce
• Grief
• Relationship challenges
• Stress and coping difficulties
• Work-related issues

How does cognitive behavioral therapy work?

CBT takes place in a safe, supportive and nonjudgmental setting, where you can speak openly and privately with a trained mental health provider. They’ll collaborate with you regarding your concerns and goals.

Your therapist uses questions and discussion to help you see situations in a new way. Over time, you learn healthier ways to manage unhelpful thoughts and improve your ability to respond to stressful situations.

Progress doesn’t happen overnight. Many of these skills require practice over time. Some parts of therapy may feel uncomfortable, but that’s a normal part of change.

What happens during treatment?

Here’s what you can expect during CBT:

• Sharing your concerns: Early in therapy, you’ll talk about the challenges you’re facing, symptoms you’ve noticed and any diagnoses you have. This helps you and your therapist set goals for treatment together.
• Exploring thoughts and feelings: Your therapist will ask questions to help you look at past experiences, worries, fears and behaviors. Together, you’ll explore how your thoughts influence the way you feel and respond in situations.
• Noticing unhelpful patterns: You’ll learn to pay closer attention to thoughts, emotions and behaviors that may be making things harder for you.
• Making helpful changes: Your therapist will help you practice new ways of thinking and behaving. These skills may help you handle stress, challenges and future situations more effectively.

What are the techniques of CBT?

Here are some common CBT techniques that you might learn and practice:

• Noticing thoughts: CBT helps you spot quick thoughts that pop into your mind right away. These are called automatic thoughts, and they may affect how you feel and act.
• Challenging unhelpful thinking patterns: You learn to recognize thinking habits that aren’t accurate or helpful, like extremes (“all or nothing”), frequently expecting the worst or assuming you know what others are thinking (“mind reading”). Therapy helps you question these thoughts and replace them with more balanced ones.
• Changing behaviors: Therapy uses practical steps to help you act differently. For example, you might slowly return to activities you enjoy if depression made you withdraw from them. You’ll use clear routines, rewards and feedback to improve your focus and behavior.

What are the benefits of cognitive behavioral therapy?

This type of therapy can be helpful, though progress often takes time and practice. Research shows that CBT may support a wide range of mental health conditions, as well as some physical conditions.

One benefit of CBT is that it’s structured and goal-focused. You work with your therapist on specific skills to change unhelpful thoughts and behaviors. This may make problems feel more manageable. It’s also collaborative and personalized, meaning your therapist works with you at your own pace to focus on your needs and goals.

You can try CBT on its own or alongside medications. For some conditions, using CBT with a medication may improve results more than either treatment alone. Another benefit is that therapy helps you build skills you can keep using over time, even after therapy ends.

What are the limitations of cognitive behavioral therapy?

While therapy can be helpful for many people, it doesn’t work the same way for everyone and may have some limits. These could include:

• Other needs coming first: Urgent issues like severe depression, suicidal thoughts, psychosis or unsafe housing may need attention before CBT can be effective.
• Finding the right fit: You may meet with more than one therapist before you find someone you feel comfortable talking with. This is common and expected.
• Uncomfortable feelings: Talking about difficult thoughts or experiences may feel upsetting. Your therapist can help you work through these and use new skills to manage strong emotions as they come up.
• Barriers: Regular sessions may be hard to attend because of cost, transportation, childcare needs, work schedules or limited access to trained therapists.
• Motivation and support: CBT works best when you practice skills between sessions. If you feel unsure about therapy, don’t have support or feel pressured into it, progress may be slower.
• Stigma: Worry about judgment around mental healthcare may make it harder for you to start or stick with therapy.

CBT is one option among many. A healthcare provider or therapist can help you decide whether this is a good fit for you and suggest other approaches if your needs change.

How long will I need cognitive behavioral therapy (CBT)?

Sessions usually last about 60 minutes and may occur weekly, biweekly or monthly depending on your needs. Many people attend therapy for eight to 12 visits. Sometimes, more sessions are needed.

CBT should move at a pace that feels right for you. If there’s a topic that feels too hard to talk about or you don’t feel ready yet, it’s OK to say so. Sharing how you feel helps your therapist adjust your care.

What are CBT coping skills?

Coping skills are tools you can use in everyday life to handle difficult situations better.

Here are a few examples:

• Handling strong emotions: Instead of fighting fear or sadness, you learn how to let feelings rise and fall on their own.
• Mindfulness: You focus on the present moment without judging yourself. This may reduce constant overthinking and stress. A strategy like deep breathing can help you redirect your thoughts to the present.
• Thinking more flexibly: Instead of jumping to scary conclusions, you learn to look at situations from different angles.

When should I call my healthcare provider?

Contact your healthcare provider if symptoms start to get worse or you notice a big change in how you feel.

Get help right away if you have thoughts about suicide or harming yourself or others. You can call or text the Suicide & Crisis Lifeline at 988 (U.S.), available 24/7. If you’re in immediate danger, call 911 or your local emergency number.

How do I find a CBT therapist?

Trained mental health providers offer cognitive behavioral therapy. People of all ages, including children, can benefit from it.

Finding the right therapist can take time. Try not to get discouraged. Start by asking your primary care provider or talking with trusted friends or family members who may have recommendations.

You can also search online through local or state psychology associations or therapist directories. Your insurance company may also have a list of covered providers.

Before scheduling an appointment, make sure the therapist is licensed in your state and has experience treating your specific concern. Many therapists list this information on their website. If you’re unsure, you can call or email their office to ask questions before deciding.