Cognitive-Behavioral Therapy (CBT)
(Rational Emotive Therapy; Rational Behavior Therapy; Rational Living Therapy; Dialectic Behavior Therapy; Schema Focused Therapy)
Cognitive-behavioral therapy (CBT) is a form of talk therapy. This means that you discuss your thoughts, feelings, and behaviors with a mental health professional. CBT focuses on how the way you think affects the way you feel and act.
CBT is a problem-solving approach. While you cannot control other people or situations, you can control the way you perceive and react to a particular situation. CBT teaches you the skills to change your thinking. It can also help you manage your reactions to stressful people and situations.
Reasons for Procedure
CBT is used to treat many health concerns. Some of these include:
- Depression and mood swings
- Social anxiety disorder
- Feelings of extreme shyness
- Panic disorders
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Borderline personality disorder
- Eating disorders, including anorexia nervosa, bulimia nervosa, and obesity
- Insomnia and other sleep problems
- Substance abuse
- Chronic pain
- Difficulty with relationships
- Low self-esteem
- Poor coping skills
- Uncontrolled anger
Managing Mental Health Concerns
CBT may not be effective for everyone. Talk to your therapist about your progress or other treatments that may help you.
What to Expect
Prior to Procedure
There is no specific preparation for CBT. You may be asked to fill out a questionnaire about your feelings.
Description of the Procedure
You may receive CBT in one-on-one therapy sessions or in a group format. CBT can be divided into two parts: functional analysis and skills training.
You and your therapist will identify stressful situations. You will also determine the thoughts that lead to or worsen these situations. These thoughts will then be analyzed to see if they are realistic and appropriate. For example, your therapist may point out negative thought patterns, such as “I cannot handle this” or "people are laughing at me.”
Next, your therapist guides you to reduce unhealthy ways of thinking and to learn healthier ways. Instead of thinking “I cannot handle this,” you will learn to draw on your strengths: “I have handled difficult situations before, so I can handle this one.”
You will also learn to ask more questions about yourself before making a conclusion. For example, “Could those people be laughing at something other than me?” The goal is to replace irrational thought patterns with better ones.
Skills training takes a lot of practice. You will often be given homework. You might practice deep-breathing exercises or role-play how to act in certain social situations. For example, a person dealing with substance abuse might practice ways to decline an alcoholic drink.
Homework is vital to the success of CBT. You must practice new, rational responses until they replace your previous, unhealthy responses. Homework also allows you to try new skills. You will then be able to give feedback on which works best for you.
How Long Will It Take?
The length of an individual session is usually 50-100 minutes. Group sessions may last longer. Treatment sessions may occur 1-2 times per week for 12-16 weeks.
This is a general guideline. Depending on your situation, treatment may be longer or shorter. Keep in mind that it may take several tries to unlearn poor habits and to learn healthy ones.
You may be given homework between sessions. You will need to practice the strategies you and your therapist have discussed.
Some therapists advise that you return for a check-up about three, six, and twelve months after therapy has ended. In addition, you may call your therapist whenever the need arises.
Call Your Doctor
If the thoughts, feelings, or other difficulties that led you to seek therapy are returning or worsening, call your doctor. If you have thoughts of hurting yourself or others, call your doctor or call for medical help right away.
American Psychological Association
The Beck Institute for Cognitive Therapy and Research
Canadian Psychiatric Association
Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clin Psychol Rev. 2006;26(1):17-31.
A cognitive-behavioral approach: Treating cocaine addiction. National Institute on Drug Abuse website. Available at:http://archives.drugabuse.gov/TXManuals/CBT/CBT1.html. Accessed August 8, 2013.
Cognitive-behavioral therapy. National Association of Cognitive-Behavioral Therapists website. Available at: http://www.nacbt.org/whatiscbt.htm. Accessed August 8, 2013.
Goals of cognitive therapy. The Beck Institute for Cognitive Therapy and Research website. Available at: http://www.beckinstitute.org/cognitive-behavioral-therapy-goals. Accessed August 8, 2013.
Morris N, Raabe B. Some legal implications of CBT stress counselling in the workplace. British Journal of Guidance and Counselling. 2002;30(1):55-62.
Last reviewed June 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.