CBT Explained

---

What Is CBT?

CBT focuses on the connection between our thoughts, emotions, and actions. The core idea of CBT is that our thoughts significantly influence our emotions and behaviours. Negative or unrealistic thoughts can lead to distressing emotions and unhelpful behaviours. But, by identifying and restructuring these negative thoughts, individuals can develop healthier emotional responses and behaviours.

A fundamental principle of CBT is the concept of cognitive restructuring, which involves challenging and changing distorted or unhelpful thoughts. The process helps individuals look at situations more realistically, reducing emotional distress and promoting beneficial behaviours.

CBT emphasises the role of learning in the development and maintenance of problematic thoughts and behaviours, and therefore emphasises skill acquisition and practice. With CBT, individuals learn coping skills, problem-solving strategies, and how to set realistic goals.

How Does CBT Work?

The CBT process typically begins with an assessment, where the therapist and individual work together to identify specific problems. Together, they set goals for therapy, aiming to change patterns of thinking, emotional responses, and behaviours linked to the individual's issues.

Sessions follow a structured format, with therapists introducing concepts and techniques for skill development. Individuals often have homework tasks, such as monitoring their thoughts and emotions and practising new skills in real-life situations. This homework reinforces learning and applying skills practically.

Regular review sessions are held to track progress towards goals, adjust tactics as needed, and solve any problems. CBT is collaborative, involving individuals actively in their treatment and making adjustments based on their experiences and feedback.

Typically, CBT is time-limited, lasting from 5 to 20 sessions, depending on the individual's needs and the complexity of their issues. The focused, goal-oriented approach is designed to work within a limited number of sessions.

The Pros and Cons of CBT

Why CBT Is Effective

• Evidence-Based: CBT is one of the more extensively researched talking therapies. The NHS lists it as a recommended treatment for conditions including depression, anxiety disorders and post-traumatic stress disorder (see Additional Resources below).
• Short-Term: CBT is usually shorter than many other therapies, with a typical course running 5 to 20 sessions. This makes it a practical option for people who want a defined, time-limited piece of work.
• Skill Development: CBT teaches practical skills for managing negative thoughts, emotions, and behaviours. These tools are not only for the immediate difficulty; many people go on using them afterwards.
• Structured Approach: The structured nature of CBT makes progress easier to track. Goals are set explicitly, and each session builds on the last.
• Active Participation: CBT asks the person to take an active part, learning to notice and work with their own thinking patterns rather than receiving treatment passively.

Limitations of CBT

• Requires Effort and Engagement: To be effective, CBT demands significant effort from the individual, including doing homework and applying strategies outside of sessions. Not everyone is ready for this level of involvement.
• Focuses Mainly on the Present: While effective for current problems, CBT's focus on present thoughts and behaviour patterns might not fully address deep-rooted issues or the source of the problems that stem from the past.
• Not Suitable for All: While CBT is helpful for many, some individuals may benefit more from therapies that offer deeper explorations of emotions or longer-term treatment.
• Therapist Expertise Is Key: The success of CBT heavily relies on the therapist's expertise, including their ability to tailor the approach to the individual's specific needs. Finding a skilled CBT therapist is essential.

Weighing the two lists, CBT suits people looking for a structured, time-limited therapy who are ready to engage actively and practise skills between sessions. People who want a deeper exploration of past experience, or who prefer a less structured therapy, may find another approach fits better.

Is CBT Right for You?

Several factors can guide your decision about whether Cognitive Behavioural Therapy (CBT) suits you:

• Nature of Your Concerns: CBT is well suited to specific, identifiable difficulties such as anxiety, depression, and certain phobias. Where the difficulty is well-defined and present-focused, CBT may offer the structured support you are after.
• Preference for Active Involvement: CBT is built around setting clear goals and working with tangible skills and strategies. A willingness to do homework and apply the ideas outside of sessions is part of the method.
• Learning Style: CBT's structured, largely educational approach asks you to grasp and apply cognitive and behavioural principles in daily life. If you like learning practical skills and putting them to use between sessions, that suits how CBT is taught.
• Time and Commitment: Are you looking for shorter-term therapy with measurable goals, or are you open to a longer exploration of your thoughts and feelings? CBT is usually the former.
• Therapist Availability: Access to a skilled CBT therapist with whom you feel comfortable also matters. Availability in your area, or willingness to consider online sessions, can influence your decision. You can use an online directory to find a CBT therapist who meets your needs and preferences.
• Fit: Initial consultations are an opportunity to ask questions, raise concerns, and gauge your comfort with the therapist. This matters because the therapeutic relationship contributes to how well therapy works.

If you are unsure whether CBT is the right fit, it is worth reading about the other therapeutic approaches before deciding. Our guide to which type of therapy is best sets out how the main approaches differ and what to weigh up when choosing.

Getting Started with CBT

If you think CBT might be the right approach for you, the following steps require some preparation and research:

• Research Therapists: Look for licensed therapists who specialise in CBT. Many professionals list their qualifications and therapy specialities online, making it easier to find someone who matches your needs.
• Schedule Consultations: Contact potential therapists for initial consultations. Use these meetings to ask questions, discuss your goals, and gauge your comfort with their approach. A solid therapeutic relationship is the basis of all effective therapy.
• Be Open and Honest: During your sessions, be open and honest about your thoughts, feelings, and experiences. This helps your therapist tailor the approach to suit you.
• Commit to the Process: Therapy takes time and effort. Commit to attending sessions regularly and practising the skills you learn.

Key Takeaways

• CBT's strength lies in its structured, goal-oriented method, which addresses specific difficulties such as anxiety, depression, and behaviour change.
• It offers practical skills and strategies for working with negative thought patterns.
• Active engagement matters in CBT, including completing homework and applying strategies beyond sessions.
• CBT is supported by an extensive research literature and is widely recommended in clinical guidelines for conditions such as depression and anxiety.

FAQ

How quickly can I see results with CBT?

A typical course of CBT runs 5 to 20 sessions. How much changes in that time varies from person to person and with the difficulty being worked on.

Can I do CBT online?

Many therapists offer CBT sessions online, providing flexibility for those with busy schedules or limited access to in-person therapy.

Is CBT only for specific mental health issues?

CBT is most often used for conditions such as anxiety and depression, but its principles can be applied to a wide range of mental health difficulties.

What if CBT doesn't work for me?

Therapy is a personal experience, and not every approach suits everyone. If CBT doesn't seem to meet your needs, your therapist can work with you to adjust the approach or explore alternative therapies.

Additional Resources

NHS, Cognitive behavioural therapy (CBT)
American Psychological Association, Cognitive Behavioral Therapy (CBT)