Cognitive-Behavioral Therapy (CBT)
(Rational Emotive Therapy; Rational Behavior Therapy; Rational Living Therapy; Dialectic Behavior Therapy; Schema Focused 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 the way you think, and how it drives the way you feel and act.
CBT will help you solve problems. You can't always control other people or situations. But, you can control how you react. CBT teaches you how 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:
- Depression and mood swings
- Social anxiety disorder
- Feelings of extreme shyness
- Panic disorders
- Post-traumatic stress disorder (PTSD)
- Attention deficit hyperactivity disorder (ADHD)
- Autism spectrum disorders (ASD)
- Obsessive-compulsive disorder (OCD)
- Borderline personality disorder
- Eating disorders such as anorexia or bulimia
- Insomnia and other sleep problems
- Substance misuse
- Chronic pain
- Problems with people in your life
- Low self-esteem
- Poor coping skills
- Anger problems
A combination of physiological and emotional triggers causes many mental health problems. CBT can help people cope by decreasing the effects of emotional triggers.
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CBT may not work for everyone. You and your therapist will watch your progress. There may be other methods that work better for you.
What to Expect
Prior to Procedure
You may be asked to fill out a questionnaire about your feelings.
Description of the Procedure
CBT can be done alone or in a group. CBT can be split into 2 parts:
You and your therapist will identify stressful situations. You will also learn the thoughts that lead to make problems worse. These thoughts will be worked on to see if that's the best way to handle problems. Your therapist may point out negative thought patterns such as “I can't handle this” or "people are laughing at me.”
Next, you will work on lessening negative thoughts. This will help you learn healthier ways. This may involve exposure to the situation that causes your problems. You will learn to draw on your strengths so you can think "I can" instead of "I can't".
You will also learn to ask more questions. For example, “Could those people be laughing at something other than me?” The goal is to replace unhealthy thoughts with healthy ones.
This takes a lot of practice. You will often be given homework. You may have to practice deep-breathing or role-play how to act. For example, a person dealing with substance abuse might practice ways to say no to alcohol.
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?
One session is usually 50-100 minutes. Group sessions may last longer. You may need to go 1-2 times per week for 12-16 weeks.
Depending on your situation, you may need a longer or shorter time frame. Keep in mind it may take many 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 want you to return for a check-up about 3, 6, and 12 months after therapy has ended. You may call your therapist at any time.
The goal of CBT is to change your thought process. This will allow healthy and realistic responses to difficult situations. Many patients notice an improvement in their symptoms within 3-4 weeks of beginning CBT.
Call Your Doctor
If the thoughts, feelings, or other problems that led you to CBT are returning or getting worse, call your doctor. If you have thoughts of hurting yourself or others, call for emergency medical services right away.
American Psychiatric Association
Beck Institute for Cognitive Therapy and Research
Canadian Mental Health Association
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. Available at: http://johnjayresearch.org/cje/files/2012/08/Empirical-Status-of-CBT.pdf.
Cognitive and behavioral therapies for depression website. Available at: https://www.div12.org/treatment/cognitive-behavioral-analysis-system-of-psychotherapy-for-depression. Accessed August 31, 2018.
Cognitive and behavioral therapies for generalized anxiety disorder website. Available at: https://www.div12.org/treatment/cognitive-and-behavioral-therapies-for-generalized-anxiety-disorder. Accessed August 31, 2018.
What is cognitive-behavioral therapy (CBT)? Beck Institute for Cognitive Therapy and Research website. Available at: https://beckinstitute.org/get-informed/what-is-cognitive-therapy. Accessed May 5, 2016.
What is cognitive-behavioral therapy (CBT)? National Association of Cognitive-Behavioral Therapists website. Available at: http://www.nacbt.org/whatiscbt.htm. Accessed May 5, 2016.
11/23/2015 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116638/Major-depressive-disorder-MDD: Coffey SF, Banducci AN, Vinci C. Common questions about cognitive behavior therapy for psychiatric disorders. Am Fam Physician. 2015;92(9)807-812.
Last reviewed May 2018 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 8/31/2018