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 used by mental health professionals to treat a wide range of problems. It teaches a person how to identify and change thought patterns that have a negative influence on behavior and emotions.
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. There may be other methods that work better for certain people.
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 two parts:
You and your therapist will identify stressful situations. You will also learn the thoughts that make problems worse. These thoughts will be worked on to see if that is 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 to 100 minutes. Group sessions may last longer. You may need to go 1 to 2 times per week for 12 to 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 to 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
Cognitive and behavioral therapies for depression. Society of Clinical Psychology website. Available at: https://www.div12.org/treatment/cognitive-behavioral-analysis-system-of-psychotherapy-for-depression. Accessed November 20, 2020.
Cognitive and behavioral therapies for generalized anxiety disorder. Society of Clinical Psychology website. Available at: https://www.div12.org/treatment/cognitive-and-behavioral-therapies-for-generalized-anxiety-disorder. Accessed November 20, 2020.
National Collaborating Centre for Mental Health commissioned by the National Institute for Health and Care Excellence (NICE). Depression in adults: the treatment and management of depression in adults (updated edition). NICE 2009 Oct:CG90, updated 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 November 20, 2020.
What is cognitive-behavioral therapy (CBT)? National Association of Cognitive-Behavioral Therapists website. Available at: http://www.nacbt.org/whatiscbt.htm. Accessed November 20, 2020.
11/23/2015 DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/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 September 2020 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 11/20/2020