What Is Cognitive Behavioral Therapy (CBT)?

Verywell / Daniel Fishel

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior and emotions.

Cognitive behavioral therapy focuses on changing the automatic negative thoughts that can contribute to and worsen emotional difficulties, depression, and anxiety. These spontaneous negative thoughts have a detrimental influence on mood.

Through CBT, these thoughts are identified, challenged, and replaced with more objective, realistic thoughts.


Everything You Need to Know About CBT

This video has been medically reviewed by Steven Gans, MD.

Types of Cognitive Behavioral Therapy

CBT encompasses a range of techniques and approaches that address thoughts, emotions, and behaviors. These can range from structured psychotherapies to self-help materials. There are a number of specific types of therapeutic approaches that involve CBT, including:

  • Cognitive therapy centers on identifying and changing inaccurate or distorted thinking patterns, emotional responses, and behaviors.
  • Dialectical behavior therapy (DBT) addresses thoughts and behaviors while incorporating strategies such as emotional regulation and mindfulness.
  • Multimodal therapy suggests that psychological issues must be treated by addressing seven different but interconnected modalities: behavior, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.
  • Rational emotive behavior therapy (REBT) involves identifying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought patterns.

While each type of cognitive behavioral therapy takes a different approach, all work to address the underlying thought patterns that contribute to psychological distress.

CBT Techniques

CBT is about more than identifying thought patterns; it is focused on using a wide range of strategies to help people overcome these thoughts. Techniques may include journaling, role-playing, relaxation techniques, and mental distractions.

Identifying Negative Thoughts

It is important to learn how thoughts, feelings, and situations can contribute to maladaptive behaviors. The process can be difficult, especially for people who struggle with introspection, but it can ultimately lead to self-discovery and insights that are an essential part of the treatment process.

Practicing New Skills

It is important to start practicing new skills that can then be put in to use in real-world situations. For example, a person with a substance use disorder might start practicing new coping skills and rehearsing ways to avoid or deal with social situations that could potentially trigger a relapse.


Goal setting can an important step in recovery from mental illness and helping you make changes to improve your health and life. During CBT, a therapist can help with goal-setting skills by teaching you how to identify your goal, distinguish between short- and long-term goals, set SMART (specific, measurable, attainable, relevant, time-based) goals, and focus on the process as much as the end outcome.


Learning problem solving skills can help you identify and solve problems that arise from life stressors, both big and small, and reduce the negative impact of psychological and physical illness.

Problem solving in CBT often involves five steps:

  1. Identifying a problem
  2. Generating a list of possible solutions
  3. Evaluating the strengths and weaknesses of each possible solution
  4. Choosing a solution to implement
  5. Implementing the solution


Also known as diary work, self-monitoring is an important part of CBT that involves tracking behaviors, symptoms, or experiences over time and sharing them with your therapist. Self-monitoring can help provide your therapist with the information needed to provide the best treatment. For example, for people coping with eating disorders, self-monitoring may involve keeping track of eating habits as well as any thoughts or feelings that went along with consuming that meal or snack.

What CBT Can Help With

Cognitive behavior therapy can be used as a short-term treatment to help individuals learn to focus on present thoughts and beliefs.

CBT is used to treat a wide range of conditions including:

In addition to mental health conditions, CBT has been found to help people cope with the following:

  • Chronic pain or serious illnesses
  • Divorce or break-ups
  • Grief or loss
  • Insomnia
  • Low self-esteem
  • Relationship problems
  • Stress management

Benefits of Cognitive Behavioral Therapy

The underlying concept behind CBT is that thoughts and feelings play a fundamental role in behavior. For example, a person who spends a lot of time thinking about plane crashes, runway accidents, and other air disasters may avoid air travel as a result.

The goal of cognitive behavior therapy is to teach people that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.

CBT is often known for the following key benefits:

  • It allows you to engage in healthier thinking patterns by becoming aware of the negative and often unrealistic thoughts that dampen your feelings and moods.
  • It is an effective short-term treatment option; for example, improvements can be seen in five to 20 sessions.
  • It has been found effective for a wide variety of maladaptive behaviors.
  • It is often more affordable than some other types of therapy.
  • It has been found to be effective online as well as face-to-face.
  • It can be used for those who don't require psychotropic medication.

One of the greatest benefits of cognitive behavioral therapy is that it helps clients develop coping skills that can be useful both now and in the future.

Effectiveness of CBT

CBT emerged during the 1960s and originated in the work of psychiatrist Aaron Beck, who noted that certain types of thinking contributed to emotional problems. Beck labeled these "automatic negative thoughts" and developed the process of cognitive therapy. 

Where earlier behavior therapies had focused almost exclusively on associations, reinforcements, and punishments to modify behavior, the cognitive approach addressed how thoughts and feelings affect behaviors.

Today, cognitive behavioral therapy is one of the most well-studied forms of treatment and has been shown to be effective in the treatment of a range of mental conditions including anxiety, depression, eating disorders, insomnia, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and substance use disorder.

  • CBT is the leading evidence-based treatment for eating disorders.
  • CBT has been proven helpful in those with insomnia as well as those who have a general medical condition that interferes with sleep, including those afflicted with pain or mood disorders such as depression.
  • Cognitive behavioral therapy has been scientifically proven to be effective in treating symptoms of depression and anxiety in children and adolescents.
  • A 2018 meta-analysis of 41 studies found that CBT helped to improve symptoms in people with anxiety and anxiety-related disorders, including obsessive-compulsive disorder and post-traumatic stress disorder.
  • CBT has a high level of empirical support for the treatment of substance use disorders, helping improve self-control, avoid triggers, and develop coping mechanisms for daily stressors.

CBT is one of the most researched types of therapy, in part because treatment is focused on highly specific goals and results can be measured relatively easily.

Verywell Mind's Cost of Therapy Survey, which sought to learn more about how Americans deal with the financial burdens associated with therapy, found that Americans overwhelmingly feel the benefits of therapy:

  • 80% say therapy is a good investment
  • 91% of Americans are satisfied with the quality of therapy they receive
  • 84% are satisfied with their progress toward mental health goals

Things to Consider and Potential Challenges of CBT

There are several challenges that people may run into during the course of cognitive behavioral therapy.

Change Can Be Difficult

Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simply becoming aware of these thoughts does not make it easy to alter them.

CBT Is Very Structured

Cognitive behavioral therapy doesn't tend to focus on underlying unconscious resistances to change as much as other approaches such as psychoanalytic psychotherapy. It is often best-suited for clients who are more comfortable with a structured and focused approach in which the therapist often takes an instructional role.

People Must Be Willing to Change

For cognitive behavioral therapy to be effective, the individual must be ready and willing to spend time and effort analyzing their thoughts and feelings. Such self-analysis and homework can be difficult, but it is a great way to learn more about how internal states impact outward behavior.

Progress Is Often Gradual

In most cases, CBT is a gradual process that helps a person take incremental steps toward a behavior change. For example, someone with social anxiety might start by simply imagining anxiety-provoking social situations. Next, they might start practicing conversations with friends, family, and acquaintances. By progressively working toward a larger goal, the process seems less daunting and the goals easier to achieve.

How to Get Started With CBT

Cognitive behavior therapy can be an effective treatment choice for a range of psychological issues. If you feel that you or someone you love might benefit from this form of therapy, consider the following steps:

  • Consult with your physician and/or check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a licensed professional in your area.
  • Consider your personal preferences, including whether face-to-face or online therapy will work best for you.
  • Contact your health insurance to see if they cover CBT, and if so, how many sessions they cover per year.
  • Expect your initial experience to be similar to a doctor's appointment, including filling out paperwork such as HIPAA forms, insurance information, medical history, current medications, a questionnaire about your symptoms, and a therapist-patient service agreement. If you're participating in online therapy, you'll likely fill out these forms online.
  • Be prepared to answer questions about what brought you to therapy, your symptoms, and your history, including your childhood, education, career, relationships (family, romantic, friends), and current living situation.
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