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Therapists use cognitive behavioral therapy to help people with mental and physical health challenges like: irritable bowel syndrome (IBS) The goal of CBT is to help you adapt and change your mindset and behaviors by reassesing distorted thought patterns . Whether you’re living with a mental health condition or just keep finding yourself worrying about the little things, CBT could be a helpful tool if you’re looking for an evidence-backed therapy to relieve persistent mental health symptoms. How does cognitive behavioral therapy work? Basically, CBT works by identifying, tackling, and changing unhelpful thinking so that your mindset, behaviors, and overall well-being improve with practice. When you change the way you feel about specific situations, for example, it will likely be easier to adapt your behaviors in the future. In mental health conditions like depression, anxiety, substance use, phobias, and many others, negative thinking takes many forms, like: thinking in black and white overgeneralizing ignoring the positive and focusing on the negative catastrophizing In CBT, you’ll work with your therapist to identify the thinking patterns that cause your distress. This is an important step in managing overwhelming emotions and unhelpful behaviors. Though many people think therapy is just chatting with a doctor, CBT is actually very structured and tailored to each person. Over time, you’ll learn CBT techniques to acknowledge and challenge thoughts that get in your way. CBT strategies might include: keeping track of your thoughts and reviewing them later confronting situations that create anxiety to learn coping mechanisms practicing problem-solving with your therapist role-playing interactions with others By practicing CBT strategies like these with your therapist — and at home by yourself — you’ll develop useful skills like: gaining awareness of unhelpful thoughts and how they impact your emotional state getting a more logical understanding of other people’s actions challenging automatic assumptions accurately assessing reality coping with triggering or upsetting situations learning positive self-talk and how to boost confidence relaxation techniques The idea is to apply the skills you learn in therapy to your daily life. It’s like exercising any muscle to make it stronger, except this time that muscle is your brain. It requires both you and your therapist to be collaborative, committed, and communicative. What’s the principle behind CBT? In the 1960s, psychiatrist Aaron Beck realized that the people he helped with depression often showed specific thinking patterns that didn’t serve them. He explained emotional conditions using a cognitive model : Thoughts control how people view themselves, others, and their environment, which impacts their mood and behavior. In other words, if you perceive everything around you to be bad, you’ll likely feel pretty bad, too. The basic principle that underlies cognitive behavioral therapy is that most emotional and behavioral reactions are learned — and so they can be unlearned or changed. Unlike many other forms of psychotherapy , CBT is mostly concerned with present feelings and events, not past trauma or life history. That’s not to say those topics won’t come up in therapy, but they’re not the central focus of CBT treatment. What are some common goals in CBT? Some goals in CBT include: forming new habits learning interpersonal skills developing constructive coping mechanisms

reducing or managing stress and anxiety shifting from negative thinking to a more balanced outlook learning how to express feelings How long does cognitive behavioral therapy take to work? The time it takes to make progress toward these goals is different for everyone. Some people see results after only a few CBT sessions, while others require a few months to learn how to manage their symptoms. You may start out with one session per week, and then gradually decrease the frequency. However, this will depend on both your and your therapist’s availability and accessibility. What are the benefits of CBT? Research in 2015 indicated that CBT is often just as or more effective in reducing symptoms than other types of therapy, especially when it comes to anxiety disorders. That being said, medication does still perform better for some conditions, and many people find it most beneficial to combine CBT with medication. The benefits of CBT are extensive. For example: It often leads to long-term results. Since the emphasis is on identifying unhelpful thinking patterns and building skills for everyday use, CBT’s positive effects can last long after treatment has stopped. It’s an effective alternative to medicine. For some people, medication simply doesn’t work for them. CBT offers another form of treatment using a completely different approach. The duration of treatment is pretty short. Unlike other kinds of talk therapy, CBT doesn’t have to go on for years. It can last anywhere around 5 to 20 sessions , though occasional follow-up sessions can be useful. CBT can take place one-on-one, in groups, or even on your own. Though the approach to CBT is structured, it’s flexible in terms of format. Some apps and workbooks even allow you to practice CBT techniques on your own. The skills you’ll learn can help beyond your original reason for treatment. The skills CBT often emphasizes, like problem-solving, personal interaction, and time management, can serve you in many aspects of your life. Are there any risks in CBT? Though CBT is generally a safe and effective treatment option, it has some potential drawbacks, too. One 2018 study found therapists reported worsening symptoms in 9% of people in therapy. And during CBT, 27% experienced distress or negative well-being. Still, it can help to keep in mind that this discomfort tends to be temporary and a normal part of some types of CBT. The most significant drawback of CBT could be the reappearance of symptoms after therapy has ended. But it’s also not uncommon for this to happen. Your therapist may work with you to create a maintenance plan to keep symptoms at bay when you’re no longer having regular sessions. Still, the overwhelming majority of research suggests the benefits of CBT outweigh the risks. Besides the possibility of side effects, CBT does have some drawbacks to consider. For example: It’s a big commitment. Even though treatment may only last a few months, it takes commitment and persistence to get the results you want. You’ll likely need to practice the skills you’re learning often for them to stick. It may not be enough. For people with more complex or intense health concerns, CBT may not be the right approach — or it may simply not be enough to reduce symptoms by itself. It can be uncomfortable. Since part of CBT is addressing how distorted thinking makes you feel, therapy can temporarily stir up or worsen emotional symptoms. It can help to prepare yourself for some discomfort. It can be expensive. Depending on your insurance, where you live, and other factors, CBT with a professional might be out of reach due to its cost . Still, some therapists offer therapy with sliding scale fees, which means you pay what you can — it can help to look for therapists who offer this. What can I expect in CBT? Before therapy even begins, your therapist will probably ask you to fill out a questionnaire used to assess your mental health and keep track of progress later on. They’ll likely spend most of the first session asking questions and getting to know you and your thought processes so treatment can be customized for you. Since CBT is a collaborative effort, it’s important to feel comfortable with and connected to your therapist. Even though it can be frustrating and time consuming, don’t be afraid to meet with multiple therapists until you find one that you’re happy with. Once you’ve gone through all the basic questions, established your goals, and identified distorted patterns of thinking, your therapist can work with you to pick the right techniques to assess and adjust those thoughts. Be prepared to get some homework, too. CBT often includes out-of-session practice like self-reflection tasks, behavioral exercises, and readings. Although CBT usually takes place in-person, online options are also available and effective. Is CBT right for me? Questions to ask before you start What is CBT used for? Some of the mental health conditions most commonly treated with CBT include: generalized anxiety disorder bulimia nervosa and other eating disorders major depressive disorder substance use disorder bipolar disorder post-traumatic stress disorder (PTSD) Physical conditions treated with CBT could include: irritable bowel syndrome (IBS) chronic fatigue syndrome Who’s most likely to benefit from CBT? Research shows people of all ages, ethnicities, and genders can benefit from CBT. But as mentioned before, some people may be more suited for CBT than others. It’s most likely to help people who: have challenges they can identify and want to change have tried medication but not seen any or enough positive results are eager to improve their mental health and have time to fully commit Last medically reviewed on May 28, 2021 18 sources collapsed Beck JS. (n.d.). Common questions. https://www.academyofct.org/page/FAQ Chand SP, et al. (2021). Cognitive behavior therapy. https://www.ncbi.nlm.nih.gov/books/NBK470241/ Fenn K, et al. (2013). The key principles of cognitive behavioural therapy. https://journals.sagepub.com/doi/full/10.1177/1755738012471029 Fordham B, et al. (2021). Cognitive-behavioural therapy for a variety of conditions: An overview of systematic reviews and panoramic meta-analysis. https://www.ncbi.nlm.nih.gov/books/NBK567941/ Gilpin HR, et al. (2017). Predictors of treatment outcome in contextual cognitive and behavioral therapies for chronic pain: A systematic review. https://www.jpain.org/article/S1526-5900(17)30557-6/fulltext Grant PM, et al. (2017). Six-month follow-up of recovery-oriented cognitive therapy for low-functioning individuals with schizophrenia. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201600413 Hall J, et al. (2016). Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults: Systematic review, meta-analysis, and meta-regression. https://www.sciencedirect.com/science/article/abs/pii/S1064748116301476 Hehlmann MI, et al. (2021). The use of digitally assessed stress levels to model change processes in CBT - A feasibility study on seven case examples. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985334/ Hetterich L, et al. (2020). Psychotherapeutic interventions in irritable bowel syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205029/ History of cognitive behavior therapy. (n.d.). https://beckinstitute.org/about-beck/history-of-cognitive-therapy/ Kaczkurkin AN, et al. (2015). Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/ Linardon J, et al. (2017). The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. https://content.apa.org/record/2017-48283-005 MacDuffie KE, et al. (2018). Single session real-time fMRI neurofeedback has a lasting impact on cognitive behavioral therapy strategies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005804/ Ruggiero GM, et al. (2018). A historical and theoretical review of cognitive behavioral therapies: From structural self-knowledge to functional processes. https://link.springer.com/article/10.1007/s10942-018-0292-8 Schermuly-Haupt M-L, et al. (2018). Unwanted events and side effects in cognitive behavior therapy. https://link.springer.com/article/10.1007%2Fs10608-018-9904-y Sztein DM, et al. (2018). Efficacy of cognitive behavioural therapy delivered over the Internet for depressive symptoms: A systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/28696153/ What is cognitive behavioral therapy? (n.d.). https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral.pdf Wojnarowski C, et al. (2019). Predictors of depression relapse and recurrence after cognitive behavioural therapy: A systematic review and meta-analysis. https://www.cambridge.org/core/journals/behavioural-and-cognitive-psychotherapy/article/abs/predictors-of-depression-relapse-and-recurrence-after-cognitive-behavioural-therapy-a-systematic-review-and-metaanalysis/653444A1EDC910538C898F11E381D7B0 10 Tips to Help the Therapist Help You Get the Most Out of Sessions Cognitive Behavioral Therapy (CBT) for Schizophrenia What Is Dialectical Behavior Therapy? How to Identify Cognitive Distortions: Examples and Meaning What to Do When You Can’t Afford Therapy 10 Tips to Help the Therapist Help You Get the Most Out of Sessions Medically reviewed by Joslyn Jelinek, LCSW, ACSW, RDDP Two things we care about almost as much as the issue we're seeking therapy for: our precious time and money. Learn 10 tips to make therapy really… READ MORE Two things we care about almost as much as the issue we're seeking therapy for: our precious time and money. Learn 10 tips to make therapy really… Cognitive Behavioral Therapy (CBT) for Schizophrenia Medically reviewed by Nicole Washington, DO, MPH Schizophrenia treatment often includes talk therapy. Here's how cognitive behavioral therapy (CBT) may benefit people with schizophrenia. READ MORE Schizophrenia treatment often includes talk therapy. Here's how cognitive behavioral therapy (CBT) may benefit people with schizophrenia. What Is Dialectical Behavior Therapy? Medically reviewed by Nicole Washington, DO, MPH Dialectical behavior therapy is often touted as a good therapy for borderline personality disorder, but it could help people without mental health… READ MORE Dialectical behavior therapy is often touted as a good therapy for borderline personality disorder, but it could help people without mental health… How to Identify Cognitive Distortions: Examples and Meaning This list of cognitive distortions might be causing your negative thoughts. Here's how to identify and stop these distorted thoughts. READ MORE This list of cognitive distortions might be causing your negative thoughts. Here's how to identify and stop these distorted thoughts. What to Do When You Can’t Afford Therapy Medically reviewed by Karin Gepp, PsyD The cost of therapy may stop some people from getting the help they need. These tips may help make therapy more affordable. READ MORE The cost of therapy may stop some people from getting the help they need. These tips may help make therapy more affordable. Things to Expect (and Not!) in Your First Therapy Session Medically reviewed by N. Simay Gökbayrak, PhD You're nervous. It feels awkward, but you know it's time to see a counselor and get mentally healthy. Here's what you should know. READ MORE You're nervous. It feels awkward, but you know it's time to see a counselor and get mentally healthy. Here's what you should know. How to Vet a Therapist Medically reviewed by Karin Gepp, PsyD You've said yes to therapy, now how in the world do you get started? Here's everything you need to know and would ever think to ask. READ MORE You've said yes to therapy, now how in the world do you get started? Here's everything you need to know and would ever think to ask. How to End Therapy the Right Way Medically reviewed by Joslyn Jelinek, LCSW, ACSW, RDDP People end therapy for various reasons. If you're unsure about how to "break up" with your therapist, this article provides valuable tips on how to do… READ MORE People end therapy for various reasons. If you're unsure about how to "break up" with your therapist, this article provides valuable tips on how to do… Podcast: What Are Prescription Digital Therapeutics (PDTs)? Can an app improve your mental health? Experts explain the facts on this podcast episode. PDT - Prescription Digital Therapeutics READ MORE Can an app improve your mental health? Experts explain the facts on this podcast episode. PDT - Prescription Digital Therapeutics 5 Tips to Finding a Therapist for Depression in California When you live with depression, finding a therapist is crucial to managing your symptoms. An online therapist provides a lower cost and convenient… READ MORE When you live with depression, finding a therapist is crucial to managing your symptoms. An online therapist provides a lower cost and convenient…