Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a type of psychological treatment that focuses on changing the ways we react to negative, false thinking patterns and behaviors. CBT may be used by itself or alongside other types of mental health treatment.

What is cognitive behavioral therapy?

Cognitive behavioral therapy (CBT) is a common, well-studied type of psychological treatment used to treat a range of mental health challenges. While the length of treatment depends on the needs of the person receiving care, CBT usually happens over a limited number of sessions. Though no single form of mental health treatment works for every person, there is a lot of scientific evidence that CBT can help people lead healthy, balanced lives.

What kinds of challenges does CBT help to treat?

CBT may be used to treat a huge range of mental health challenges, including (but not limited to):

  • Anxiety disorders, especially obsessive-compulsive disorder and post-traumatic stress disorder
  • Attention deficit/hyperactivity disorder (ADHD)
  • Bipolar disorder
  • Borderline personality disorder
  • Chronic pain
  • Depression
  • Eating disorders
  • Grief and mourning
  • Schizophrenia
  • Stress
  • Substance use challenges

What are the main principles of CBT?

Psychologists who practice and recommend CBT believe that we can gain a better understanding of our mental health through a few specific lenses:

  • Our thoughts, feelings, and actions are all connected to each other
  • Some mental health problems may be partially based on unhelpful, false ways of thinking (cognitive distortions), as well as problematic core beliefs about ourselves, others, and the world
  • Mental health problems may also be based on unhelpful behaviors, both mental and physical, that we repeat over and over until they become bad habits
  • We can learn coping skills to change our thoughts and behaviors and help us live healthier lives

What are cognitive distortions?

A “cognitive distortion” is the psychological term for the negative, inaccurate ways of thinking that can get stuck in our heads. Cognitive distortions include, but are not limited to:

  • Black-and-white or all-or-nothing thinking: “I am a horrible/unlovable person.”
  • Catastrophizing: “If I break up with my partner, I will never find love again no matter how hard I try.”
  • Comparison: “My classmates are so much smarter and happier than me.”
  • Emotional reasoning: “I feel anxious and frightened, so something must be terribly wrong.”
  • Fortune-telling: “I am going to fail this test.”
  • Labeling/mislabeling: “Because I made a mistake, I am a failure.”
  • Magnification/minimization: “It doesn’t matter that something good happened to me today; something bad will probably happen tomorrow.”
  • Mental filter: Remembering the all the negative elements of an event or interaction and none of the positives.
  • Mind-reading: “Everyone in my class thinks I am loud and annoying.”
  • Overgeneralization: “I was excited to try a new sport today but I was horrible at it. It’s just too hard.”
  • Personalization: “I think I said something awkward while hanging out with my friend yesterday; that must be why she’s acting weird and quiet today.”
  • Self-critical “should” language: “I should have studied harder for that test.”

What do CBT therapists do to help challenge cognitive distortions?

Therapists experienced in CBT help you to identify cognitive distortions in your own mind and realize that these distortions are not true. From there, your therapist will work with you to build a “toolkit” of problem-solving techniques to use when those negative thoughts appear. When you change the way you react to false, negative thoughts, you are actually teaching your brain not to listen to those thoughts! CBT also teaches mindfulness: letting thoughts flow in and out of your brain without judging or trying to do something about them. With time, CBT can build self-confidence and reduce distortions. Think of your brain as a muscle – you have to exercise it to get stronger!

How is CBT different from talk therapy?

Unlike classic “talk therapy,” CBT does not focus on the past events that caused you to feel bad or uncomfortable. CBT focuses on what’s happening right now, and how to make things better in the future. Both CBT and talk therapy, together and/or separately, can be very helpful for mental health.

How do I know if CBT is right for me?  

Like all forms of therapy, CBT can be emotionally “activating” and upsetting, because you’re facing some pretty huge fears and negative thought patterns! A good mental health care provider (HCP) will challenge you to push yourself while making sure that you are safe the whole time. To get the most out of CBT, it’s essential to have an open, honest, and continuing conversation with your therapist and other HCPs on your care team. Don’t be afraid to be honest about how you are feeling and what you need – therapy is a two-way relationship between you and your provider, and we are confident that you will find the provider that is right for you.