CBT (Cognitive behavioural therapy)

CBT

What is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT), is a type of psychotherapy.

In CBT, considered a type of talk therapy, a trained mental health professional therapist will guide you through each session.

The aim of cognitive behavioral therapy is to help you identify negative and unhealthy thoughts or behaviors.

By becoming more self aware of these negative behaviors, you can work to modify them in a more healthy and productive manner.

CBT thus helps you improve the way you approach difficult situations and helps you resolve these situations in a more healthy, productive manner. 

CBT may be used alone as a treatment modality, or it can be used in conjunction with other therapies as well.

CBT is an efficacious modality in treating a wide breadth of mental health disorders.

Some examples in which CBT may be used include, depression, post-traumatic stress disorder, anxiety, or eating disorders.

However, individuals do not need to have a mental health disorder in order to benefit from CBT.

CBT is also an effective treatment to help individuals learn improved coping mechanisms and may be applied to help people manage stressors they may encounter on a day to day basis.

CBT (Cognitive behavioural therapy)

Why use CBT?

Cognitive behavioral therapy is used to treat a wide breadth of disorders and issues.

CBT is a commonly used form of psychotherapy in practice as it can help individuals learn to quickly and efficiently identify issues and then learn to cope with the challenge.

In general, CBT is needed in fewer sessions than other forms of therapy. 

Mental health disorders that may be treated either solely with CBT, or in conjunction with other treatments, include: 

  • Anxiety disorders
  • Depression
  • Phobias
  • Post-traumatic stress disorder (PTSD)
  • Sleep disorders
  • Eating disorders
  • Obsessive-compulsive disorder (OCD)
  • Substance use disorders
  • Bipolar disorders
  • Schizophrenia
  • Sexual disorders

Beyond the treatment of mental disorders, CBT may also be used to help individuals manage emotional difficulties.

Some examples of situations in which CBT may be used and may be helpful include:

  • Management of mental health symptoms, especially when pharmacologic treatment is not a preferred option
  • Prevention of the relapse of symptoms
  • Improvement of coping mechanisms for life stressor
  • Identification and management of emotions
  • Resolution of interpersonal conflict
  • Improvement of communication skills
  • Improved coping with grief
  • Overcome emotional trauma related to abuse or violence
  • Management of chronic physical symptoms

What are the risks of CBT?

Overall, there is little risk with CBT.

As CBT may involve opening up and speaking about uncomfortable topics, it is possible that you may feel uneasy at some points during the sessions.There have been a number of criticisms on CBT and it’s effectiveness. However, like every other form of treatment CBT too has advantages and disadvantages.

In addition, subsequent to exploring these difficult topics and emotions, you may feel yourself become upset or angry, thus feeling physically drained.

In addition, as some types of CBT will guide you to confront difficult situations, you may experience associated stress or anxiety.

However, it is important to note that your therapist, a trained professional, is there to help you navigate through these difficult points during the therapy session.

Your therapist will help you work through these emotions and overcome them.

The aim is to help you improve your coping mechanisms and be able to better manage the situation and emotions.

How do I start CBT?

If you think CBT is something that you may benefit from and would like to try, here is what you can do:

  1. Find a therapist. There are multiple ways to go about this. You may either seek a referral from a doctor or your health insurance, or you may choose to follow a recommendation from a friend. Another option is to research therapists on your own, whether online or through psychology associations.
  2. Understand the possible expenses. Your health insurance may cover a portion of your therapy fees. The number of sessions your insurance covers may vary so it is important to find this out beforehand. You can also speak with the therapist about your payment options.
  3. Come prepared to speak about any concerns. Think about the topics you want to go over with your therapist beforehand. This way, you and your therapist can discuss which topic to start with. 

Who can provide CBT?

Trained professionals who can provide CBT may include psychiatrist, psychologists, licensed social workers, family therapists, psychiatric nurses, etc.

The term psychotherapist is not an indication of a particular type of education, and is instead, used as a general term.

Prior to seeing your therapist, be sure to check their:

  • Background and education. Psychotherapists may have trained in a variety of roles with varying education. Most psychotherapists will hold either a masters or doctorate degree. Psychiatrists, who are trained medical doctors, may provide medication prescriptions in conjunction with therapy. 
  • Certification and licensing. Make sure your therapist has the requisite certifications and licensing. 
  • Area of expertise. Your therapist may have a particular area of expertise such as eating disorders. You can ask them in regards to their experience in treating your areas of concern or issues you would like to address.. 

You can also get CBT in different counselling centers, such as the Synergie Counselling.

What is a session of CBT like?

CBT sessions may be conducted on a one or one basis or in a group setting.

Group settings may comprise of family members or a group of individuals who may face similar  concerns as yourself. 

Each session may include identification and better awareness of your condition or emotions.

You may also learn coping mechanisms such as for relaxation, stress management, and assertiveness.

What can I expect in my first session of CBT?

Your first session of CBT will typically be a time in which you and your therapist will get to know each other.

Your therapist will try to gain an understanding of what aspects you would like to work on and topics you would like to discuss.

Your therapist will most likely also try to gauge a sense of your health history, possibly both physical and emotional, as well as your current health in order to best understand your needs.

This is also the time in which you can see whether your therapist is suitable for you.

You can get a sense of your therapist’s approach and the types of therapy that may be used.

Together, you and your therapist may also discuss the length of each session, the frequency of sessions, and the length of time you may attend therapy.

As therapy involves personal matters and feelings, it is important that you find a therapist that you feel comfortable with and whom you feel like will be beneficial for your situation.

CBT (Cognitive behavioural therapy)

What will happen during CBT?

During a CBT session, you will be encouraged to speak about your emotions or about anything that is causing you conflict.

Your therapist will guide you through this process as it may be difficult for you to express these difficult feelings and open up.

Depending on the therapist and your situation, he/she may either use CBT alone, or combine other therapy modalities during your session.

In addition, throughout your therapy progress, your therapist may also give you small assignments.

These small assignments may range from activities or readings and are aimed to help you apply what you’ve learned in therapy to your everyday life. 

The process of CBT:

  1. Identify conflicts or matters causing you distress. Such conflicts and issues may include, but are not limited to, health problems, marital issues, loss of a loved one, anger, or a mental health disorder. 
  2. Identify the associated emotions and thoughts. After identifying the issue, you may then be encouraged to share how you feel about it and talk about the situation. Your therapist may guide you in sharing aspects from your view of the situation, your thoughts on the meaning of the situation, to other factors and people relating to the situation. 
  3. Identify any negative or harmful thoughts/behaviors. It is important to note any patterns of thoughts/behaviors that may be causing the problem. Your therapist may have you note any emotional and/or behavioral responses you have to varying situations in order to identify any relevant patterns. 
  4. Modify the negative or harmful thoughts/behaviors. You may be asked to ask yourself whether your perception of the situation aligns with an unbiased view of the actual situation. This part of therapy may take practice as your thinking may be rooted in long standing habits. 
CBT (Cognitive behavioural therapy)

What is the typical length of a course of CBT?

As CBT is generally a form of therapy used short term, the average number of sessions typically range from 5-20 sessions.

Multiple factors will affect the duration of time you may be in CBT therapy.

Such factors may include the following:

  • Type of disorder 
  • Severity of your symptoms
  • Length of time your symptoms have persisted
  • Rate of your progress
  • The amount of stress you have experienced
  • The strength of your support system

The role of confidentiality in CBT:

Except in very specific circumstances, conversations with your therapist are confidential.

However, a therapist may break confidentiality if there is an immediate threat to safety or when required by state or federal law to report concerns to authorities.

These situations include:

  • Threatening to immediately or soon (imminently) harm yourself or take your own life
  • Threatening to imminently harm or take the life of another person
  • Abusing a child or a vulnerable adult ― someone over age 18 who is hospitalized or made vulnerable by a disability
  • Being unable to safely care for yourself

Results

While CBT may not definitively cure your condition or eradicate the problem, it can help you cope with the situation.

In addition, it can help modify your behaviors and thinking to improve your resilience and thus help you live a healthier life. CBT (Cognitive behavioural therapy)

How do I get the most out of CBT?

While CBT is not the most suited for everyone, ways to ensure that you are maximizing your experience include being open and honest with your therapist.

In order to progress in therapy, you must be willing to broach difficult problems and emotions.

While it may be difficult, your therapist is there to support and guide you through the process.

In addition, it is important to adhere, and remain constant, with your therapy sessions and any assignments your therapist may give you.

In this way, you can apply your progress in therapy to situations in daily life and truly improve in your coping mechanisms.

Finally, it is important to communicate with your therapist.

Let them know if you have any reservations about anything or if you do not feel as though you are benefitting from the sessions.

You can work with your therapist on how to set your goals and the best way to reach them. 

Frequently Asked Questions (FAQ’s)

Can CBT be harmful?

CBT is a low risk treatment modality.

It is unlikely you will receive any physical harm from CBT.

However, as CBT sessions may involve in depth discussions about difficult emotions, you may feel drained after sessions.

What techniques are used in CBT?

Techniques used in CBT may vary by session, therapist style, and your situation.

However, techniques used may involve guided discovery, exposure therapy, journaling, role playing, and/or stress reduction techniques.

Can I do CBT by myself?

While a trained professional can help guide you through therapy, it is also possible to learn techniques through other resources such as self-help books and journals.

Want to learn more about cognitive behavioral therapy? Check out these resources!

Cognitive Behavioural Therapy: 7 Ways to Freedom from Anxiety, Depression, and Intrusive Thoughts

This book provides guidance and advice for individuals suffering from anxiety and depression.

It teaches you strategies and ways to help you overcome these negative thoughts and to learn self-compassion.

This resource also covers practices around the world ranging from Buddhist to Stoic philosophies and teachings. 

The Comprehensive Clinician’s Guide to Cognitive Behavioral Therapy

The authors created a resource geared towards mental health professionals of varying levels to help implement CBT theory into clinical practice.

They provide in depth current knowledge about CBT and include worksheets, detailed activities, and coping cards for clinicians to use for CBT in practice.

These resources are aimed to help patients build self-confidence and gain the tools necessary for their recovery. 

Cognitive Behavioral Therapy Made Simple: 10 Strategies for Managing Anxiety, Depression, Anger, Panic, and Worry

This book will teach you how to implement the principles of CBT into your daily life and relieve yourself of anger, panic, and stress.

This resource provides soothing strategies and methods of positive self-evaluation to help you monitor your progress and reflect positively on your aims. 

References:

  1. Cognitive Behavioral Therapy
  2. What is Cognitive Behavioral Therapy?

CBT (Cognitive behavioural therapy)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behavior, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.