Cognitive Behavioural Therapy CBT

Authored by Dr Colin Tidy, 03 May 2017

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Reviewed by:
Dr Laurence Knott, 03 May 2017

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you feel, think and act. CBT aims to find practical ways to help you deal with problems in a more positive way by breaking them down into smaller parts.

Cognitive means the way we think about things. Cognitive therapy helps us to understand our thoughts so that we can think about things more positively. Behavioural therapy helps us to change any of our actions that cause us harm or are unhelpful (for example, staying at home all the time because of a fear of something outside). Cognitive and behavioural therapies are often used together because how we behave often depends on how we think about certain things or situations.

What conditions can be helped by this treatment?

CBT can be used to help people with many different mental health conditions (for example, anxiety, depression and eating disorders) and physical conditions (for example, persistent pain).

Read more about CBT and which conditions it can help to treat.

Your feelings often affect your thoughts - for instance, if you're feeling depressed and someone you know rushes past you without saying hello, you might think it's because they're deliberately blanking you. This can lead to a vicious cycle of thoughts - they're ignoring me because they don't like me; maybe other people feel the same; maybe I'm just a bad person. This can make you feel worse and behave in ways that can reinforce your feelings. If you have a particular fear, you may change your behaviour to avoid whatever you're scared of. This can have a major impact on what you can do and how you live your life.

Cognitive behavioural therapy (CBT) aims to stop these negative cycles by helping you to recognise and challenge these negative thoughts and behaviours, and replace them with more positive ones. 

CBT deals with any problems you have now, rather than focusing on issues from your past. It doesn't suit everyone and it isn't helpful for all conditions. You need to be committed to tackling and improving your health problem with the help of the therapist. It can be hard work. It can also be difficult and challenging. But it can also be very effective and worth every minute.

Find out more about how CBT works.

You can have cognitive behavioural therapy (CBT) with a therapist either one-to-one or in a group. If you have one-to-one CBT with a therapist this usually involves a number of therapy sessions (often somewhere between 5 and 20 sessions). The therapy sessions are usually in a clinic but can take place in other places such as your own home if you have conditions like agoraphobia or obsessive-compulsive disorder (OCD).

After an initial assessment period, the therapist will gradually help you to break down problems into their separate parts. This helps you to identify ways that you can make changes to the ways you think and act, and so help to make you feel better. Your therapist won't ask you to do things you don't want to do and will only work at a pace you're comfortable with.

If you think you have a problem that may benefit from treatment with cognitive behavioural therapy (CBT), the first step is usually to speak to your doctor. This is important so you can check that CBT is right for you. Your doctor may also be able to refer you to a therapist or recommend one. In the UK, the British Association for Behavioural & Cognitive Psychotherapies (BABCP) keeps a register of all accredited therapists. The British Psychological Society (BPS) has a directory of chartered psychologists, which includes psychologists who specialise in CBT.

Find out more about CBT with a therapist.

You don't have to see a therapist to have cognitive behavioural therapy (CBT). For some people, self-help therapy can be as effective as CBT with a therapist. The options for self-help CBT include books, online mental health services, phone or email CBT, and computerised CBT.

Read more about self-help CBT.

Further reading and references

  • Computerised cognitive behaviour therapy for depression and anxiety; NICE Technology Appraisal Guidance, February 2006 (last updated May 2013)

  • Gartlehner G, Gaynes BN, Amick HR, et al; Comparative Benefits and Harms of Antidepressant, Psychological, Complementary, and Exercise Treatments for Major Depression: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016 Mar 1164(5):331-41. doi: 10.7326/M15-1813. Epub 2015 Dec 8.

  • Pompoli A, Furukawa TA, Imai H, et al; Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database Syst Rev. 2016 Apr 134:CD011004. doi: 10.1002/14651858.CD011004.pub2.

  • James AC, James G, Cowdrey FA, et al; Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2015 Feb 182:CD004690. doi: 10.1002/14651858.CD004690.pub4.

I have gone through a hell of 18 months Of therapy that made me worse. Im trying to get an insight and closure of what happened and is it normal what I experienced in a therapy realtionship? I...

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