The Basics of Cognitive Behavioral Therapy

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy, or CBT, is one form of psychotherapy. Psychotherapy is the overarching term that refers to all types of “talk therapy,” which are treatments that involve discussing and working through issues with a licensed and experienced professional. According to the National Alliance on Mental Health, CBT is focused on patterns and relationships between your feelings, thoughts, and actions.

During CBT, the professional helps someone uncover patterns that aren’t healthy, such as negative thoughts and the responses that have developed to go with them. CBT works to retrain the brain, replacing negative thoughts when possible and supporting someone as they learn to respond to situations and thoughts with healthier actions.

Generic Treatment Name Cognitive Behavioral Therapy
Other Names CBT
Conditions Commonly Treated Mental health disorders, addiction, eating disorders, post-traumatic stress disorder, and general stress or struggles with daily life
Availability/how to receive it Administered by a licensed therapist
Where does the treatment take place? CBT can take place in an inpatient or outpatient environment, including a hospital, rehab center, or therapist’s office
Is medication required? While CBT may be used alongside medication in a comprehensive treatment plan for certain conditions, medication is not part of or required for CBT itself
How long does the treatment take? Many CBT sessions follow a format that takes around 60 minutes; some formats support treatment that lasts around 30 minutes at a time
How long does it take the treatment to work? CBT has been shown to be effective at treating a wide range of issues, including addiction to cannabis, alcohol, and other substances as well as depression, anxiety, and psychological disorders. However, CBT isn’t always the only treatment, and it’s not meant to provide an immediate cure or even immediate relief of symptoms in every case; it can be a long-term treatment that helps over time.

The History of CBT

CBT has a long-standing history within the realm of psychotherapy. It is a combination of two other forms of therapy: cognitive therapy, which deals with thoughts and actions, and behavioral therapy, which deals with actions. The driving principle behind CBT is that someone’s thoughts, feelings, and behavior are all intertwined. You can’t address one without addressing them all — along with the patterns between them, says CBT.

How Cognitive Behavioral Therapy Works

According to the American Psychological Association, CBT is based on certain principles. Psychological problems — or other issues CBT is used to treat (such as drug abuse) — are based, at least in part, on unhelpful or negative thought processes as well as learned behavior patterns that are also not helpful. But individuals suffering from these issues can learn more helpful patterns of behavior and ways of dealing with these thoughts, and practicing what they learn can reduce their symptoms and help them live more effective, happier lives.

CBT works by helping someone:

  • Identify these negative or unhelpful thoughts and behaviors
  • Gain more understanding about their own behaviors as well as the motivations of others
  • Learn to identify what is reality and what may not be reality and realign thought and behavior accordingly
  • Face fears and concerns in a positive and more effective manner
  • Practice relaxing techniques and other coping skills to better respond to situations that might lead to negative thoughts and behaviors
  • Reprogram their thought processes for healthier responses

What CBT Is Commonly Used For

Cognitive behavioral therapy is extremely flexible and can be applied to numerous situations where someone is struggling with mental health, stress, negative behaviors, or psychological concerns. Just some of the areas where CBT has been shown to be effective include:

  • Individual, family, and couples therapy
  • Treating eating disorders
  • Treating a variety of mental health disorders, including anxiety, depression, and mood disorders
  • Preventing relapse and helping people with drug or alcohol addiction recovery
  • The criminal justice system, where CBT is used to help rehabilitate offenders and reduce the likelihood they may commit crimes after serving their time

How Is CBT Administered?

CBT is administered in a therapeutic setting — typically an office of some type. The room usually includes comfortable seating that supports someone in sitting, talking, and listening for up to an hour at a time. While different models exist, all CBT is made up of two important components: functional analysis and skills training.

Functional analysis occurs when the counselor or other CBT professional evaluates the situation at hand. They ask questions and listen to the patient or client talk about the situation and their own thoughts and behaviors. During this time, the professional receives insight into the situation, potential triggers, and struggles of the person so they can offer the best guidance for new thoughts and behaviors.

Skills training is the part of CBT where the therapist offers guidance about these new thought processes and behaviors. This part of the therapy is highly customized to each person’s needs and capabilities. CBT might include role-playing so the person can practice these new skills right away, but it also likely includes homework so that individuals can practice the new skills between therapy appointments and report back on what they experienced. In most cases, CBT professionals build on these skills, working with the person to continue to identify unhelpful thoughts and responses and put newer, positive processes in place going forward.

Cost, Side Effects, and Other Considerations Relevant to CBT

The cost of cognitive behavioral therapy depends on a variety of factors. First, where and how you receive the therapy is reflected in the cost. CBT is often offered as part of a comprehensive inpatient or intensive outpatient program when treating addiction or various mental health disorders. It’s also offered in general outpatient settings, with individuals seeing a therapist or other provider once a week or on some other schedule.

According to Northwestern Mutual, the average cost of therapy in a general outpatient setting can range from $75 to $150 per session. If you have health insurance, it’s very likely that you have some coverage for therapy sessions. Many employers also offer Employee Assistance Programs (EAPs) that cover free access to some therapy sessions, and you may be able to locate a community mental health clinic in your town that offers free or reduced-cost therapy if you can’t afford to pay full price.

While CBT is considered very safe, it can cause a few side effects. The act of going through fears or negative thoughts during therapy can cause those things to rally in the form of nightmares or other issues for some people. Therapy professionals are typically aware of these issues and provide instructions on what someone should do if they experience side effects.

The United Kingdom National Health Service points out that CBT has a few potential disadvantages. It does involve attending treatment sessions as scheduled and carrying out homework assigned by the therapist. Effectiveness also depends in part on you committing to the process; if you aren’t serious about the process of CBT, it won’t do much good.

How to Get Help & Additional Resources

  • The U.S. National Library of Medicine has a lengthy journal article titled The Efficacy of Cognitive Behavioral Therapy that looks at studies on whether CBT is a viable treatment method in a wide range of situations.
  • The Substance Abuse and Mental Health Services Administration has a resource that explains more about how CBT works and what you might expect from treatment.
  • Read more about CBT’s role in treating ADHD in children from the CDC.

Note: This guide is for informational purposes only, to educate the public on how Cognitive Behavioral Therapy is used and is not recommending a specific treatment regimen or giving medical advice. Always consult with your doctor, as well as other medical professionals before beginning any type of treatment.