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What is Cognitive Behavioural Therapy (CBT) and does it work?

Updated: May 16

Man in therapy

Cognitive Behavioural Therapy (CBT) is a widely used psychotherapy approach that focuses on identifying patterns of thinking and behaviour that contribute to emotional distress and mental health difficulties such as anxiety and depression. In CBT you learn techniques to improve your relationship with anxious thoughts and try out alternative behaviours with the support of your therapist.  The techniques can be incorporated into your everyday life, even after treatment has ended.


What Can You Expect in a CBT Session?


CBT can be carried out online or in-person. Your initial session with your therapist will primarily be focused on hearing about your difficulties and goals, and exploring whether CBT aligns with these. Through open conversations, your therapist will inquire about various aspects of your life, gently exploring your background and previous significant events that will have shaped your responses. Together, you consider how your emotions and/or behaviour impacts your daily life in terms of work, family and social life. Should CBT be deemed an appropriate approach, your therapist will outline the approach, often using a helpful diagram to explain it. They will offer you a roadmap for the following appointments and provide clarity on what will be expected in future sessions.

It's helpful to allow time between sessions to work on the content that arose, for example you might be offered a handout to read to help you understand a concept, or invited to try out new techniques or behaviours that came up during your discussion in therapy.

How Does CBT Work?

The first aspect of CBT is to explore the interplay and connections between thoughts, feelings, behaviours, and actions and their roles in creating negative emotional responses. This is one of the most crucial steps of CBT as it sets the foundation and avenue for future therapeutic sessions. You will often be asked to keep a record or write down your thoughts and behaviour patterns in certain situations so that your therapist can analyse the problems and break them down into separate parts to make them more manageable.


By gaining awareness of your responses, you and your therapist will decide whether your thoughts, feelings and behaviours are excessive (for the current situation) or unhelpful, and determine the effect this has on you. This will help to explore alternative interpretations, giving a more realistic and balanced idea of given situations and allowing you to reframe them so you have fresh perspectives. In doing so, you and your therapist will discuss the things that you are able to change which will guide future coping strategies.


After, your therapist will guide you in recognising the early warning signs of distress and these negative emotions or behaviours and help to develop strategies to implement before these feelings occur. They will ensure that you are comfortable with trying these techniques before practising them. This empowers you to proactively manage challenges and maintain emotional balance, giving you a proactive approach to your mental and emotional well-being. If you are comfortable, your therapist will ask you to practice these changes in your daily life to assess whether they have a positive effect, they will then problem-solve any blocks to these with you or coach you through how to use these as real-life problems occur.

How effective is CBT?


CBT is one of the most researched psychotherapy techniques to date and has been shown to help those with a variety of mental health problems such as PTSD (post-traumatic stress disorder), OCD, depression, anxieties disorders, and phobias.


If you are considering whether CBT is right for you, then this meta-analysis (multiple studies) in 2023 concluded that CBT is the leading therapy to treat depression and other common mental health problems, across a variety of ages, target groups, and settings. This shows the effectiveness of CBT and its adaptability to help those from diverse backgrounds and contexts. Additionally, CBT has shown to be effective in both the short-term and long-term in managing symptoms, offering benefits beyond the duration of therapy sessions. This means that you can perform CBT in everyday life once you have completed therapy, promoting your mental health and well-being over the course of your lifetime.


However, due to the versatile nature of CBT in helping with a variety of conditions, it will be helpful to understand whether it is the right therapeutic technique to choose from. If trauma forms the basis of your mental health difficulty, then EMDR may be best suited instead of CBT. In order to fully understand what is needed, please get in touch here to discuss.


Here are some other useful links surround CBT and its effectiveness:


·       CBT and Depression

·       CBT and Anxiety

How to choose a therapist

When choosing a therapist for CBT check that they have experience of applying CBT to the type of difficult you are coming with. There are specialist CBT models for different types of presentation, for example, for trauma there is a Trauma-Focused CBT (TF-CBT) approach which your therapist will need to have had extra training in. The gold standard for accreditation in CBT is with the British Association for Behavioural and Cognitive Psychotherapies so ask your therapist if they are accredited or supervised by a BABCP therapist to ensure that they have the best standards of therapy.

CBT Sessions

Due to the nature of CBT, and the person-centred approach that it adopts, there is no set duration for this psychotherapy technique as there is variety in individual concerns and severities in situations. However, sessions typically last between 50 – 60 minutes with the treatment taking 10-20 sessions.

Please read this blog: How many sessions of therapy will I need? for more information regarding the typical number of sessions required.

About the author:

Brandon is an assistant psychologist working in CAMHS Somerset. His interests are trauma and Adverse Childhood Experiences and he has extensive experience working with those diagnosed of dementia, acquired brain injuries and learning disabilities.

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