What Is Cognitive Behavioral Therapy (CBT) and How Does It Work?

Cognitive behavioral therapy (CBT) is a form of psychotherapy that treats fear and boosts happiness by modifying dysfunctional emotions, behaviors, and thoughts.

CBT focuses on solutions. It encourages patients to challenge distorted cognitions (understandings) and change destructive patterns of thought and behavior.

CBT is founded on the idea that thoughts and perceptions influence behavior. CBT aims to identify harmful thoughts. It then assesses whether those thoughts are an accurate depiction of reality. If they are not, CBT employs strategies to challenge and overcome them.

CBT is appropriate for people of all ages, including children, adolescents, and adults. Evidence has grown that CBT can benefit numerous conditions, such as:

• major depressive disorder 
• anxiety disorders 
• post-traumatic stress disorder
• eating disorders
• obsessive-compulsive disorders 
• other mental health conditions

Why Do We Use Cognitive Behavioral Therapy (CBT)?

CBT, like all effective psychosocial therapies, prioritizes the therapeutic relationship, rapport, and a working connection between counselor and patient.  

According to Dr. Arnold A. Lazarus, “The therapeutic relationship is the soil that enables the techniques to take root.”  Thus, the cultivation and evolution of a trusting and honest therapeutic alliance is the essential foundation of CBT. 

CBT can also have a positive impact on how people feel and act and equip them with coping strategies that help them deal with challenges. Research shows that CBT can offer support to people with depression, panic disorder, and various other health conditions. There is also growing evidence that it can help to relieve chronic pain.

What You Can Expect with Cognitive Behavioral Therapy (CBT)

When we use CBT, we treat the whole person and treatment is not just about symptom reduction. CBT believes that many of the problems that people have are founded in “biopsychosocial” processes.  

This means that:

• People have a physical body that can have physiological or metabolic problems. 
• We also have a mind, emotions and sensations. 
• And, very importantly, we are social beings whose relationships and interpersonal connections are important parts of our lives.  

So, while symptom reduction is certainly among our goals, CBT’s success comes from treating the whole person. According to Medical News Today, “Practitioners base CBT on the theory that problems arise from the meanings people give to events, as well as the events themselves. 

What the Patient Will Encounter with CBT

Unhelpful thoughts can make it difficult for a person to function confidently in different situations.” CBT treats the whole body and works to change negative thoughts for the most positive outcomes.

What the patient will encounter with the therapist:

• Identify troubling situations or conditions and problems
• Become aware of thoughts, emotions and beliefs about these problems
• Identify negative or inaccurate thinking
• Reshape negative or inaccurate thinking

What the Patient Will Learn with CBT

Here are 16 things a patient will learn with CBT:

• identify problems more clearly and thoroughly
• develop an awareness of automatic thoughts
• challenge any assumptions that may be wrong
• distinguish between facts and irrational thoughts
• understand how past experience can affect present feelings and beliefs
• stop fearing the worst
• see a situation from a different perspective
• better understand other people’s actions and motivations
• develop a more positive way of thinking 
• become more aware of their own mood
• establish attainable goals
• avoid generalizations and all-or-nothing thinking
• stop taking the blame for everything
• focus on how things are rather than how they think they should be
• face their fears rather than avoid them
• describe, accept, and understand rather than judge themselves or others

How the Patient will Learn with CBT

Below are five ways the patient can learn how to do the above:

• regular one-on-one or group discussion sessions, or a combination of both
• feedback given consistently
• role-playing activities
• learning techniques to calm the mind and body
• homework assignments

How to be Prepared and Successful When Going through Cognitive Behavioral Therapy (CBT)

Approach Therapy as a Partnership

Therapy is most effective when the participant is active and shares in decision-making. Agreeing about the major issues and how to tackle them together, you can set goals and assess progress over time.

Be Open and Honest

Success with therapy depends on the willingness to share thoughts, feelings and experiences, and on being open to new insights and ways of doing things.

If the patient is reluctant to talk about certain things because of painful emotions, embarrassment or fears about the therapist’s reaction, notify the therapist about the reservations.

Stick to Your Treatment Plan

If feeling down or lacking motivation, it may be tempting to skip therapy sessions. Doing so can disrupt progress. Attend all sessions and give some thought to what discussion topics.

Don’t Expect Instant Results

Working on emotional issues can be painful and often requires hard work. It’s not uncommon to feel worse during the initial part of therapy while confronting past and current conflicts. It may take several sessions before seeing improvement.