What is Cognitive-behavioural therapy (CBT)?
Cognitive-behavioural therapy (CBT) is a practical, short-term form of psychotherapy. It helps people to develop skills and strategies for becoming and staying healthy.
CBT focuses on the here-and-now—on the problems that come up in day-to-day life. CBT helps people to examine how they make sense of what is happening around them and how these perceptions affect the way they feel.
- is structured
- is time-limited (usually 6-20 sessions)
- is problem-focused and goal-oriented
- teaches strategies and skills
- is based on a poaitive, shared therapeutic relationship between therapist and client
In this video, Dr. Zindel Segal, a CBT expert, discusses how CBT works. The video also features people explaining how CBT helped them deal with various mental health problems, including depression and schizophrenia.
The CBT model is built on a two-way relationship between thoughts (“cognitions”) and behaviours. Each can influence the other.
There are three levels of cognition:
- Conscious thoughts: Rational thoughts and choices that are made with full awareness.
- Automatic thoughts: Thoughts that flow rapidly, so that you may not be fully aware of them. This may mean you can’t check them for accuracy or relevance. In a person with a mental health problem, these thoughts may not be logical.
- Schemas: Core beliefs and personal rules for processing information. Schemas are shaped by influences in childhood and other life experiences.
Behaviour can be changed using techniques such as self-monitoring, activity scheduling (for depression) and exposure and response prevention (for anxiety).
What happens in CBT?
In CBT, clients learn to identify, question and change the thoughts, attitudes and beliefs related to the emotional and behavioural reactions that cause them difficulty.
By monitoring and recording thoughts during upsetting situations, people learn that how they think can contribute to emotional problems such as depression and anxiety. CBT helps to reduce these emotional problems by teaching clients to:
- identify distortions in their thinking
- see thoughts as ideas about what is going on, rather than as facts
- stand back from their thinking to consider situations from different viewpoints.
Where is CBT used?
There has been a lot of research on CBT. Evidence suggests that it is particularly effective in treating anxiety and depression. CBT has also been tailored to other specific problems.
For example, CBT is also used to treat:
- bipolar disorder
- eating disorders
- generalized anxiety disorder
- obsessive-compulsive disorder
- panic disorder
- posttraumatic stress disorder
- schizophrenia and psychosis
- specific phobias
- substance use disorders.
CBT and self-help
There are many self-help books and websites based on cognitive-behavioural principles. Evidence shows that these resources are more useful when the person also gets support from a therapist, especially if he or she experiences low mood. CBT-based self-help approaches include:
- computer-based CBT
- professionally supported self-management.
Other therapies that are related to CBT include:
- dialectical behaviour therapy
- mindfulness-based cognitive therapy
- relapse prevention.