What is cognitive behavioural therapy (CBT)?
Types of therapy

Cognitive behavioural therapy (CBT) is a type of therapy that looks at your thoughts, feelings and behaviours and helps to change some of these to manage your problems.

A key part of this is identifying the negative thinking patterns that you may feel trapped in, helping you to break free from these and to feel better.

CBT focuses on equipping you with the tools to address current problems in your life and relieve the symptoms you’re facing, before making links to your past and how your beliefs started.

Elaine Davies, a cognitive behavioural counsellor and BACP accredited member, says: “CBT is a model of therapy where you learn to understand your feelings and emotions about events in your life, to identify and examine the thinking patterns that are taking place and how they may impact on your behaviour.

“You and your therapist work together on understanding your thoughts and behaviours using techniques that will bring eventual change.”

Some counsellors may predominantly use CBT, while others may use techniques or skills from CBT along with approaches from other models of therapy too.

What can CBT help with?

The National Institute for Health and Care Excellence (NICE), which provides guidance for the treatment of mental ill health in the NHS, recommends CBT for anxiety, depression, panic attacks, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), health anxiety and schizophrenia. Some therapists who undergo extra training are able to use it with their clients as an early intervention for psychosis and a treatment for personality disorders.

There are also CBT interventions for people who are struggling with anger issues, sleep problems, chronic fatigue and other long-term health conditions, such as diabetes, chronic pain and cancer.

How does CBT work?

Elaine describes how CBT works as an “education on understanding thoughts, feelings, physical sensations and behaviours triggered in certain environments and situations”.

CBT starts by looking at your negative automatic thoughts.

“Negative automatic thoughts can be fleeting, but disturbing when a client is distressed,” says Elaine.

“Early therapy sessions help clients to identify these thoughts and look for evidence to support or dismiss them.”

As therapy continues, behavioural experiments will help to test out longstanding assumptions that you may hold about yourself.

“We test different techniques. It’s quite scientific in that respect,” adds Elaine.

CBT also works on your core beliefs.

“Clients have held beliefs about themselves since early childhood,” says Elaine. “In therapy the aim is to find evidence that doesn’t support the belief and to help them build a new belief – such as moving from thinking ‘I am unlovable’ to ‘I am loveable’.”

The aim of CBT is that through the sessions, homework and practice you will find out what skills and techniques help you to have a better quality of life.

Elaine adds: “It’s a collaboration; a guided discovery. As therapists we’re just the facilitators.”

What are the techniques used in CBT?

There are a variety of techniques used in CBT – including keeping thought records, relaxation and breathing, progressive muscle relaxation, identifying and challenging your style of thinking and behavioural experiments.

One technique is behavioural activation which looks at how you engage in certain activities, such as hobbies and socialising, and how you can increase your chances of enjoying them and getting a sense of achievement from life.

Another is exposure therapy which helps you learn to face your fears in a methodical and structured way.

How is CBT delivered?

CBT can be delivered in a variety of ways - online, by telephone, through text or messenger services or in face-to-face appointments.

How long does CBT take?

CBT is a short-term model of therapy. People tend to have it over a period of weeks or a few months, rather than years.

You'll usually discuss the number of sessions with your therapist at your first appointment. It may depend on the setting or how your sessions are funded, for instance if they are paid for by your employer or you're having them through the NHS.

How to choose a CBT therapist

Take a look at the therapist's website or our Therapist directory listing to see whether they have detailed training or qualifications that are specific to CBT.

Choosing a therapist who is a member of a body with an accredited register, such as BACP, means you know that are highly qualified and adhere to high ethical and practice standards.