Cognitive behavioural therapy

What is cognitive behavioural therapy (CBT)?

CBT is a practical and solution-focused therapy that helps us understand how our thoughts and behaviours influence each other. The aim is that by changing the way we think or behave in a situation, we can change the way we feel about life. The therapy explores learnt behaviours, habits and negative thought patterns, and helps us adapt them to become more supportive.

Counsellor Marian Hanson explains CBT in this short video:

Unlike some other therapeutic approaches, CBT focuses on the present moment and looking forward. While it can involve reflecting on past experiences to provide context, the primary focus is on addressing current challenges. In sessions, your therapist will work with you to identify unhelpful thought patterns and explore how they may be influencing your emotions and actions. Most importantly, you’ll learn practical ways to change these patterns.

Depending on your specific concerns, your therapist may lean more towards either cognitive or behavioural techniques. For instance, issues such as anxiety or depression often benefit from a cognitive focus - examining and reframing negative thoughts - while conditions involving repetitive behaviours, like obsessive-compulsive disorder (OCD), may involve a greater emphasis on behavioural strategies.

What can CBT help with?

CBT is particularly helpful for specific issues. This is because it’s very practical (rather than insight-based) and focuses on solving the problem. Some of the concerns that may benefit from CBT include:

• anxiety disorders
• depression
• eating disorders
• obsessive-compulsive disorder (OCD)
• phobias and fears
• post-traumatic stress disorder (PTSD)
• sleep problems, such as insomnia

CBT can also be used for long-standing health problems, such as chronic pain or irritable bowel syndrome (IBS). While the therapy cannot cure physical illness, it can help you cope better with the symptoms and lower stress levels.

Sometimes, CBT is adapted to support a specific issue. An example of this is trauma-focused CBT. This approach may be offered to those who have experienced trauma and have PTSD. By integrating family therapy elements and looking through a trauma-informed lens, the standard CBT approach is enhanced to help with this particular issue.

What to expect from CBT sessions

CBT is a collaborative therapy, meaning you and your therapist work together to set goals, monitor progress, and practise techniques. Sessions typically take place weekly, lasting around 50 minutes to an hour, and the course of therapy may run for six weeks to six months, depending on your individual needs. 

At the start of your treatment, you’ll meet your therapist and discuss why you’re seeking CBT. You’ll be able to outline what you hope to gain from CBT and set goals for the future.

As therapy progresses, you'll become more active in steering sessions and implementing what you've learned between appointments. Homework exercises are a key component of CBT and are designed to reinforce what’s covered in therapy. The idea is that, once your treatment comes to an end, you will feel confident and comfortable enough to continue the work on your own.

CBT can be delivered in various formats, including one-to-one sessions, group therapy, and online counselling.

CBT helps me to recognise my negative thoughts, to break the habit of these thoughts, and to find a more positive way of thinking. So far, it’s helped me greatly, and I am grateful I’ve had the chance to go through with my sessions. I have almost finished my sessions now and am using the techniques learned daily. 

- Happiful magazine reader

How does CBT work?

Cognitive behavioural therapy helps you make sense of what can feel like an overwhelming problem by breaking it down into more manageable parts. These smaller parts are your thoughts, feelings, actions and even physical sensations. When these elements become locked in a negative loop, it can lead to increased stress, low mood, or anxiety. CBT techniques aim to break this cycle and promote more balanced thinking.

For example, if you’re experiencing relationship difficulties, you might have thoughts like, “I’m not good enough,” which trigger sadness or shame. This can lead to avoiding social contact or withdrawing from loved ones. This negative spiral can then trap you into feeling isolated and unhappy. CBT can help you identify these thought patterns and replace them with more supportive beliefs, leading to improved mood and behaviour.

Your therapist may also use tools such as thought records, behavioural experiments, or activity scheduling to help you develop awareness and build confidence in responding differently.

Guided discovery in CBT

Guided discovery is a technique some cognitive behavioural therapists use to help you reflect on the way you process information. This can encourage more open thinking, which helps pave the way for changing unhelpful perceptions and behaviours.

Used by cognitive therapists, guided discovery is a two-way, collaborative process that can help clients learn to develop different interpretations of their problems. Through collaboration, this can assist in creating and fostering a positive therapeutic relationship, whilst getting clients to focus on not only the problem, but also the solution. 

- Learn more about guided discovery in CBT.

Is CBT the right approach for you?

While CBT is a highly effective therapy for many people, it may not be suitable for everyone. It is most helpful for individuals who:

• want to actively engage in the therapeutic process
• are open to examining their thinking and behaviour patterns
• feel comfortable completing practical tasks between sessions
• prefer a structured, goal-oriented approach

Being committed and doing the assignments set for you is an integral part of CBT. While the sessions offer support and space to explore your concerns, it’s the work you do outside of your sessions that’s likely to have the most impact. By staying focused and completing assignments, you’ll help yourself progress quickly. This way, you will hopefully start to develop a stronger sense of self-confidence and self-belief.

If you're interested in trying CBT, connect with a counsellor today using our search tool.