A practical guide to cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a type of talking therapy that has gained widespread recognition and acceptance as an effective treatment for a variety of mental health conditions. It is a structured, time-limited approach that focuses on the interaction between thoughts, feelings, and behaviours. The fundamental premise of CBT is that our thoughts about a situation can profoundly affect how we feel emotionally and physically, and how we subsequently act. By addressing and altering negative thought patterns and behaviours, CBT aims to alleviate distress and improve functioning.


During CBT, therapists work collaboratively with clients to identify and challenge distorted or unhelpful thinking patterns. They also focus on changing behaviours that contribute to or maintain the individual’s psychological distress. This dual approach – modifying both cognitive processes and behaviours – makes CBT a versatile and effective therapy for a wide range of conditions.

Conditions that CBT can help with

The National Institute for Health and Clinical Excellence (NICE) endorses CBT for several mental health conditions, highlighting its efficacy through extensive research and clinical practice. Here are some of the primary conditions CBT is recommended for:

Anxiety disorders

  • Generalised anxiety disorder (GAD): CBT helps individuals manage excessive worry and anxiety.
  • Panic disorder: Techniques include exposure therapy and cognitive restructuring to reduce the frequency and intensity of panic attacks.
  • Post-traumatic stress disorder (PTSD): CBT, often in the form of trauma-focused CBT, assists in processing traumatic events and reducing associated symptoms.
  • Social anxiety disorder: CBT addresses the fear of social situations by challenging negative thoughts and gradually exposing individuals to feared scenarios.


CBT for depression focuses on identifying and challenging negative thought patterns, increasing engagement in positive activities, and developing coping strategies.

Obsessive-compulsive disorder (OCD)

CBT for OCD typically involves exposure and response prevention (ERP), helping individuals face their fears and reduce compulsive behaviours.

Schizophrenia and psychosis

CBT can be used as an adjunct to medication, helping individuals manage symptoms such as delusions and hallucinations, and improving overall functioning.

Bipolar disorder

CBT helps individuals recognise and manage mood swings, adhere to treatment plans, and develop strategies to prevent relapse.

Additional conditions where CBT is beneficial

Beyond the conditions highlighted by NICE, CBT has shown effectiveness in treating a variety of other mental health and behavioural issues:

  • Chronic fatigue syndrome (CFS): CBT aims to reduce fatigue and improve quality of life by addressing the thoughts and behaviours that perpetuate symptoms.
  • Behavioural difficulties in children: CBT can help children develop better coping mechanisms and improve behaviour by teaching them to understand and manage their emotions.
  • Anxiety disorders in children: Similar to adult treatment, CBT for children with anxiety focuses on recognising and challenging anxious thoughts and gradually facing fears.
  • Chronic pain: CBT helps individuals manage chronic pain by altering pain-related thoughts and behaviours, reducing the emotional impact of pain, and improving coping skills.
  • Physical symptoms without a medical diagnosis: For conditions like somatic symptom disorder, CBT helps reduce distress and impairment by changing the way individuals think about and respond to their symptoms.
  • Sleep difficulties: CBT for insomnia (CBT-I) addresses the thoughts and behaviours that interfere with sleep, promoting better sleep hygiene and practices.
  • Anger management: CBT helps individuals understand the triggers and underlying thoughts that lead to anger, teaching them healthier ways to express and manage their emotions.
  • Self-esteem issues: CBT works on improving self-esteem by challenging negative self-beliefs and encouraging positive self-reflection and behaviours.

How does CBT work in practice?

CBT sessions are typically structured and goal-oriented. Here’s what a typical course of CBT might look like:

  • Assessment: The therapist conducts an initial assessment to understand the client’s issues, goals, and history.
  • Goal setting: Specific, measurable, and achievable goals are set collaboratively.
  • Psychoeducation: The therapist educates the client about the cognitive model and how thoughts, feelings, and behaviours are interconnected.
  • Skill development: Clients learn specific skills to challenge and change unhelpful thoughts and behaviours.
  • Homework: Clients are often given tasks to complete between sessions to practice new skills and reinforce learning.
  • Review and adaptation: Progress is regularly reviewed, and strategies are adapted as needed.

Choosing the right therapist

Finding the right therapist is crucial for the success of CBT. It is essential to work with someone who has the appropriate training and experience in CBT.

Cognitive behavioural therapy is a powerful tool in the treatment of a wide range of mental health conditions. By focusing on the interconnectedness of thoughts, feelings, and behaviours, CBT helps individuals gain insight into their issues and develop practical strategies to overcome them. Whether dealing with anxiety, depression, chronic pain, or other challenges, CBT offers hope and a path toward improved mental health and well-being.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Cambridge CB5 & Oxford OX4
Written by Hope Therapy & Counselling Services
Cambridge CB5 & Oxford OX4

Hope Therapy offers UK wide, Mental Health and Wellbeing Support via Coaching, Counselling, Cognitive Behavioural Therapy (CBT), EMDR, Hypnotherapy, Mindfulness and Psychotherapy.

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