What Is Cognitive Behavioral Therapy (CBT)?
Cognitive Behavioral Therapy, or CBT, is one of the most well-researched and widely used forms of therapy for a range of mental health concerns, including anxiety, depression, and trauma. CBT shows us how thoughts, feelings, and behaviors connect. At its core, CBT helps people identify and change unhelpful patterns of thinking and behavior. Here are the basics:
The CBT Triangle:
Imagine a triangle with each corner labeled:
Thoughts – What we tell ourselves (e.g., “I’ll fail,” “They don’t like me”)
Feelings – How we emotionally respond (e.g., anxious, hopeless, angry)
Behaviors – What we do or avoid (e.g., procrastinate, isolate, lash out)
CBT works by helping you:
Recognize patterns of negative or distorted thinking
Challenge and reframe those thoughts
Practice healthier behaviors that support your goals
Let’s walk through it:
Situation: You text a friend and don’t get a reply for two days.
Thought: “They’re ignoring me. I must have done something wrong.”
Feeling: Worried, sad, rejected
Behavior: You stop texting them, overthink the situation, and isolate yourself.
CBT in Action: Using the Triangle to Shift the Pattern
New Thought: “Maybe they’re just busy or going through something. I don’t know the full story.”
New Feeling: Calmer, more understanding, less anxious
New Behavior: You wait a little longer or send a gentle follow-up message without jumping to conclusions.
By changing what you think, you change the way you feel and behave. You might wonder, “Is CBT just positive thinking?” Nope. CBT is not about pretending everything is great. Rather, it’s about getting realistic. Many people have thoughts that are overly negative, distorted, or automatic. CBT helps you examine them logically and respond with more balanced thinking, without minimizing the truth.
CBT isn’t just about talking. It’s about learning skills. Here are some tools commonly used in CBT sessions:
Thought Records-A worksheet used to identify a negative thought, evaluate its accuracy, and replace it with a more balanced one.
Behavioral Experiments-You test out a belief in real life. For example, if you think “If I speak up in a meeting, I’ll embarrass myself,” you try speaking up and observe what actually happens.
Cognitive Restructuring-This means finding and changing “thinking traps” like:
Catastrophizing (“This is going to ruin everything!”)
Black-and-white thinking (“If I’m not perfect, I’m a failure”)
Mind reading (“They must think I’m stupid”)
Exposure Techniques-For anxiety and phobias, CBT may include gradual exposure to feared situations while practicing new coping tools.
Problem-Solving Skills-Learning how to break big challenges into smaller, manageable steps.
CBT is often structured and goal-oriented. Here’s what a typical session might include:
A check-in on mood and symptoms
Reviewing homework or techniques from the last session
Working on a specific skill (e.g., thought tracking, behavioral experiments)
Setting new goals or experiments for the week
Sessions typically last 45–60 minutes and may be short-term (e.g., 8–20 sessions), depending on your needs.
CBT can be adapted for individuals, couples, teens, or groups. It’s especially effective for people who:
Want to learn practical tools for change
Enjoy structure and goal-setting
Are willing to do work between sessions
Common problems CBT has been shown to be highly effective for:
Generalized anxiety
Panic attacks
Social anxiety
Depression
OCD (with Exposure and Response Prevention)
PTSD
Insomnia
Eating disorders
Phobias
Stress and burnout
Pros of CBT
Evidence-based and backed by decades of research
Skill-focused – teaches you tools for life
Collaborative – you and your therapist are partners
Can be combined with medication, mindfulness, or other therapies
CBT isn’t magic, but it is powerful. It gives you tools to understand yourself better, interrupt patterns that no longer serve you, and respond to life with more clarity and confidence.
References
Beck, A. T., & Dozois, D. J. A. (2011). Cognitive therapy: Current status and future directions.
Annual Review of Medicine, 62, 397–409. DOI: 10.1146/annurev-med-052209-100032
American Psychological Association (APA).Cognitive Behavioral Therapy Overview.
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
National Institute for Health and Care Excellence (NICE), UK. Guidelines for the use of CBT in anxiety, depression, and PTSD. https://www.nice.org.uk
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36, 427–440. DOI: 10.1007/s10608-012-9476-1
National Alliance on Mental Illness (NAMI). Cognitive Behavioral Therapy (CBT) Resource Page. https://www.nami.org/About-Mental-Illness/Treatments/Psychotherapy
Mayo Clinic: CBT Overview. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610