Cognitive-behavioural therapy (CBT) combines basic theories about how people learn (behaviourism) with theories about the way people think about and interpret events in their lives (cognition). CBT is now firmly established as the leading psychological treatment for many mental health conditions. Many research studies have demonstrated its effectiveness.1 Research shows that the skills people learn through CBT last long after the treatment ends.2
In CBT, the therapist and the client work together to identify unhelpful patterns of thinking and behaviour. For example, someone might only notice the negative things that happen to them and not notice the positive things. Or, someone might set unrealistic standards for themselves, such as “making mistakes at work is unacceptable.” It’s also important to identify unhelpful behaviours that maintain symptoms, such as avoiding certain situations and withdrawing from others.
The client and therapist also look at how thoughts and behaviours impact feelings. For example, if someone believes that nothing will work out for them in life, they may withdraw from others and avoid new opportunities. This, in turn, can lead to feelings of increased sadness, emptiness and anxiety. This is sometimes called a “vicious circle” of thoughts, feelings and behaviours.
Carefully constructed exercises are used to help clients evaluate and change their thoughts and behaviours. Some aspects of treatment focus more on thoughts and some aspects focus more on behaviours. If a client has difficulty identifying and challenging negative thoughts, the therapist might focus on addressing behaviours such as avoidance, withdrawal or poor social skills. On the other hand, if such behaviours are not as noticeable, the therapist may focus on challenging unrealistic thinking.
CBT is most widely applied to mood disorders (such as depression) and anxiety disorders. It is also used to help people with substance use problems, personality disorders, eating disorders, sexual problems and psychosis. It is successfully delivered in individual, group and couples formats.