Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.
It's most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.
This topic covers:
How it works
What happens during a session
Pros and cons
Finding a therapist
How CBT works
CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.
CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You're shown how to change these negative patterns to improve the way you feel.
Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.
Read more about how CBT works.
Uses for CBT
CBT has been shown to be an effective way of treating a number of different mental health conditions.
In addition to depression or anxiety disorders, CBT can also help people with:
CBT is also sometimes used to treat people with long-term health conditions, such as:
Although CBT can't cure the physical symptoms of these conditions, it can help people cope better with their symptoms.
What happens during CBT sessions
If CBT is recommended, you'll usually have a session with a therapist once a week or once every two weeks. The course of treatment usually lasts for between five and 20 sessions, with each session lasting 30-60 minutes.
During the sessions, you'll work with your therapist to break down your problems into their separate parts – such as your thoughts, physical feelings and actions.
You and your therapist will analyse these areas to work out if they're unrealistic or unhelpful and to determine the effect they have on each other and on you. Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.
After working out what you can change, your therapist will ask you to practise these changes in your daily life and you'll discuss how you got on during the next session.
The eventual aim of therapy is to teach you to apply the skills you've learnt during treatment to your daily life.
This should help you manage your problems and stop them having a negative impact on your life – even after your course of treatment finishes.
Pros and cons of CBT
Cognitive behavioural therapy (CBT) can be as effective as medication in treating some mental health problems, but it may not be successful or suitable for everyone.
Some of the advantages of CBT include:
- it may be helpful in cases where medication alone hasn't worked
- it can be completed in a relatively short period of time compared to other talking therapies
- the highly structured nature of CBT means it can be provided in different formats, including in groups, self-help books and computer programs
- it teaches you useful and practical strategies that can be used in everyday life – even after the treatment has finished
Some of the disadvantages of CBT to consider include:
- you need to commit yourself to the process to get the most from it – a therapist can help and advise you, but they need your co-operation
- attending regular CBT sessions and carrying out any extra work between sessions can take up a lot of your time
- it may not be suitable for people with more complex mental health needs or learning difficulties – as it requires structured sessions
- it involves confronting your emotions and anxieties – you may experience initial periods where you're anxious or emotionally uncomfortable
- it focuses on the individual’s capacity to change themselves (their thoughts, feelings and behaviours) – which doesn't address any wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing
Some critics also argue that because CBT only addresses current problems and focuses on specific issues, it doesn't address the possible underlying causes of mental health conditions, such as an unhappy childhood.
Finding a CBT therapist
If you think you have a problem that may benefit from treatment with CBT, the first step is usually to speak to your GP.
Your GP may be able to refer you for CBT that's free on the NHS, although you may have to wait.
Find psychological therapy services.
If you can afford it, you can choose to pay for your therapy privately. The cost of private therapy sessions varies, but it's usually £40-100 per session.
If you're considering having CBT privately, ask your GP if they can suggest a local therapist.
The British Association for Behavioural & Cognitive Psychotherapies (BABCP) keeps a register of all accredited therapists in the UK and The British Psychological Society (BPS) has a directory of chartered psychologists, some of whom specialise in CBT.