What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy helps you talk through negative thoughts that cause sadness or anxiety so you can manage your emotions. Here's what you should know.

Americans are more stressed, anxious, and depressed than ever before, especially young adults. More than four of 10 adults say they've recently experienced high levels of emotional distress. Among people ages 18 to 29, the number jumps to 58 percent.

Antidepressants and other medications are one way to combat depression and anxiety. Another method is a type of talk therapy (psychotherapy) called cognitive behavioral therapy (CBT). During therapy sessions, a mental healthcare provider teaches you how to change the negative thoughts that cause you distress.

CBT works as well as medication, but research shows that 70 percent of people with depression prefer talk therapy. Even so, fewer than one quarter of people who could benefit from CBT use it.

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What is CBT?

CBT is based on the idea that mental health issues like depression and anxiety are at least partly due to unhelpful beliefs, thought patterns, and behaviors.

In this program, you work with a mental health professional such as a psychologist, therapist, or counselor to change those unhelpful thoughts. Over a series of sessions, you learn healthier and more productive ways to cope with your emotions.

What conditions does CBT treat?

Mental health professionals use CBT to treat:

• Anxiety disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder
• Depression
• Eating disorders such as anorexia nervosa and bulimia
• Insomnia and other sleep disorders
• Obsessive-compulsive disorder (OCD)
• Phobias
• Post-traumatic stress disorder (PTSD)
• Schizophrenia
• Substance and alcohol use disorders

Sometimes CBT is more effective when it's combined with antidepressants or other medications.

CBT is also helpful for managing relationship and life problems, including:

• Abuse or violence
• Gambling and smoking
• Divorce
• Family problems
• Grief or loss
• Issues related to a move or job change
• Work Stress

A form of CBT called exposure therapy is helpful for people who have phobias, such as a fear of flying or needles. The treatment slowly and gradually exposes you to the object of your fear to overcome it.

What to expect during cognitive behavioral therapy

CBT sessions can occur with just you and your therapist or during a group setting. You can have CBT in a clinic, a therapist's office, or your own home using telemedicine.

You'll meet with a therapist for about five to 20 sessions at regular intervals (such as once or twice a week). Each session lasts between 30 to 60 minutes.

The therapist will ask what problems you're having and what you hope to achieve through CBT. Each therapist has their own approach, but the process generally involves working together to find solutions to your problems. You may get assignments to apply what you've learned at home in between therapy sessions.

Exposure therapy takes a ladder-like approach to help you overcome a phobia. For example, if you have a fear of needles, you might:

1. Look at a picture of a needle
2. Look at a real needle
3. Hold a needle
4. Watch a video of someone getting an injection
5. See someone getting an injection in person
6. Get an injection yourself

Each time your anxiety subsides, you're ready to move to the next step on the ladder.

How effective is CBT?

Mental health professionals consider CBT the gold-standard or best treatment for conditions like anxiety and depression because volumes of scientific evidence confirm that it works.

Studies show that CBT is effective for a wide range of mental health and medical issues, including anxiety, depression, ADHD, chronic pain, substance use issues, and gambling. And because therapy is an evolving practice, it is constantly being updated as new evidence emerges.

What you can do

Find a mental health provider who practices CBT, such as a:

• Counselor
• Psychologist
• Psychiatrist
• Social worker
• Therapist

Ask your primary care doctor or friends for a referral, check your health insurance plan’s covered therapists, or search online through an organization like the American Psychological Association or Psychology Today.

Finding someone you trust is important. You'll have more success with CBT if you're honest and open with your mental health provider.

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