Cognitive Behavioural Therapy (CBT): What is it and who can it help?

Updated: 26/11/24

Written by Dr Sara Tookey, Clinical Psychologist​​

 

 

Cognitive Behavioural Therapy (CBT): Understanding How Thoughts, Feelings, and Behaviours Connect

 

Cognitive Behavioural Therapy (CBT) is one of the most extensively researched and effective forms of psychotherapy. Developed by Dr. Aaron Beck in the 1960s, CBT is based on the understanding that our thoughts, feelings, behaviours, and physical sensations are all interconnected, and that changing one aspect can positively impact the others.

 

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What is Cognitive Behavioural Therapy?

CBT is a structured, time-limited approach that focuses on identifying and changing unhelpful patterns of thinking and behaviour. It emphasises the importance of the present while acknowledging how past experiences shape our current ways of thinking and behaving.

 

 

The Science Behind CBT

 

Research consistently shows that CBT is effective in treating various mental health conditions. Key findings include:

 

• Significant reduction in depression symptoms (Cuijpers et al., 2023)

• Lasting improvement in anxiety disorders (Carpenter et al., 2018)

• Effective treatment for PTSD (Lewis et al., 2020)

• Helpful in managing chronic pain (Williams et al., 2020)

 

 

Core Principles of CBT

 

The Cognitive Triangle

 

CBT works with the interconnection between:

1. Thoughts (cognitions)

2. Feelings (emotions)

3. Behaviours (actions)

4. Physical sensations (body responses)

 

Key Concepts

 

• Thoughts influence feelings and behaviours

• Behaviours can change thoughts and feelings

• Physical sensations affect and are affected by thoughts and emotions

• All these elements can be modified through conscious awareness and practice

 

 

Who Can Benefit from CBT?

 

CBT has proven effectiveness for:

 

• Depression and anxiety

• Panic disorder

• OCD

• PTSD

• Eating disorders

• Sleep problems

• Chronic pain

• Substance use disorders

 

 

What to Expect in CBT Sessions

 

A typical course of CBT includes:

 

1. Assessment and goal setting

2. Learning to identify thoughts, feelings, and behaviours

3. Understanding how these elements interact

4. Developing and practicing new skills

5. Regular homework assignments

6. Progress review and maintenance planning

    

    

Key CBT Techniques

 

Cognitive Techniques

• Thought records

• Cognitive restructuring

• Identifying cognitive distortions

• Balanced thinking exercises

 

Behavioural Techniques

• Behavioural activation

• Exposure therapy

• Activity scheduling

• Problem-solving training

 

Relaxation Methods

• Progressive muscle relaxation

• Controlled breathing

• Mindfulness practices

• Grounding techniques

 

 

The Evidence Base

 

CBT's effectiveness is supported by extensive research:

 

Recent meta-analyses show:

• CBT outperforms wait-list and placebo controls for most conditions (Cuijpers et al., 2023)

• Effects are maintained at follow-up (Hans & Hiller, 2013)

• CBT works across different delivery formats (in-person, online, group) (Carlbring et al., 2018)

 

Specific findings include:

• 50-75% response rate for anxiety disorders (Carpenter et al., 2018)

• Significant reduction in depression relapse rates (Zhang et al., 2019)

• Comparable effectiveness to medication for many conditions (Dunlop et al., 2019)

 

 

What Makes CBT Different?

 

CBT is:

• Structured and goal-oriented

• Present-focused

• Skills-based and practical

• Collaborative between therapist and client

• Evidence-based and regularly evaluated

• Time-limited with clear endpoints

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