Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) can help you understand how your thoughts and actions affect the way you feel.

*Last updated: 30 July 2021

CBT is based on the idea that our feelings, thoughts and actions are all connected. By changing one of these, we can change the others.

How does CBT work?

When we’re upset, we often fall into patterns of negative thinking and responding that can make us feel worse. If we don’t challenge these negative thoughts and behaviours, they can become a cycle.

For example, if you feel depressed, you may withdraw from your friends. You may think you’re no good or that you don’t deserve their friendship. This can make you feel more depressed, which make you withdraw even further.

In CBT, your therapist will help you notice and change how you think and behave so you can break this cycle and feel better.

CBT usually takes place over a set number of sessions, often 6-12 weekly sessions. This might be delivered one-to-one or in a group with a therapist, via a self-help book or through an online CBT programme.

How is CBT different to other therapies?

CBT is different to other talking therapies in several ways.

  • It tends to be short-term.
  • It’s focused on specific problems rather than how you feel more generally.
  • It takes a very structured approach. You’ll talk about specific problems and goals with your therapist.
  • It’s much more about the present than about the past. You’ll look more at how you think and act now than about your past experiences.
  • You’ll have ‘homework’ to do between sessions. This could be keeping a diary of your thoughts and feelings or practicing the skills you’ve learned in therapy.

What does a session of CBT look like?

Not every session of CBT looks exactly the same, but they tend to follow a similar structure.

If you had any tasks to complete after your previous session, you’ll look at how they went. If you weren’t able to complete them, let your therapist know so you can talk about what stopped you.

Then you’ll decide what you want to focus on today. This might include recent problems, reflections on the previous session or planning for future events you might find difficult. Your therapist might give you exercises to do to explore your thoughts, feelings and behaviour. These could be worksheets, role plays or discussions.

Based on what you’ve talked about, your therapist might suggest some more tasks to try. For example, if you’ve talked about feeling worried about letting your friends down, you might try saying ‘no’ to some small requests from them and seeing how that feels.

Confronting your fears can be difficult, and your therapist won’t ask you to do things you don’t want to do. They should always work at your pace and check to see how you’re feeling about your progress.

What can CBT help with?

CBT is one of the most common treatments offered for mental health problems. Evidence suggests it can be used to treat depressionanxietyobsessive compulsive disorder (OCD)eating disorderspost-traumatic stress disorder (PTSD), schizophrenia and more.

It’s also sometimes used to help people with long-term health conditions such as irritable bowel syndrome or chronic fatigue syndrome. CBT can’t change someone’s physical symptoms but it can help people cope better with them.

What if I don’t find CBT helpful?

While CBT can be helpful for many different people, it isn’t right for everyone – just like every treatment.

If you’re having CBT now and not finding it helpful, talk to your therapist about it. They may be able to help you get more from the sessions by making changes or trying a different approach.

If you don’t feel comfortable with your therapist, you may be able to switch to a different one. Having a good relationship with your therapist is key to getting the most out of your sessions. Ask your doctor or whoever is providing your therapy about switching.

It may be that CBT isn’t the right sort of therapy for you. Perhaps you need something more long-term or that looks more at your past. Go back to your doctor or the organisation providing your therapy to ask about alternatives. Our page on talking therapies can help think about what approach might be right for you.

How can I get CBT?

You can get CBT (along with other talking therapies) on the NHS, although there may be a long waiting list. You can refer yourself directly or ask your doctor for a referral. Your doctor may also be able to refer you to low-cost counselling services in your area or give you a login for an online CBT programme.

You can also get CBT through a private therapist. Our page on talking therapies can help you find one.