What is Cognitive Behavioral Therapy?

Like all behavioral therapies, therapists use cognitive behavioral therapy (CBT) in an attempt to change behavior that doesn’t work for you and replace it with behaviors that are more in line with your goals. The difference is that CBT adds another dimension to behavioral therapy, and that is the “cognitive” part. This is how we think, feel, and perceive events. Before we get into what CBT is, let’s take a look at cognitive therapy by itself.

Cognitive Therapy

The way you interpret and assign meaning to your life is based on many factors such as your upbringing, your current social environment, and your world view. In cognitive therapy, the goal is to examine beliefs about yourself, other people, and the world. Beliefs that hinder you from living your life to the fullest are examined and new healthier ones are introduced. This is all done through a series of techniques the therapist guides you with. For example, if you come to therapy because you think you are a “bad” person, your therapist might ask you test that theory out. Are you really “bad”? All the time? Do you ever do any “good” things? Through these kinds of questions they are trying to help you see maybe some of your beliefs aren’t true, at least all the time. Your therapist will collaborate with you to help you to test your theories to determine which are helpful and which are not.

Cognitive therapists also talk about a concept known as “automatic thoughts.” These are thoughts that just seem to pop up in your mind without you really having to think about it. These are negative such as, “I’ll never get that job,” or “I don’t have any talent.” Part of the goal in cognitive therapy is to track these thoughts. How often do they come up for you? Are there certain situations when you are more negative? Why? It helps to keep a daily log so we can recognize and then begin to change the way we talk to ourselves.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a combination of both cognitive therapy and behavioral therapy. We are looking to change the way we behave AND the way we think.

Here is an example. You come into therapy because you are feeling very overwhelmed at work. You believe that you aren’t doing as good a job as you would like to and don’t know if you can ever measure up to your colleagues. This in turn has you feeling tense, distracted, and unable to focus at work.

A cognitive behavioral therapist might first ask you to track your thoughts and feelings. They are going to try and see if there may be a pattern somewhere in your thinking and see if there is anything that can be done to change it. Then they may look at some of your behaviors. Are you sleeping well? Do you tend to believe you won’t do well and then actually do poorly at work because of it? They may teach you relaxation skills and discuss with you how you came up with such negative views of your life.

Each session is relatively structured and examining very specific things in your life. This kind of therapy works particularly well with anxiety and depression because it focuses so much on specifics. You and your therapist work together to deal with specific behaviors, specific thoughts, and you are offered specific techniques to try.

A good cognitive behavioral therapist takes everything about you into consideration before offering any thoughts, reflections, or feedback. They should be looking at who you are in a holistic way and offering support and guidance in a gentle but effective way.

Since CBT is so specific it has been easier for researchers to track its effectiveness over the years, whereas other forms of therapy are less able to do so. For example, if you come in to therapy and I suggest you learn a hobby and replace your negative automatic thoughts 3 times a day, I can actually track that progress. Has learning that new hobby increased your life satisfaction at all? Did challenging those automatic thoughts lessen anxiety at all, and by how much? When you go in to therapy and just talk to your therapist about feelings, it can be harder to do research on its effectiveness (though I believe it can be effective as well!).

I have spent the majority of my counseling career learning and practicing CBT. I have seen it work well for many clients.

Every person is unique and what works for one person may or may not work for someone else. I always collaborate with clients. I ask questions like, “what would you like to try?” “what are you looking to get out of therapy, a space to process feelings or techniques to get through a specific issue?” “what are you comfortable and not comfortable with?” There is no right or wrong answer, simply ones that fit you and ones that don’t.

I hope this article has helped explain some facets of cognitive behavioral therapy. Please keep in mind this article is not intended as professional therapy or clinical advice. If you need help with a mental health issue you are facing, please contact a licensed mental health clinician.

I wish you well.

-Dr. Zaleski

Dr. Katrina Zaleski is a licensed clinical psychologist providing therapy in the state of California. One of her specialties is working with those looking for help with depression and anxiety. Learn more about Dr. Zaleski’s services for Depression Counseling and Anxiety Counseling.