Cognitive Behavioral Therapy (CBT)

Mental health care looks different for everyone. However, for many, one approach consistently rises to the top: cognitive behavioral therapy (CBT). Known for its practical, goal-oriented structure, CBT is a form of psychotherapy that helps people shift how they think so they can change how they feel and behave. Whether someone is struggling with anxiety, depression, trauma, or other challenges, CBT can offer a structured path toward healing, one thought at a time.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a therapeutic intervention that helps people identify and change negative thought and behavior patterns. It’s based on the idea that a person’s thoughts, or more often their perceptions, influence their feelings and behaviors. Thus, by addressing unhelpful thoughts and objectively examining perceptions, people can change the emotions and behaviors that stem from them ^[1]. 

Unlike other therapeutic approaches that often focus on childhood experiences or unconscious motivations, CBT emphasizes the present. It equips people with practical tools to reframe distorted thinking, manage emotions, and solve real-world problems. Whether delivered in-person, virtually, or in a group setting, CBT can be adapted to meet various needs and preferences. As such, it’s often used as a first-line treatment for many mental health conditions.

The prevalence of CBT in mental health treatment is reflected in recent statistics. According to the 2023 National Survey on Drug Use and Health (NSDUH), more than 59 million U.S. adults (23%) received mental health treatment in the past year, including counseling, medication, or other forms of care ^[2]. Given that CBT is one of the most extensively researched and widely practiced forms of therapy, many of these people likely benefited from CBT-based interventions or techniques ^[3].

Unhelpful Thoughts and Behaviors

To better understand CBT, it helps to explore the thoughts and behavior patterns it addresses. These ways of thinking and acting can negatively impact mental health and daily functioning, and they often create a self-reinforcing cycle where negative thoughts lead to problematic behaviors, which in turn validate the original negative thoughts ^[3]. These patterns can emerge gradually, sometimes going unnoticed for years until they begin to impact relationships, work, or overall well-being. Regardless of when they develop, however, these patterns are learned and changeable, which makes them ideal targets for intervention.

Unhelpful thoughts are often automatic and distorted, meaning they may not accurately reflect reality. Common examples of unhelpful thought patterns include: 

• Catastrophizing (expecting the worst to happen)
• Black-and-white thinking (seeing situations as all good or all bad)
• Personalizing (assuming excessive responsibility for negative events)
• Overgeneralizing (drawing broad conclusions based on a single event)
• Mind reading (assuming you know what others are thinking)
• Mental filtering (ignoring the positive to focus on the negative)

Similarly, unhelpful behaviors unintentionally worsen a person’s emotional state or reinforce unhelpful thinking. Unhelpful behaviors include avoidance and procrastination, social withdrawal and isolation, substance misuse, emotional suppression, and more. 

CBT helps break these patterns by teaching people to identify them, challenge their validity, and develop more balanced ways of thinking and healthier behavioral responses. When practiced over time, this process promotes better mental health outcomes.

Conditions Commonly Treated with CBT

CBT is often combined with various forms of treatments, such as psychiatric medications and lifestyle changes, to treat a host of mental health conditions, including ^[4]: 

• Depression
• Generalized anxiety disorder (GAD)
• Personality disorders
• Obsessive-compulsive disorder (OCD)
• Eating disorders
• Post-traumatic stress disorder (PTSD)
• Bipolar disorder
• Schizophrenia
• Attention deficit hyperactivity disorder (ADHD)
• Substance use disorders

CBT can also be adapted to address other symptoms and challenges while maintaining its core focus on the relationship between thoughts, feelings, and behaviors. Therefore, CBT benefits extend to various medical conditions and life challenges, including insomnia, migraines, chronic pain, chronic fatigue syndrome, irritable bowel syndrome (IBS), relationship issues, divorce, stress, employment, and more ^[4].

Its wide-ranging applications show that CBT is more than just a treatment for mental illness. Rather, it’s a tool for improving quality of life. From managing pain to building healthier relationships, CBT supports growth across many areas.

CBT Effectiveness

CBT’s wide-ranging uses speak to its effectiveness. However, both CBT and therapy as a whole are backed by decades of research. 

Studies suggest that roughly 75% of people who partake in psychotherapy experience meaningful improvements in their daily functioning, including enhanced emotions and behaviors. Beyond these psychological benefits, therapy is also linked to positive changes in the brain and body, resulting in fewer sick days, reduced disability, and greater satisfaction in both work and personal life ^[5]. 

When it comes to CBT specifically, research indicates that it’s particularly effective for anxiety disorders, depression, PTSD, and OCD ^[6][7]. CBT regularly helps those with anxiety to identify and change negative or unhelpful thought patterns and behaviors that contribute to anxiety, leading to improved coping strategies and reduced anxiety symptoms.

Studies also show promising outcomes in treating substance use disorders, sleep issues, and chronic pain. For many people, CBT is as effective as medication, and when used in combination with pharmacological treatment, outcomes can be even stronger ^[6][7]. 

Further evidence supports CBT’s broad impact. According to insights from the American Psychological Association, CBT has been shown to significantly improve functioning and quality of life across many conditions, including depression, anxiety, substance use, marital problems, eating disorders, and even severe mental illness ^[1]. Due to its success as shown in multiple rigorous, randomized controlled trials, CBT is widely considered a well-established and empirically supported therapy ^[7]. 

What to Expect in a CBT Session

CBT sessions come in various formats, including guided self-help with therapist support, one-on-one sessions, and group therapy involving others facing similar challenges. Generally speaking, each CBT session centers on identifying and changing patterns that contribute to difficulties. 

The therapist and participant explore challenging situations, examining how these affect thoughts, feelings, and behaviors. Together, they develop new ways to approach these challenges by questioning negative beliefs, observing emotions without immediate reactions, or gradually engaging in activities they may have previously avoided. Through the sessions, therapists guide the process to find strategies that best suit each person ^[8]. 

An important aspect of CBT involves practicing newly learned skills between sessions. Progress is often tracked through worksheets or diaries, reinforcing learning and supporting lasting change. After completing various CBT sessions, maintaining these techniques is essential, with the therapist helping people explore ways to continue applying them in daily life ^[8].

If symptoms persist following the initial sessions, additional therapy might be recommended. Overall, CBT represents a collaborative, practical process aimed at empowering people to manage and overcome difficulties effectively.

Credentialed CBT Providers 

A wide range of mental health professionals offer CBT, each bringing different educational backgrounds, training, and specialties. Although licensing, titles, and practice standards differ across states, the following overview offers a glimpse of who provides CBT and what credentials they typically hold ^[9]: 

• Psychologist (PhD/PsyD): These professionals hold doctoral degrees in clinical psychology or related disciplines. They are skilled in conducting clinical assessments and psychological testing, diagnosing mental health disorders, and delivering therapy either individually or in groups.
• Psychiatrist (MD): As medical doctors with specialized training in psychiatry, psychiatrists can diagnose mental illnesses, prescribe medications, and provide treatment. Some focus on specific populations, such as children or older adults.
• Licensed Clinical Social Worker (LCSW): With master’s degrees in social work, LCSWs are trained in both therapeutic methods and supportive services like case management and advocacy. They also assess mental health and offer counseling.
• Licensed Professional Counselors (LPC/LMHC): These professionals typically hold master’s degrees in counseling or related fields and are trained to evaluate mental health concerns and apply various therapeutic approaches.
• Licensed Marriage and Family Therapist (LMFT): Specializing in relationship and family dynamics, LMFTs focus on improving communication and resolving conflicts within family systems.

When considering therapy, confirming that the provider holds a valid license in the relevant state is essential, ensuring adherence to required education, training, and ethical standards.

Treatment Settings for CBT 

When it comes to mental health treatment, a host of care options are available, each of which can be tailored to symptom severity and each person’s needs. Therapy is frequently combined with medication and delivered through various settings and formats. 

Treatment programs within each setting can be modified to meet specific needs and circumstances, ensuring that people receive the right level of support at the right time. As symptoms improve or needs change, transitions between these levels of care can help maintain progress and support long-term recovery.

Outpatient Therapy

One of the most common levels of care, outpatient therapy comprises therapy sessions that are scheduled around each person’s daily activities. This flexible form of treatment allows people to maintain their usual routines and responsibilities. 

Intensive Outpatient Programs (IOPs)

These programs offer more structured support, with therapy sessions occurring multiple times per week for several hours each day. Despite the increased intensity, participants usually continue living at home and managing work, school, or family responsibilities.

Partial Hospitalization Programs (PHPs)

PHPs provide comprehensive, high-intensity treatment during the day, often five to seven days a week, while allowing patients to return home in the evenings. Some people choose to stay in recovery housing or a sober living environment during PHP. This level of care is more intensive than IOPs but less restrictive than complete inpatient treatment.

Residential/Inpatient Care

Residential treatment settings offer 24/7 care and supervision within a treatment facility. Offering intensive support and structure, inpatient care is designed for people experiencing severe symptoms, crises, or substance use disorders.

Beyond Therapy

While mental health care is rarely a one-size-fits-all solution, CBT therapy offers a structured and proven way forward for many. Whether addressing anxiety, depression, trauma, or everyday stressors, CBT equips people with the tools to change their thinking, shift their behaviors, and regain control of their lives. With decades of research and clinical success behind it, CBT remains a trusted and widely used path to mental wellness.

What’s more, the skills learned in CBT don’t end when therapy does. From building healthier habits to rethinking self-defeating beliefs, CBT empowers people to continue growing long after their sessions have ended. Offering far more than symptom relief, CBT helps people live with greater confidence, resilience, and hope.