How does Cognitive Behavioural Therapy (CBT) actually work? How does CBT actually work?

How does Cognitive Behavioural Therapy (CBT) actually work?

September 10, 2025

Cognitive Behavioural Therapy (CBT) is a structured, goal-oriented type of psychotherapy that focuses on the relationship between thoughts, emotions, and behaviours. The basic idea behind CBT is that our thoughts can influence how we feel and act, and that by changing unhelpful or distorted thinking patterns, we can improve our emotional well-being and behaviour.

Here’s how CBT generally works:

1. Identifying Negative or Distorted Thoughts

The first step in CBT is recognizing and identifying negative thoughts that may contribute to emotional distress or unhealthy behaviours.
These thoughts often follow a pattern, like catastrophizing (thinking the worst will happen), all-or-nothing thinking (seeing things as completely good or bad), or overgeneralization (drawing broad conclusions from a single event).

2. Challenging and Restructuring Thoughts

Once these negative thoughts are identified, the therapist helps the person challenge them.
The person is encouraged to evaluate whether these thoughts are based on facts or if there is evidence to the contrary.
The goal is to replace irrational or unhelpful thoughts with more balanced, realistic ones.

3. Behavioural Changes

CBT also includes focusing on behaviour. The therapist may ask the individual to engage in new behaviours or avoid old patterns that maintain negative feelings.
For example, someone with social anxiety might be encouraged to gradually engage in social situations to reduce avoidance and build confidence.

4. Developing Coping Skills

CBT teaches practical coping skills to help people handle difficult situations in healthier ways. These might include relaxation techniques, problem-solving strategies, and mindfulness exercises.
The goal is to empower the individual with tools they can use independently in the future.

5. Homework Assignments

A key component of CBT is “homework.” Clients are often asked to apply the techniques they’ve learned in therapy to real-life situations and bring back their experiences to discuss in future sessions.
This helps to reinforce the skills and encourage real-world practice, making the therapy more effective.

6. Time-Limited and Goal-Oriented

CBT is typically a short-term therapy (often 12-20 sessions) focused on specific goals, such as reducing anxiety, improving mood, or changing a particular behaviour.
Progress is often tracked through measurable changes in thought patterns, emotional states, and actions.