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What Is Cognitive Behavior Therapy?

As the science and education behind psychology continue to grow, so do the methods available to therapists. When trying to repair and improve someone’s mental health and well-being, there are many different routes that can be taken. While medication can help in some cases, most therapists’ goal is to reach the root of the specific problem and treat the cause through therapy sessions and self-help.

One of the methods that a behavioral therapist uses to treat mental health disorders is to identify and help to change potentially self-destructive, unhealthy behaviors or mental health conditions through mindfulness. One of the more common types of behavioral therapy is cognitive behavior therapy.

What Is Cognitive Behavior Therapy

Cognitive-behavioral therapy (CBT)is a psychological treatment that has been known to be effective for a large variety of issues and problem-solving. There have been multiple studies into the effectiveness of cognitive-behavioral therapy and they suggest this therapy typically leads to a significant improvement in function and quality of life for the patients. 

Often cognitive behavioral therapy has proven to be just as effective, or even more effective, than other forms of psychological therapy and psychiatric related medication. There are four basic steps involved with cognitive behavior therapy as they are as follows:

  1. Identify the troubling situations and conditions: The first step is identifying what the problem is exactly. This can include a wide variety of answers as cognitive behavior therapy can be used to treat lots of different issues. Some examples would be a diagnosed mental health illness, a divorce, grief, anger, or a medical condition. This step will revolve around the patient and therapist identifying what issue or issues are to be solved and the ultimate goals of the therapy. 
  2. Become aware of thought patterns, emotions, and beliefs In regards to the issues: Now that the issues have been identified, it’s time for the therapist to help guide the patient into sharing their thoughts. The therapist will observe what the patient has to say in regards to the problem or experience (called self-talk), the patient’s interpretation of the meaning of a situation, and general beliefs about themselves or other people and events. The goal here is to uncover the reasoning behind the issue or problem attempting to be resolved.
  3. Identify negative behavior or inaccurate thinking: In order to help the patient recognize flawed patterns of thinking and negative behavior, the therapist will focus their attention on the physical, emotional, and behavioral responses a patient has in various situations. This is where specific actions and thoughts can be identified in order to focus on. Often a patient will have no idea they have these negative behaviors and flawed thinking, and this is the attempt to show them.
  4. Reshape negative behavior or inaccurate thinking: This step can be quite difficult but this is where the therapist will encourage the patient to question their perception of a situation. The patient may have long-standing ways of thinking that are inaccurate or flawed, and here is where the goal is to help reform them. Essentially the goal here is to replace the negative habits that a patient has picked up and replace them with more positive ones. The process is goal-oriented through short-term goals that help alter thinking patterns through the cognitive behavior therapy.

The History of Cognitive Behavior Therapy

During the 1960s, a psychiatrist at the University of Pennsylvania named Dr. Aaron Beck designed and performed several experiments testing the psychoanalytic concepts of depression. What he discovered was that depressed patients experienced streams of negative thoughts that would seem to appear spontaneously. He would refer to these cognitions as “automatic thoughts,” and they fell into three distinct categories: self, the world in general, and the future. 

Cognitive behavior therapy was born when Dr. Beck helped these patients to identify and evaluate these automatic thoughts, and as a result, they could function better emotionally. Once the patients were able to identify and change their underlying beliefs about themselves, the world, and the future, they enjoy long-lasting positive changes. 

The thought process behind cognitive behavior therapy was basically that inaccurate or negative perceptions contribute to overall emotional distress. These thoughts and the emotional distress created will lead to negative or harmful behavior. This negative behavior will then help to influence the inaccurate or negative perceptions, thus becoming an endlessly repeating pattern. It’s only by changing the thoughts and behaviors of the patient that can stop the cycle from repeating. This is similar to psychotherapy or talk therapy as it uses a lot of the same systems as cognitive behavioural therapy

What Conditions Does Cognitive Behavior Therapy Treat?

There are dozens, if not hundreds, of issues that cognitive behavior therapy can help to treat. Some of them may end up being much harder than others to solve, but there are few better options for a lot of them. 

Some of the more common issues often treated by cognitive behavior therapy include: 

  • Depression
  • Anxiety disorders or social anxiety
  • Antisocial behaviors
  • Post-traumatic stress disorder
  • Alcohol, drug abuse or substance use disorders 
  • Bipolar disorder
  • Obsessive-compulsive disorder (OCD)
  • Marital problems
  • Attention deficit hyperactivity disorder (ADHD)
  • Bulimia 
  • Anorexia or other eating disorders
  • Schizophrenia
  • Anger issues
  • Self-harm
  • Phobias or Panic Disorder

Alongside treating symptoms such as the ones listed above, cognitive behavior therapy can also benefit patients in other ways. Some of the additional benefits are:

  • Learning techniques for handling stressful situations
  • Identifying new ways to manage emotions and responses
  • Resolving conflicts in relationships
  • Learning more effective ways of communicating with others
  • Coping skills with grief or loss
  • Overcoming emotional trauma from abuse or violence
  • Managing chronic physical pain
  • Coping with a medical or mental illness diagnosis

How to Get the Most From Cognitive Behavior Therapy 

Any form of therapy will require the patient to put forth their best effort in order to enact real changes. Anyone that finds themselves engaged in therapy will have, on some level at least, admitted they have an issue that needs to be fixed. Here are some things that should be taken into consideration during cognitive behavior therapy:

  • View it as a partnership: Instead of a therapist and patient, think of the relationship as more of a partnership. The two of you are looking for a problem and how best to solve it together. Being an active participant and sharing in the decisions making will help improve the effectiveness of any kind of therapy.
  • Be as open and honest as possible: Lying or hiding from thoughts, feelings and experiences will severely impact the effectiveness of therapy and may render the whole experience pointless. Also, it’s important to remain open to new ways of thinking and doing things. Being closed off to new suggestions will negate any progress being made in eliminating negative habits. 
  • Stick with it: Therapy takes time, and even when motivation may be lacking, it’s important to maintain the plan and stick to it. Attend all sessions that you can and make the most out of them. Without the work, there can be no progress.
  • It will take some time: When dealing with complex emotional issues and behaviors, the results won’t come overnight. This therapy is designed to reimagine your entire way of thinking and handling situations, so don’t stress out if that takes some time. It took a long time to develop these habits and it will take some time get the restructuring down for them as well.

Exposure Therapy 

One of the most common examples of CBT focuses on exposure therapy. This specific form is particularly useful for patients with phobias or obsessive-compulsive disorder but can serve to illustrate how cognitive behavior therapy works very well. 

First, the phobia will be identified. For this example, we will say the patient has a fear of the dark or nyctophobia. Once the issue is identified then the exposure will begin. The therapy will involve placing someone around the item or situation that causes them anxiety (in this case, a dark room) but only for a tolerable amount of time. 

The idea here is to start small (maybe a minute or two) and slowly work up to once the anxiety begins to subside. These exercises should be performed multiple times a day for weeks the duration of the therapy and increased as the tolerance builds up. All thoughts and feelings should be recorded and given to the mental health professional. This style of cognitive behavior therapy can be extremely challenging for a person to endure but studies have shown it can be very effective if completed.

The Takeaway

Cognitive behavior therapy is one of the most well-known and utilized therapy methods worldwide. The potential effective treatments are almost endless and their effectiveness is rarely matched by other methods or medications. 

Changing the way that someone thinks can be a grueling and challenging process but it can end up improving their lives dramatically. Having a qualified therapist or psychotherapist guiding their patient through the four steps of cognitive behavior therapy will no doubt improve the patient’s ability to function in day-to-day life. Replacing negative habits with positive ones will have a tremendously positive effect on the quality of life for anyone able to do so. Look into a CBT therapist with your healthcare provider. 


  1. History of Cognitive Behavior TherapyCBT (beckinstitute.org)
  2. VeryWellMind.com: What Is Cognitive Behavioral Therapy (verywellmind.com)
  3. What Is Cognitive Behavioral Therapy? (apa.org)
  4. Cognitive-behavioral therapy” (mayoclinic.org) 

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