Cognitive-behavioural therapy (CBT) is an intensive, short-term, problem-oriented form of psychotherapy. With its practical, goal-focused approach, it helps people to develop skills and strategies for becoming and staying healthy.
CBT focuses on the here-and-now – on the problems that come up in day-to-day life. CBT helps people to examine how they interpret and evaluate what is happening around them and how these perceptions affect their emotional experience.
- is structured
- is time-limited (usually 6–20 sessions)
- is problem-focused and goal-oriented
- teaches strategies and skills
- emphasizes the importance of a collaborative therapeutic relationship between therapist and client.
In this video, Dr. Zindel Segal, a CBT expert at the Centre for Addiction and Mental, discusses how CBT works. It also features people explaining how CBT helped them deal with various mental health problems, including depression and schizophrenia.
The CBT model is built on a two-way relationship between cognition or thoughts and behaviours (each can influence the other).
There are three levels of cognition:
- Consciousness: Rational decisions are made with full awareness.
- Automatic thoughts: Thoughts flow rapidly and may not be accessed for accuracy or relevance. In a person with a mental health problem, these thoughts may not be logical.
- Schemas: Core beliefs and fundamental rules for information processing are shaped by developmental influences and life experiences.
- Behaviour can be changed using techniques such as self-monitoring, activity scheduling (for depression) and exposure and response prevention (for anxiety).
What happens in CBT?
In CBT, clients learn to identify, question and change the thoughts, attitudes, beliefs and assumptions related to their problematic emotional and behavioural reactions in certain kinds of situations.
By monitoring and recording their thoughts during situations that lead to emotional upset, people learn that how they think can contribute to emotional problems such as depression and anxiety. CBT helps to reduce these emotional problems by teaching people to:
- identify distortions in their thinking
- see thoughts as ideas about what is going on rather than as facts
- stand back from their thinking to consider situations from different viewpoints.
Where is CBT used?
CBT is the most extensively studied psychosocial treatment. Evidence suggests that it is particularly effective in treating anxiety and depression. Similar frameworks are used to treat different emotional problems, but the particular approach and strategies used in diagnosis-specific CBT are tailored to specific problems.
CBT is used to treat:
- bipolar disorder
- eating disorders
- generalized anxiety disorder
- obsessive-compulsive disorder
- panic disorder
- posttraumatic stress disorder
- schizophrenia and psychosis
- specific phobias
- substance use disorders.
CBT and self-help
Clients may find self-help books based on cognitive-behavioural principles. Websites that provide free information about CBT techniques may also be useful for clients. Evidence shows that these resources are more useful when the person also gets support from a therapist, especially if the person experiences low mood. CBT-based self-help approaches include:
- computer-based CBT
- supported self-management.
- dialectical behaviour therapy
- mindfulness-based cognitive therapy
- relapse prevention.
British Medical Association. (2013). How good is the research on cognitive behaviour therapy?
Current Opinion in Psychiatry. (2012). The third wave of cognitive behavioural therapies: What is new and what is effective?
National Institute for Health and Clinical Excellence. (2013). Computerised Cognitive Behaviour Therapy for Depression and Anxiety
CBT courses and workshops
Certificate in Cognitive Behavioural Therapy (OISE, University of Toronto)
Cognitive Behaviour Certificate Program (tapestudies)
Enhancing Cognition and Function in Older Patients with Schizophrenia: A Focus on Cognitive Behaviour Therapy & Social Skills Training (Centre for Addiction and Mental Health)
The Canadian Association of Cognitive and Behavioural Therapies list of conferences and workshops
Psychology Tools (worksheets to download and print)
Guides and manuals
U.S. Department of Veterans Affairs. (2008). A Therapist's Guide to Brief Cognitive Behavioral Therapy
Information for clients and families
Centre for Addiction and Mental Health. (2010). Cognitive-Behavioural Therapy: An Information Guide
MoodGYM (interactive program, Flash plug-in required)