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Cognitive Behavioral Therapy (CBT)

Medically Reviewed and Edited by 
Olga Kyrychenko, Psychologist

The APA defines Cognitive Behavioral Therapy (CBT) as a therapeutic approach wherein the goal is to empower people to act as their own therapists. To achieve this goal, you are given in-session activities and home tasks designed to develop coping abilities. Through these, you are able to alter your own thought processes, control your emotions, and modify your behavior.

CBT centers itself around the principle of removing poor or harmful thoughts and unhelpful behavioral patterns leading to the exacerbation of psychological issues. By adopting more effective coping mechanisms, symptoms of these psychological issues may be reduced as well as improve one’s general functioning.

This article is written with the intent to enumerate CBT treatment types and techniques, the benefits of CBT, and its drawbacks. Additionally, I aim to help you deduce whether CBT would be a viable therapeutic strategy for you and how to get started with seeking help in the form of cognitive behavioral therapy.

What are the Different Types of Cognitive Behavioral Therapy?

CBT is an umbrella term for various treatment types that are structured around the use of both cognitive and behavioral therapy fundamentals. Therefore, it is important to note that CBT strategies aim to intervene with both thinking and behavior patterns. 

Michael Twohig and his colleagues published a research on CBT and its types in 2013. In this section of the article, I will be discussing the prominent types of cognitive behavioral therapy the researchers have mentioned, how they differ from one another, and how they incorporate both cognitive and behavioral approaches.

Motivational Interviewing (MI)

In Motivational Interviewing (MI), the therapist adopts a very directive role. The therapist then uses this role to encourage patients to change their behaviors into more beneficial ones. By using this evidence-based psychotherapy strategy, they also guide you to increase your intrinsic drives which then influence the aforementioned behavioral change.

Exposure and Response Intervention (ERP)

Exposure and Response Intervention (ERP) has two components: exposure and intervention. During these phases, you confront ideas, pictures, things, and situations that cause anxiety and in some cases, obsessions.

The therapist helps train patients to face such triggers during the exposure stage of ERP followed by urging them to not engage in compulsive behaviors. ERP gradually retrains your brain to not engage in behaviors that act as responses to the triggers and as such is considered a very effective treatment for OCD.

Mindfulness-based Cognitive Therapy (MBCT)

Practicing mindfulness involves intentionally focusing on the present moment and accepting things as they are without judgment. Through such, you are able to increase awareness of your surroundings and inner feelings.

Mindfulness-based Cognitive Therapy (MBCT) uses such a notion to encourage you to place less emphasis on actively altering or confronting your disruptive thought patterns. Through MBCT, you are able to develop a more conscious outlook on life and how to deal with your inner experiences.

Functional Analytical Psychotherapy (FAP)

Greater emphasis is placed on the client-therapist relationship when undergoing Functional Analytical Psychotherapy (FAP). At the foundation of FAP is the concept of the therapist practicing “genuineness, intensity, compassion, and effectiveness” at all times.

Because the therapist plays such a role in the therapeutic relationship, your “cultural, social, and generational experiences” would be highly taken into account. As a result of such consideration, there is a high chance that you will undergo personal growth and adopt a more functional routine.

Metacognitive Therapy (MCT)

Metacognitive Therapy (MCT) aims to dissolve the “perseverative thinking style” termed cognitive attentional syndrome (CAS). The therapist will communicate to you the effects of constant worrying and rumination on your coping mechanisms.

By undergoing MCT, you are guided to shift your negative cognitions to positive and thus, enabling you to disengage from your irrational thoughts and not react to them anymore. At the end of this CBT treatment type, you are expected to have fostered adaptive beliefs and developed a more resilient attitude.

Rational Emotive Behavior Therapy (REBT)

As its name suggests, the goal of Rational Emotive Behavior Therapy (REBT) is for you to replace irrational thought processes with “rational non absolute thinking”. Rational non absolute thinking is defined as a cognitive pattern where you fully accept that some life conditions and aspects of yourself are unchangeable.

Once you have adopted such a way of thinking, you then allow yourself to come up with attainable and sustainable goals and, sequentially, work towards achieving those goals.

Acceptance and Commitment Therapy (ACT)

This CBT type incorporates mindfulness and acceptance frameworks that promote healthy behavior strategies you can fully commit to. This therapeutic approach centers itself on the idea of psychological flexibility or the state of being a “fully conscious human being” who is able to change or maintain healthy behaviors. You are expected to be able to fully recognize your values and use them to commit to behavior change that would benefit you even after the therapy has ended.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) places emphasis on dysfunction and dysregulation. The DBT perspective views dysregulated emotions as the cause of behavioral dysfunctions and thus, through this type of CBT your mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills will be honed. The role of therapists who use DBT is to guide you regulate your emotion, improve your relationships, and view distressing life events as things you are able to surpass.

Cognitive Behavioral Therapy Techniques

Now that you have learned a bit more about  the different examples of CBT, I will be presenting some of the most common CBT techniques used by therapists. Understanding these methods will help you better understand how CBT functions and how suitable it may be for you as a treatment option.

Increased Functioning

Most therapies focus on alleviating symptoms caused by psychological disturbances. With CBT, there is a shift in attention toward improving general functioning. Instead of sticking to the common belief that as long as you do not present symptoms anymore it means the treatment is successful, in CBT what matters more is that there is an evident movement towards healthier and more positive everyday activities.

Acceptance

By promoting acceptance techniques in CBT, you are encouraged to be open about experiencing unsettling events because you have already developed proper coping strategies and regulated your emotions enough not to feel any significant distress from such events anymore. This contrasts with other therapy which directs you to avoid triggers so as to not feel disturbed.

Cognitive Defusion

With this CBT technique, you are taught to take things as it is: a thought is a thought, and a feeling is a feeling. Once you learn to not overly interpret cognitions and emotions when they come to you, the unreasonable behaviors or responses that result from such will not manifest. On the contrary, cognitive fusion is a technique used in other non-CBT approaches wherein you are encouraged to put meaning to your thoughts and feelings in order to act on them properly.

Mindfulness

In its simplest form, mindfulness is “being present”. In a way, it is almost synonymous with cognitive defusion wherein cognitions and emotions are viewed in a nonjudgmental manner. However, with mindfulness, there is already the response, and such a response is also done in a direct and nonjudgmental way.

To put it simply, after undergoing CBT sessions and learning how to be mindful, you do not let yourself dwell over things that are not “in the present”. Your actions should not focus on repercussions or your previous experiences of doing such actions but rather, on what is most appropriate to do at the moment.

Cognitive Behavioral Therapy Uses

It is important to keep in mind that although CBT is designed to be short-term, undergoing such therapy can have positive long term impact. While this section focuses on particular mental disorders wherein CBT has been proven effective, if you are experiencing distress without the presence of a disorder, you may still benefit from CBT.

Prominently, CBT is used in the treatment of the following disorders:

Overall, the use of CBT is primarily to help you recognize and challenge harmful thought patterns and behavior. You can strive for better understanding, self-awareness, and eventually improved mental health and wellness by seeking to undergo CBT.

Is Cognitive Behavioral Therapy Effective?

The effectiveness of CBT is mainly studied among clinical populations – mainly people with anxiety or OCD. Recent studies such as what has been reported in the Dialogues in Clinical Neuroscience present numerical data that supports the efficacy and effectiveness of CBT as a treatment method. Such findings mainly stem from the homogeneity found among such patients in terms of their behavior, cognition, emotion, and overall functioning.

As for Internet-Based CBT (ICBT) or online CBT, a paper published by Kumar et al. presented information that ICBT has been found effective as a treatment option. Additionally, online CBT has been found to be cost-effective and a good alternative to face-to-face therapy. Since most ICBT options are self-guided, it highlights one of the main features of CBT which is active client participation.

To find online therapy sites that offer virtual CBT treatments, visit our full list of therapy platforms reviews.

Cognitive Behavioral Therapy Benefits

Understanding the benefits of CBT can help you make an informed decision about whether this type of therapy is right for you. As I have previously mentioned, CBT is not only for those with certain diagnoses or disorders. 

Based on research published in the Journal of Clinical Psychology, CBT benefits are as follows:

  • Develop the ability to recognize one’s thoughts when facing particular problematic situations.
  • Develop the ability to distinguish between and recognize emotional states from the past and present.
  • Develop the ability to take control of their own recovery process.
  • Develop the ability to establish and maintain meaningful relationships with individuals outside of therapy.
  • Develop coping mechanisms that alleviate anxiety and uphold a positive self-perception.

The aforementioned points prove that the CBT techniques I have listed earlier in this post can also help if you are looking to improve your general mental health and well-being.

Cognitive Behavioral Therapy Drawbacks

Knowing the limitations of any therapeutic approach is essential. CBT has been proven to be a successful treatment for a number of mental health conditions, although it may not be effective for everyone. Additionally, CBT may not be the best treatment option for a person’s specific needs or may only provide limited benefits for some people. Here are some of the main drawbacks CBT suffers from:

  • For disorders like depression, other therapies are more efficient.
  • CBT is considered a “short-term patch”.
  • Activities given by the therapist may be time-consuming. CBT requires more self-work.
  • CBT does not take a lot of predisposing factors into consideration.
  • The influence of family, peers, and the environment is not the highlight of CBT.
  • There is ambiguity surrounding interchangeable concepts used in CBT.
  • Sometimes CBT taps into personality traits that do not need to be changed.

It is worth noting that acknowledging the issues with CBT does not make it any less valuable or effective as a treatment option.

Getting Started With Cognitive Behavioral Therapy

CBT is a widely-available therapy option in the US. Sessions may be delivered in a variety of formats. You can opt for individual or group settings, as well as choose between in-person or online meetings with your therapist.

Accessing CBT in the US can be done through private clinics, government-funded programs, or community mental health centers. Most online therapy sites also offer CBT as a treatment option. 

The National Association of Cognitive-Behavioral Therapists (NACBT) stated on their website that by contacting them they are able to help you get in touch with a CBT therapist. Similarly, the Association for Behavioral and Cognitive Therapists (ABCT) also has a directory of therapists you may seek help from.

Is CBT Right For You?

Now that you were able to get ahold of credible information regarding CBT, we can conclude that CBT is indeed a highly effective and widely-used therapeutic approach. Utilizing different techniques and having numerous types, you can definitely find a treatment plan that best suits your specific needs. We can also deduce that you can gain increased self-awareness and learn how to manage your thoughts, feelings, and behaviors in more constructive ways through CBT.

I have also highlighted that it is important to recognize that CBT has its limitations and may not work for everyone thus, I hope that you are able to weigh the pros and cons of CBT. If the pros of CBT outweigh its cons and you have decided to seek help, having a qualified therapist with realistic expectations regarding the effectiveness of CBT is your best choice. 

Overall, CBT is a viable option for you who may be in distress. It may be helpful if you simply want to enhance your mental health and wellness too.

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