If you've researched therapy, you've probably come across the term CBT — Cognitive Behavioural Therapy. It's one of the most widely researched forms of psychotherapy in the world, with a strong evidence base for anxiety, depression, and a range of other mental health concerns. Here's what it actually means and how it works in practice.
The core idea
CBT is built on a straightforward premise: our thoughts, emotions, physical sensations, and behaviours are all connected. When we're struggling, we often have patterns of thinking that are distorted or unhelpful — and those thoughts influence how we feel and what we do. CBT aims to help you identify these patterns and learn to shift them.
For example: you make a mistake at work. The thought might be "I'm completely incompetent" (all-or-nothing thinking). This leads to feelings of shame and anxiety. The behaviour: you avoid your manager, stop putting forward ideas. CBT would help you examine that initial thought, test it against evidence, and replace it with something more realistic — "I made a mistake. It's not ideal, but it doesn't define my competence."
What happens in CBT sessions
CBT tends to be structured and goal-focused, with a set number of sessions agreed at the start. Sessions typically involve:
- Discussing current concerns and what you'd like to work on
- Identifying specific thought patterns connected to your difficulties
- Learning to examine and challenge those thoughts
- Practising new ways of responding through behavioural experiments
- Sometimes: homework between sessions (journaling, trying a new behaviour)
Unlike some therapies, CBT is relatively active. You'll be learning skills you can continue to use after therapy ends.
What CBT helps with
CBT has strong evidence for: anxiety and depression, panic disorder, social anxiety, OCD, phobias, PTSD, eating difficulties, and insomnia. It can also be adapted for relationship issues, low self-esteem, anger, and grief.
Is CBT right for you?
CBT works best when you're willing to be active in the process — reflecting on your thoughts, trying things between sessions, and being honest about what's working. It's not the only effective therapy; some situations call for different approaches. A good therapist will discuss what's right for your specific concerns and preferences.
If you're curious about whether CBT could help you, the best starting point is a conversation. Book a session to discuss your situation and explore your options together.
