Mental Health

How Does Cognitive Behavioral Therapy (CBT) Work?

Talor Bianchini12 Oct 2021

Cognitive-behavioral therapy (CBT) is a commonly used type of psychotherapy. Therapists work with their patients to help find positive coping strategies for potentially harmful thoughts. CBT is most often used to treat depression and anxiety disorders. Patients can make the most of their experience by continuing to stick to their treatment plan. 

If you are looking for a specialist to help you on your cognitive behavioral therapy journey, Mira can help you locate someone close to you. In addition, Mira members get access to low-cost urgent care visits, up to 80% off on over 1,000 prescriptions, and same-day lab testing. 

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a type of talk therapy or psychotherapy used to treat a wide variety of mental health conditions and stress disorders. CBT is very structured and instead of being ongoing is limited to a certain number of sessions. CBT is based on the principle that how we think, feel, and behave are closely connected with one another. 

Source: ncbi.nlm.nih.gov

During CBT, the therapist works with the patient to recognize signs of negative or false thoughts so that difficult situations can be handled in a more productive way. This way, the patient can work to become their own therapist and handle future problems independently. Unlike other psychotherapy methods,  CBT focuses on current problems instead of solving past issues. 

Disorders Treated by CBT 

Many disorders are treated through cognitive behavioral therapy. The model was first created over 50 years ago by American psychiatrist Aaron T. Beck to treat his patients suffering from depression. 

CBT is most notably used to treat anxiety and depression, but can also be used for a wide range of conditions. CBT has been used to treat:

  • Bipolar disorder
  • Eating disorders
  • Obsessive-compulsive disorders
  • Phobias
  • Schizophrenia
  • Chronic health conditions (i.e. irritable bowel syndrome and fibromyalgia)
  • And more

While CBT works very well for individuals who are looking for a structured approach to therapy, people who have complex mental health needs may not benefit as much from CBT.

How CBT Works

The root of CBT is behaviorism, which means that human behavior is learned and can therefore be unlearned. First, the therapist will try to identify if certain behaviors that the patient exhibits intensifies their problems. 

Through CBT, patients are guided to change the way they think and then adjust behaviors. In order to adjust thinking, a therapist will work to identify the thinking patterns that lead to these stressful situations. Once they are identified, the patient and therapist will come together to find strategies to cope. Some examples include:

  • Developing more confidence in yourself
  • Understanding other people’s behavior and motivations
  • Coping with difficult situations with problem-solving skills

The therapist will then work with the patient to change behavioral patterns. This includes actions like facing fears instead of avoiding them and using role-play to act out potential stressful situations before they happen. The therapist will often assign homework assignments for the patient to help them practice these skills. 

Below we outline some examples of harmful thoughts, feelings, and behaviors as well as an example of h,ow CBT may aim to change these patterns. 

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Examples of Harmful Thought and Behavioral Patterns

Reaction

Harmful

Neutral

Thoughts

“He ignored me – he doesn’t like me anymore.”

“He didn't notice me – maybe he doesn’t feel well. I should give him a call and find out how he is doing.”

Feelings

Someone who thinks like this feels down, sad and rejected.

These thought patterns do not cause any negative feelings.

Behavior

The consequence of this thought is to avoid this person in the future, although the assumption could be completely false.

This thought is a prompt to get back in touch with the person to find out if everything is alright.

Source: ncbi.nlm.nih.gov

How Well Does CBT Work?

CBT is said to be the most effective kind of talk therapy and has even been titled the ‘gold standard' for psychotherapy treatments. CBT is the most researched form of psychotherapy, and its theoretical models are the most accurate in terms of the human mind and behavior. The American Psychological Association has noted it as the first-line treatment for many different disorders. In one study, it was found that CBT had recovery rates for anxiety in about 62.2 percent of patients, while typical therapy or counseling only had a 44.4 percent recovery rate. 

CBT has been said to work almost as well as antidepressant drugs. Taking antidepressants or anxiety medications in combination with cognitive behavior therapy techniques may help treatment to work better and more efficiently. 

In addition, although the duration of CBT is normally shorter than other therapy techniques, the results tend to last longer. The therapist sets a limit to make it easier to achieve your goals. You will typically have around five to twenty weekly sessions.  

Making the Most of CBT

Though cognitive behavioral therapy has proven to be very successful, there are steps you should take in order to make the most of your experience. Without the extra practice and dedication, the psychotherapy technique may not reach its full potential in creating positive coping mechanisms. Some tips for maximizing CBT include:

  1. Being honest with yourself and your therapist: In order to find success with CBT, you must be completely open and honest with your therapist. Without sharing your thoughts and feelings, your therapist will have a difficult time determining what steps can be taken to improve your outlook on situations. It can be difficult to open up about feelings and private thoughts with someone new, so it is important to find someone you are comfortable with.
  2. Complete the homework your therapist assigns: Throughout CBT, your therapist will most likely give you ‘homework’ to complete outside of your sessions. These tasks are assigned to help you practice techniques that you learn during CBT. In order to make progress, you will need to apply what you have learned outside of the session. This could come in the form of journaling, meditating, or even adjusting how you handle difficult situations and conversations with others.
  3. Don’t give up if you don’t see results right away: It can become frustrating if results are not seen immediately with CBT, but as with most treatments, it takes time. Tackling conditions like anxiety and depression can require a lot of hard work, as the conversation topics can be painful and difficult to discuss. Stick with the treatment and attend your sessions, even if you aren’t feeling motivated. The end results will be worth the work put into it.
  4. Embrace the process: The healing process is not something to be embarrassed or shy about. You will have to push yourself out of your comfort zone in order to see results. Work on embracing CBT and applaud yourself for all that you have accomplished. There are highs and lows to the process, but they should both be welcomed.
  5. Be clear about your goals: In addition to being open and honest with yourself and your therapist, make sure that you outline goals you want to achieve at the beginning of your sessions. It could be as general as wanting to manage your anxiety better or be very specific. Having a goal you and your therapist can continually look back on will help you to see the progress you have made throughout the CBT process.

Cognitive Behavioral Therapy Frequently Asked Questions (FAQs)

When deciding if CBT is a good fit for you, it is important to address any questions you may have about the process. Below are the answers to some frequent thoughts and questions about CBT. 

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Can you do CBT on yourself?

If you are unable to find a therapist to help you with CBT, you may consider self-directed CBT. Studies have shown that self-treatment can be very effective in decreasing the effects of anxiety and depression. It is recommended to use self-directed CBT when faced with mild to moderate symptoms, as you may see more success with the process. You can find resources online to help with self-directed CBT, including youtube videos and worksheets

Are there any risks to CBT?

Although CBT is typically beneficial, there are some drawbacks to the process. It can require a lot of time and effort to achieve the desired results. In addition, you may need to face periods of emotional distress when discussing your feelings, which can be very difficult and emotionally taxing. CBT sessions may bring on additional temporary anxiety and depression so it may not be the best technique for people who have severe mental health conditions. 

It is always a good idea to talk to your health care provider to see if they think that CBT is a good choice for you. 

How much does CBT cost?

The cost of therapy can vary depending on the geographic location and the type of specialist you are seeing. CBT is typically more on the expensive side, and can sometimes be over $100 for each hour of the session. The sessions are usually longer as well because the therapist aims to see progress made during the meeting. 

In comparison, one basic therapy session will cost between $60 and $120 for one hour without insurance. Many insurance plans cover some of the cost of therapy-related services, which you can discuss with your provider. 

If you do not have insurance, some providers may offer sliding scale payment options to make CBT and other types of therapy more affordable. In addition, you may be able to access free mental health services at support groups or community clinics. 

Can I do CBT online?

Yes, many telehealth services are available for CBT. Many online services will have your first meet with a consultant to identify your needs and match you with a therapist that is best for you. You will then have typical CBT sessions but over video chat. This is beneficial because you can connect with great therapists all over the country, rather than just those in your area. The online service may also provide you with extra videos, journaling ideas, and CBT techniques to use in between sessions. 

Bottom Line

CBT is generally considered the most effective type of psychotherapy utilized to treat a wide variety of mental health disorders. It works by identifying harmful and negative thoughts to develop healthy coping strategies. The end goal is for the patient to change the way they approach stressful situations, eventually becoming their own therapist.

Prioritizing your mental health is essential for living an overall healthy life. In addition to CBT, another way to stay healthy is by signing up for Mira. Mira members get access to low-cost urgent care visits, up to 80% off on over 1000 different prescriptions, and same-day lab testing for as little as $45 a month. Sign up today, your healthy life is on the way.