CBT Explained: The Therapy Approach Everyone’s Talking About

CBT, or Cognitive Behavioral Therapy, is a skills-based approach that helps you identify and change unhelpful thoughts and behaviors. It’s one of the most researched, and most effective, types of therapy for anxiety, depression, insomnia, obsessive-compulsive disorder, post-traumatic stress disorder, low self esteem, relationship problems, and more. Cognitive Behavioral Therapy (CBT) is the most common of therapy modalities: evidence-backed, widely used, and frequently misunderstood. CBT is often structured and present-focused, making it different from more open-ended therapy styles.

You’ve probably heard of it. Maybe a friend recommended it. But what actually happens in CBT?

Let’s break it down.

What Is CBT?

CBT is a structured, short-term type of therapy that, at its core, teaches you how to spot unhelpful thoughts and shift the behaviors they influence. It’s grounded in the principle that your thoughts, feelings, and behaviors are interconnected, and that changing one can influence the two.

How Does CBT Work?

Given the structured, skills-based nature of this therapy type, CBT typically follows a step-by-step process. 

Step 1: Identify your automatic negative thoughts. 

Negative thoughts are often subtle, habitual, and may feel true, simply, because they’re familiar phrases you say to yourself. The first step of CBT is identifying that this is a negative thought. 

An example of this type of thought is, “I always mess things up.” 

Step 2: Challenge this  thought with logic and evidence. 

Question the accuracy of this statement. This helps you break the pattern of unhelpful thinking. 

Questioning it:

• What are times when things went well? What was the commonality? 
• Is it always true? Or only true under certain circumstances?
• This thought is just an opinion and your brain can have wrong opinions.

Find evidence against it: 

• I submitted my project on time and got positive feedback, even with a few hiccups along the way. 
• I was able to apologize to my partner without shifting blame to anyone or anything else.   

Step 3: Replace them with more balanced and realistic alternatives. 

Now find an alternative that’s more balanced than, “I always mess things up.” Examples of this include: 

• I tend to make more mistakes when I’m multi-tasking. When I take my time, I actually do a really good job.
• When I go into a conversation without a plan, I stumble on my words and shut down. Instead of winging it, I’ve found that I do really well when I plan out what I want to say.

Step 4: Practice new behaviors that reinforce healthier thought patterns.  

Behaviors to reinforce this more balanced mindset could include: 

• Breaking big tasks into smaller steps so you don’t feel rushed.
• Setting aside time to double-check your work.
• Celebrating small wins to build evidence that you're capable.
• Noticing when things go right and write them down.

The process of CBT helps you become more aware of these automatic patterns so you can make intentional changes that improve how you feel and respond in everyday situations.

What Does CBT Help With?

CBT is especially helpful for identifying and breaking patterns of unhelpful thinking. Some of the most common examples are all-or-nothing thinking, automatic negative thoughts, and those guilt-inducing “should” statements that shape how you feel and act.

CBT is especially effective in treating: 

• Generalized anxiety
• Depression
• Social anxiety
• Obsessive-compulsive disorder
• Panic disorder
• Insomnia
• Low self-esteem

CBT isn’t just effective, it’s efficient. Many people notice meaningful changes in a relatively short period of time, which is what makes it such a popular modality. Though the number of sessions varies based on individual needs and goals, progress can be apparent in just a few sessions. 

What to Expect in a CBT Session

CBT is usually a shorter-term treatment that works on specific goals. Here’s what a typical session might involve: 

• Goal-orientation: Your therapist will ask what you’d like to work on, and together you'll define clear, practical goals to guide your time in therapy.
• Collaborative: You and your therapist are a team so don’t expect to be talked to. Instead, you and your therapist will work side by side to understand patterns, challenge unhelpful thoughts, and build new skills.
• Homework-inclusive: Between sessions, you’ll be given exercises to try like thought tracking, trying behavioral experiments, or practicing relaxation techniques.
• Focused: CBT sessions are usually structured. So expect less of tell me your whole life story,and more, let’s work through this thought loop together.
  

How Spring Health Can Help

At Spring Health, we have a large network of CBT-trained therapists. Whether you’re new to therapy or just want more structure, we can match you with someone who fits your needs.