What is Cognitive Behavior Therapy (CBT)?

Cognitive behavior therapy (CBT) is according to research and surveys the most widely practiced psychotherapy in the world, as well as the most researched one. That also means that it is the type of psychotherapy that has a very good chance of helping you with your psychological difficulties and to bring change in your life. On this page we try to explain the essence and essentials of what CBT is.

CBT is actually not one single psychotherapy but rather a family of many specific therapies that share certain common elements, described below.

Evidence-based

First of all, it has a strong scientific base, that is, there is since decades a lot of research that shows how specific cognitive behavior therapies can be effective for many different problems; from very specific psychological problems like a phobia (such an excessive fear of snakes or heights) to more broad and pervasive problems like post-traumatic stress disorder (such as reexperiencing severe traumatic experiences, like a physical assault were one thought one would die). On this website, we describe specific cognitive behavior therapies for many different types of psychological problems.

Time-limited

Another element of CBT is that it is often a time-limited therapy. A usual length of a cognitive behavior therapy is between 10 to 20 sessions. But it can both be shorter than that (like for a specific phobia, that can be cured in one single session), or much longer, for severe problems like posttraumatic stress disorder or long-standing emotional instability and interpersonal problems, where a therapy can last several years. This also means that the frequency of sessions can vary a lot, from every week to sometimes, in a follow up phase, one session every month or so.

Active and collaborative

One of the reasons that a CBT can be shorter, or more focused, than some other psychotherapies, is that the role of the cognitive behavioral therapist is somewhat different: He or she is often more active than in other therapies, by asking specific questions and by guiding you in therapy in a certain way. This guidance will also focus on concrete ways of eliciting you to take active part in the therapy yourself. That is, you and the therapist will work collaboratively towards changes in your life that would have been too difficult for you to reach on your own.

Focused on the present

One important element in CBT is the focus on what happens in your present, everyday life. That means that the sessions with the therapist focuses on understanding the pattern of difficult feelings, thoughts and behaviors in the here and now. This can for example be examining what you feel and think during the session but is often about discovering more about such patterns in your everyday life, that is during the time that passes between sessions.

However, the focus on what happens in the here and now in CBT doesn’t mean that we aren’t interested in your individual past. Many difficult psychological patterns have been there for a long time, for reasons that it can be helpful to understand and then learn to accept. The reason why CBT focuses more on the here and now than the past is simply that the way to change lies there: We can change the present and the future, but not the past.

Practical and skill-based

So the way to change in CBT takes place in your everyday life – by trying out new concrete ways to challenge your difficulties. The probably most known type of CBT, exposure therapy, is a good example of this. It is used for overcoming problems with anxiety, for example social anxiety, when one is terribly fearful of being wrong and judged by others, or obsessive-compulsive disorder, when one is fearful of for example being contaminated by surfaces that seems dirty or getting anxious because of thoughts that our religion or our culture judge blasphemous or forbidden. In a practical, structured and gradual way, the therapist will in exposure therapy help you confront what triggers your fears, in a specific way that you haven’t been able to do before. And in so doing, you will step by step experience less and less anxiety, and feeling more and more free in your life.

This practical and skill-based way of doing therapy also translates into how the time between sessions comes to life in CBT: through ‘homework’ (or ‘individual challenges’ that one also can call them). At the start of therapy, this can be the task observing and writing down on a piece of paper or in your phone patterns of thoughts, feelings and behaviors. Later in therapy it can for example be doing the same exposure exercise (to something you fear) that you did with your therapist, but now on your own, or with a family member or friend, in your everyday life, several times, until you feel less anxious or differently about them; until you experience something new and liberating!

Goal-oriented

In CBT your therapist will of course only focus on what you really want to change in your life – he or she will never force you to do anything, only support and help you to the often-difficult changes that you actually want in your life. This also means that setting goals for the therapy at its start is an important element in all CBT: If you don’t know where you want to go in life, chances are you won’t be able to go there. Quite often, especially when one suffers from emotional problems, one feels lost and has difficulty defining goals. That is why the initial phase of a CBT is precisely about helping you find your way and where you want to go in life, which can be less difficult to do together with someone.

Could CBT help you?

We have up until now focused on specific and common elements of all CBT, that is, what may distinguish CBT from other psychotherapies. One can actually say that if a therapy lacks these elements, it isn’t really a cognitive behavior therapy!

But of course, CBT also shares many elements with other psychotherapies; it should be a secure place where you feel listened to, understood and validated, among other things.

No change can happen if you are not feeling validated or if you feel that you are not taken seriously by your therapist. And because every therapist – just like you – is a unique human being (whether he or she works with CBT or with another type of psychotherapy), it is also essential that you feel comfortable not only with the type of therapy but also with your therapist as an individual.

We hope that you now feel that you know a little bit more about CBT and about what you can expect from a cognitive behavioral therapist. Who knows, by reading this short text maybe you have taken the first step of reaching out for help, and thus taken the first step to an essential change in your life?