Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

Cognitive Behavioral Therapy (CBT) – Addiction Treatment Therapy

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Cognitive Behavioral Therapy (CBT) is a type of therapy that helps people deal with mental health conditions. It focuses on changing negative thought and behavior patterns that cause emotional distress. The main idea is that our thoughts, feelings, and behaviors are all connected, and changing one can help improve the others.

Origins and Development of CBT

CBT’s roots go back to the 1960s when Dr. Aaron T. Beck developed cognitive therapy. Later, this was combined with behavioral therapy to form what we now know as CBT. It was a new way of looking at mental health, moving away from psychodynamic therapy, which focused more on a person’s past.

Central Goals and Principles of CBT

CBT aims to help people understand and change their thought patterns and behaviors. It helps people develop coping skills so that they can handle everyday life challenges better. The idea is not just to treat symptoms but to give people tools to keep getting better even after therapy ends.

How Does CBT Therapy Work?

CBT aims to modify thought patterns to help change moods and behaviors. In CBT, problems are broken down into five main areas: situations, thoughts, emotions, physical feelings, and actions. CBT combines cognitive therapy (examining the things you think) and behavior therapy (examining the things you do).

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Theoretical Foundation of CBT

CBT works on the idea that our thoughts affect our feelings, and our feelings affect our behaviors. So, by changing negative thoughts and unhealthy behaviors, we can improve our emotional health.

Techniques Used in CBT

CBT, or Cognitive Behavioral Therapy, uses a variety of techniques to help individuals change harmful thought patterns and behaviors. These techniques are used across different mental health conditions, from eating disorders to post-traumatic stress disorder, anxiety disorders, and major depressive disorder. Here’s an overview of some key CBT techniques:

  • Cognitive Restructuring: This is a core technique in cognitive behavior therapy. It helps people identify, challenge, and change irrational beliefs and distorted thought patterns that can lead to emotional challenges and mental illness.
  • Behavioral Activation: As a part of behavioral therapy, this technique encourages individuals to engage in activities that are enjoyable and rewarding. It’s used to help overcome inertia and avoidance behaviors, often associated with conditions like chronic illness, chronic pain, or mood disorders such as major depression and bipolar disorder.
  • Exposure Therapy: Used for conditions like generalized anxiety disorder and obsessive-compulsive disorder, exposure therapy involves gradually and repeatedly exposing individuals to feared situations or objects, helping them reduce anxiety and avoidance behavior.
  • Problem-Solving: This cognitive behavioral intervention helps individuals identify problems, generate solutions, and take action. It’s especially helpful for individuals dealing with stress management issues or coping with a medical condition.
  • Skills Training: CBT often includes teaching new coping mechanisms or enhancing existing skills. These can include communication, assertiveness, or relaxation techniques.
  • Mindfulness and Acceptance Techniques: These methods, borrowed from other therapies like cognitive behavioral therapy and psychological therapy, help individuals focus on the present moment and accept their thoughts and feelings without judgment.
  • Rational Emotive Behavior Therapy (REBT): As a part of cognitive therapy, REBT helps individuals identify irrational beliefs, challenge them, and replace them with healthier, more rational beliefs. It’s often used in treating a variety of psychological issues.

Each of these techniques can be applied in therapy sessions guided by a mental health professional. Please note that CBT isn’t a one-size-fits-all approach. The contents of cognitive behavioral therapy are tailored to each individual’s needs and goals. This customization can make CBT an effective treatment for a range of mental health conditions, from substance use disorders to various mood disorders.

Focus on the Cognitive and Behavioral Aspects of Therapy

In CBT, the focus is on how people think and behave now, not on their past. It helps people understand their thoughts and behaviors and how these can cause problems. Then, they learn how to change these patterns to feel better.

Structure of a CBT Therapy Session

Every Cognitive Behavioral Therapy (CBT) session is tailored to the individual’s unique needs, but there are several core principles that shape how a session unfolds. Here’s what a typical session with a CBT therapist might look like:

  1. Setting Goals: In the initial stages of therapy, the therapist and client together identify the issues to focus on. These could range from mental health conditions like eating disorders or substance use disorders to specific psychological issues or behavior patterns that are causing distress. The goal of cognitive behavior therapy is to help the client better manage these issues. They work together to set goals – what they hope to achieve through therapy.
  2. Reviewing Homework: CBT sessions often include homework assignments. These are practical tasks that help the client apply what they’ve learned in therapy to their everyday life. At the start of each session, the therapist may review this homework. For example, the client might have been asked to record their negative emotions or cognitive distortions – inaccurate thoughts that reinforce negative thinking or emotions.
  3. Interventions in the Session: During the session, the therapist will use cognitive behavioral interventions that align with the client’s progress and readiness. These interventions are techniques designed to help change thought and behavior patterns. They could include cognitive therapy techniques like identifying and challenging cognitive distortions or behavioral therapy techniques like learning new coping skills.
  4. Assigning New Homework: Just before the session ends, the therapist typically assigns new homework. This could involve practicing behavioral responses learned during the session or working on specific coping strategies for a mental health condition.
  5. Summarizing the Session: Finally, the therapist will wrap up the session with a brief summary of what was discussed. This helps reinforce the learning and provides an opportunity for the client to clarify any doubts.

CBT focuses on collaboration. The therapist guides the process, but the client’s active involvement is key. The number of CBT sessions needed can vary. While some people might notice improvements within a few sessions, others may need longer. Factors such as the severity of the mental health condition, the client’s readiness for change, and their commitment to therapy can all impact the therapy’s duration.

Additionally, while CBT can be highly effective on its own, in some cases, it might be delivered as part of a broader treatment plan. For example, a healthcare provider might prescribe medications to manage symptoms of a medical condition alongside CBT.

Typical Session Format and Components

In a typical CBT session, the therapist and client talk about the client’s problems and how they can be solved. They might work on specific techniques, like cognitive restructuring. Each session lasts about an hour and happens once a week for several weeks.

The Role of the Therapist in Guiding the Session

The therapist’s role is to listen, teach, and encourage. They help the client understand their problems and how CBT can help. They guide the client in learning and practicing new skills.

Collaborative Relationship Between Therapist and Client

CBT is a team effort. The therapist and client work together to understand the problem and to develop new coping strategies. The therapist helps the client learn and practice new skills, but it’s the client who puts them into action in their everyday life.

Cognitive Restructuring in CBT Therapy

Cognitive restructuring is a way of changing negative or unhelpful thoughts. The idea is that by changing the way we think, we can change how we feel and act.

Techniques for Cognitive Restructuring in Therapy

Cognitive restructuring is a key technique used in Cognitive Behavioral Therapy (CBT). It helps clients identify, challenge, and change negative thought patterns. Here are some steps a CBT therapist may guide a client through in cognitive restructuring:

  1. Identifying Negative Thoughts: The first step is helping the client become aware of their negative thoughts. These can be self-defeating beliefs or predictions about the future that cause emotional distress. For example, someone might think, “I always mess up” or “I can’t do anything right.”
  2. Recording Thoughts: The therapist might ask the client to keep a record of these negative thoughts in a diary or journal. This can help the client and therapist understand when these thoughts occur and what triggers them. This might be done as a homework assignment between therapy sessions.
  3. Challenging Negative Thoughts: Next, the therapist helps the client challenge these negative thoughts. They might ask questions like, “Is this thought based on facts, or is it just a belief?” or “What evidence do you have that this thought is true?” This process helps the client understand that thoughts are not facts.
  4. Replacing Negative Thoughts: Once the client recognizes and challenges their negative thoughts, the next step is replacing them with more positive or realistic thoughts. For example, instead of thinking, “I always mess up,” the client might learn to think, “Everyone makes mistakes. I can learn from this and do better next time.”
  5. Practicing New Thoughts: Finally, the client practices these new thoughts. Like any new skill, this takes time and repetition. The therapist might assign homework to help the client practice this skill in different situations in their everyday life.

Cognitive restructuring is a process. It may take a few sessions or more for clients to get comfortable with these techniques. And while cognitive restructuring can be a powerful tool in therapy, it’s not a cure-all. It’s often used in combination with other treatments. For example, a healthcare provider might prescribe psychiatric medications to manage symptoms of a mental illness alongside CBT.

The Relationship Between Cognitive Restructuring and Symptom Reduction

Cognitive restructuring, a core technique in cognitive behavioral therapy (CBT), significantly plays a role in reducing symptoms of various mental health conditions. But how does it do this?

  • Reducing Anxiety and Depression: By helping clients replace negative thoughts with more realistic ones, cognitive restructuring can reduce feelings of anxiety and depression. For example, a person who often thinks, “I’m a failure,” might start to feel depressed. But if they learn to replace this thought with something like, “Everyone makes mistakes, and I can learn from mine,” they might start to feel less depressed.
  • Improving Coping Skills: Cognitive restructuring can also help clients develop better coping skills. When faced with a stressful situation, a person might usually think, “I can’t handle this.” This thought can make them feel overwhelmed. But cognitive restructuring can help them learn to think, “This is tough, but I can get through it.” This new thought can help them feel more capable and less stressed.
  • Effect on Mental Illness: For people with mental illness, cognitive restructuring can be a powerful tool. It can help them challenge and change thought patterns that contribute to their symptoms. For example, a person with an anxiety disorder might often think, “The worst is going to happen.” This thought can make their anxiety worse. But with cognitive restructuring, they can get to a place where the thought process goes more like: “I’m feeling anxious, but I know I can handle whatever comes.”
  • Impact on Everyday Life: In everyday life, cognitive restructuring can lead to significant changes. As people start to think more realistically, they may notice a decrease in negative emotions and an increase in positive ones. Plus, they’ll be better equipped to handle stress and challenges.

Behavioral Activation in CBT Therapy

Behavioral activation is another important part of CBT. It helps people engage more in enjoyable or meaningful activities. It’s often used to treat depression, but it can be helpful for other mental health conditions too.

Techniques for Behavioral Activation in Therapy

Behavioral activation is a key technique used in cognitive-behavioral therapy (CBT). It focuses on helping clients engage in activities that they used to enjoy or that they are interested in trying as a way to improve their mood and increase their energy levels. Let’s break down some of the key steps and techniques involved in this process:

  1. Identifying Activities: The first step in behavioral activation usually involves working with the therapist to create a list of activities that the client once enjoyed or is interested in trying. This list can include anything from reading a book or going for a walk to trying a new hobby or reconnecting with old friends.
  2. Scheduling Activities: After the list is made, the therapist and client work together to schedule these activities into the client’s daily routine. This can be a gradual process, starting with just a few activities a week and gradually increasing.
  3. Monitoring Mood and Energy: As the client starts to engage in these activities, they are usually asked to monitor their mood and energy levels. This can help them notice any changes that occur as a result of the behavioral activation.
  4. Adjusting the Plan: Based on the client’s feedback and progress, the therapist may adjust the behavioral activation plan. This could involve adding new activities, changing the frequency of certain activities, or addressing any challenges that have arisen.
  5. Encouraging Consistency: The therapist encourages the client to consistently engage in these activities, even when they don’t feel like it. The aim is to break the cycle of negative mood leading to decreased activity, which then leads to a further drop in mood.
  6. Addressing Barriers: The therapist and client also work together to address any barriers that might prevent the client from engaging in the activities. This could include physical health issues, time constraints, or psychological issues like fear or anxiety.

Behavioral activation is an evidence-based treatment that has been shown to be effective in treating conditions like depression. However, it is not a standalone treatment for all mental health conditions. It is often combined with other CBT techniques and for some individuals, may be used alongside prescribed medications or other psychological treatments.

The Relationship Between Behavioral Activation and Symptom Reduction

By increasing engagement in positive activities, behavioral activation can help reduce symptoms of depression and anxiety. It gives people a sense of accomplishment and can help break the cycle of negative thinking.

Exposure Therapy in CBT Therapy

Exposure therapy is a technique in CBT used for treating anxiety disorders and post-traumatic stress disorder. It involves gradually exposing a person to the situations or objects they fear, helping them learn that the outcomes they fear are unlikely to happen.

Techniques for exposure therapy in therapy

Exposure therapy focuses on helping clients confront and manage their fears. The process is carefully guided by trained CBT therapists and takes place in a safe and controlled environment. Here are some steps involved in the process:

  • Building a Fear Hierarchy: The therapy often starts with the therapist and the client collaboratively creating a “fear hierarchy.” This is a list of situations that cause fear or anxiety, ranked from least to most anxiety-provoking.
  • Gradual Exposure: The client then gradually faces these fears, starting from the least anxiety-inducing situation. This process could initially involve merely thinking about the situation or fear, often called “imaginal exposure.”
  • In Vivo Exposure: As the client becomes more comfortable with the lower-level fears, they gradually progress towards facing the more anxiety-inducing situations in real life. This is known as “in vivo exposure.”
  • Systematic Desensitization: In some cases, the therapist may use a technique known as systematic desensitization. This involves teaching the client relaxation techniques, which they then use while gradually being exposed to fear-inducing situations.
  • Flooding: In some instances, a technique called “flooding” may be used. This involves exposing the client to the most fear-inducing situations right away to rapidly reduce the fear response. However, this technique is used less frequently due to its intensity.
  • Habituation and Processing: Throughout the exposure process, the goal is for the client to remain in the fear-inducing situation until their anxiety begins to decrease, a process known as habituation. After each exposure, the client and therapist process the experience together, discussing the client’s thoughts, feelings, and behaviors.

Exposure therapy is a well-researched psychological treatment used in clinical practice, and it has proven effective in treating various anxiety disorders and phobias. As always, individual responses to therapy can vary, and it’s important to have these procedures conducted under the guidance of a professional.

C. The Relationship Between Exposure Therapy and Symptom Reduction

Exposure therapy can help reduce fear and anxiety. Over time, it can help the person feel less overwhelmed by their fears and be more able to manage them.

What Can CBT Therapy Help With?

Cognitive-behavioral therapy (CBT) is used for managing conditions such as major depression, anxiety disorders, bipolar disorder, and chronic pain. It also helps with substance use disorders, anger issues, eating disorders, and panic attacks. CBT can even assist those with personality disorders, phobias, and severe mental illnesses.

Common Psychological Issues Addressed by CBT

Cognitive Behavioral Therapy (CBT) is a powerful tool for addressing a variety of psychological issues. Here are some of the most common ones:

  • Depression: CBT can help individuals understand the negative thought patterns that fuel depression, encouraging them to challenge these thoughts and engage in behaviors that combat feelings of despair.
  • Anxiety Disorders: This includes generalized anxiety disorder, panic disorder, social anxiety disorder, and others. CBT assists people in identifying the fear-driven thoughts that lead to anxiety, providing them with tools to manage these symptoms more effectively.
  • Panic Disorder: CBT helps individuals understand and manage the physical symptoms of panic, in addition to the fears and worries that can trigger panic attacks.
  • Posttraumatic Stress Disorder (PTSD): For those living with PTSD, CBT can be particularly helpful. It helps individuals process traumatic events in a healthy way, reducing distressing symptoms and improving overall emotional health.
  • Substance Use Disorders: CBT is used in both individual and group settings to help individuals understand the thoughts and behaviors that lead to substance use, offering strategies to maintain sobriety.
  • Eating Disorders: For conditions such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, CBT helps individuals address the thoughts and behaviors that contribute to unhealthy eating patterns, guiding them toward a healthier relationship with food.

CBT’s Effectiveness in Treating Various Mental Health Conditions

Cognitive Behavioral Therapy (CBT) has been proven effective in managing a wide range of mental health conditions. It helps replace harmful thought patterns with positive ones, leading to an improvement in symptoms and life quality. The benefits of CBT go beyond treatment duration, as the skills learned can be used throughout a person’s life, offering lasting relief.

The Versatility of CBT for Different Populations and Settings

CBT can be used with people of all ages, from children to older adults. It can be delivered in one-on-one therapy sessions, group sessions, or even online.

Is CBT Therapy Effective?

Cognitive-behavioral therapy is a well-established, effective type of short-term therapy that can be used to treat a wide range of mental health conditions. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. CBT can even help to reduce relapse after treatment.

Research Findings on the Efficacy of CBT

Many clinical trials have shown that CBT can effectively treat a variety of mental health conditions. It’s considered an evidence-based treatment, meaning it’s backed by scientific research.

Comparisons with Other Therapeutic Approaches

Compared to other forms of therapy, like psychodynamic therapy or ACT, CBT tends to be more focused on the present and on problem-solving. Some research suggests that CBT can be more effective than other therapies for certain conditions, but the best type of therapy really depends on the individual and their needs.

Factors Contributing to the Success of CBT

CBT’s success often depends on the individual’s commitment to the process. Regular attendance at therapy sessions, willingness to do homework, and active participation in sessions all contribute to better outcomes.

How to Find a CBT Therapist

Criteria for Choosing a CBT Therapist

When looking for a CBT therapist, it’s important to find a licensed mental health professional with training and experience in CBT. Other factors, like the therapist’s style and the client’s comfort with the therapist, are also important. Call us today to get in touch with one: (323) 307-7997

Resources for Locating Qualified CBT Practitioners

To find a CBT therapist, you might start by asking your healthcare provider for a referral. You can also search for therapists online or use resources like the Association for Behavioral and Cognitive Therapies.

Questions to Ask Potential Therapists

When considering a potential therapist for Cognitive Behavioral Therapy (CBT), you might want to ask the following questions:

  • Training and Experience: “What is your educational background and what training have you received in CBT?”
  • Experience with Specific Issues: “Do you have experience treating individuals with my specific issues or concerns?”
  • Typical Session Structure: “What does a typical CBT session with you look like?”
  • Measuring Progress: “How do you measure progress in therapy? What benchmarks do you use to assess improvement?”
  • Homework Assignments: “Do you typically assign ‘homework’ or tasks to complete outside of our sessions?”
  • Length of Therapy: “On average, how many sessions do people typically need? How long does each session last?”
  • Therapy Approach: “What is your approach to CBT? Do you integrate other therapeutic approaches into your practice?”
  • Confidentiality: “Can you explain your confidentiality policy?”
  • Fees and Insurance: “What are your fees per session? Do you accept health insurance? Do you have a sliding scale for payment?”
  • Availability: “What is your availability? Do you have an emergency or after-hours services?”

These questions can help you understand if the potential therapist’s approach, experience, and availability align with your needs and expectations.


CBT is a type of talk therapy that helps people identify and change harmful thought patterns and behaviors. It’s used for many mental health conditions and is often very effective. CBT involves techniques like cognitive restructuring, behavioral activation, and exposure therapy.

In conclusion, CBT is a proven, effective tool in the world of mental health treatment. Its practical, problem-solving approach makes it accessible for individuals dealing with a wide range of mental health conditions, and its adaptability allows it to be used with people of all ages and circumstances. So, if you or someone you know might benefit from CBT, don’t hesitate to reach out to a mental health professional for more information.

If you’re dealing with emotional difficulties or a mental health condition, CBT could be a helpful approach. It can equip you with coping skills to manage everyday life and improve your emotional health.

CBT can offer significant benefits, including reduced symptoms, improved mood, and better quality of life. It can help you feel more capable and confident in handling emotional challenges. Remember, reaching out for help is a sign of strength, and taking care of your mental health is a vital part of overall wellness.

Take Control of Your Mental Health

If you’re grappling with emotional challenges, or struggling with a mental health condition, don’t face it alone. Cognitive Behavioral Therapy (CBT) could be the helping hand you need. Call us today at (323) 307-7997 or send us a message from our contact page to schedule your friendly and personalized consultation. Take control of your future and embark on a journey toward a brighter, healthier life.

Frequently Asked Questions

CBT therapy is used for treating many mental health conditions, including depression, anxiety disorders, panic disorder, and posttraumatic stress disorder. It's also used for conditions like substance use disorders and eating disorders.
CBT is more focused on problem-solving and changing negative thought patterns. It's usually more structured and shorter-term than other forms of therapy. ACT and DBT also teach coping skills, but they focus more on acceptance, mindfulness, and emotional regulation.
Some common techniques used in CBT include cognitive restructuring, behavioral activation, and exposure therapy. These techniques aim to change harmful thought patterns and behaviors and reduce symptoms of mental health conditions.
Let's say a person is struggling with depression and has negative thoughts like "I'm worthless." In CBT, the therapist might help them challenge this thought, explore evidence against it, and develop more balanced and helpful thoughts. They might also help the person engage in positive activities to improve their mood.
Research shows that CBT can be very effective for various mental health conditions. For many people, it can lead to significant improvement in symptoms and quality of life.
Yes, CBT is suitable for individuals of all ages, from children to older adults. However, the way CBT is delivered may be adapted based on the individual's age and specific needs.
Yes, CBT is often very effective in reducing symptoms of anxiety. It can help people understand and change thought patterns that lead to anxiety and develop better coping skills.
Yes, CBT is considered a first-line treatment for obsessive-compulsive disorder (OCD). Exposure therapy, a technique used in CBT, can be particularly helpful for this condition.
A common course might involve 12 to 20 weekly sessions, but the exact number will depend on the individual and their needs.
CBT requires active effort and practice, which some people might find challenging. It also focuses mainly on the individual and their thoughts and behaviors, which means it might not address all factors contributing to a person's mental health condition, like societal or family issues.
CBT is very beneficial for treating depression. It can help people understand and change negative thought patterns that contribute to depression and develop better coping skills.
To find a qualified CBT therapist, you can ask for a referral from a healthcare provider or use online resources that list licensed mental health professionals. You can also check with your health insurance company for a list of covered providers.
Cognitive restructuring helps individuals identify and change negative or irrational thoughts, while behavioral activation encourages individuals to engage in activities that are enjoyable and rewarding, helping to improve mood and reduce symptoms of mental health conditions.
Exposure therapy is a technique used in CBT to help individuals face and overcome fears or anxiety. It involves gradually and repeatedly exposing the person to the feared situation or object under controlled conditions until the fear response decreases.

“What Is Cognitive Behavioral Therapy?”. American Psychological Association. (2017).

Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012 Oct 1;36(5):427-440. doi: 10.1007/s10608-012-9476-1. Epub 2012 Jul 31. PMID: 23459093; PMCID: PMC3584580.

Caterina del Mar Bonnín, María Reinares, Anabel Martínez-Arán, Esther Jiménez, Jose Sánchez-Moreno, Brisa Solé, Laura Montejo, Eduard Vieta, Improving Functioning, Quality of Life, and Well-being in Patients With Bipolar Disorder, International Journal of Neuropsychopharmacology, Volume 22, Issue 8, August 2019, Pages 467–477,

Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A, Dobson KS. A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry. 2013 Jul;58(7):376-85. doi: 10.1177/070674371305800702. PMID: 23870719.

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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