What is CBT?

CBT = Cognitive Behaviour Therapy

Cognitive just means thoughts – words or mental pictures

The basic idea:

Something happens -> you feel bad. BUT in between the event and the feeling there will be some thoughts or misinterpretations, usually negative.

“Nothing can happen that is so terrible that your own negative thinking can’t make it feel even worse”

Because your thoughts result in you feeling anxious/miserable etc you then behave differently, which is also often unhelpful to you – so your thoughts and behaviour help to make a vicious circle that leaves you feeling worse (in your mood and in your body).

Vicious circle or ‘Hot Cross Bun’

Vicious Circle or Hot Cross Bun


CBT is:

  • Designed to help you learn how to break out of your vicious circle by learning to change or manage unhelpful thoughts and behaviour differently.
  • Based on research, a strong evidence base about what works, so it is recommended by the NHS for a range of common mental health conditions (see Links section for NICE guidelines)
  • Brief, time-limited therapy (usually 5 to 15 or 20 sessions). Sessions are initially weekly and last from 50 minutes to an hour. It is usual to have a review session after about six treatment sessions.
  • About learning a range of coping strategies or skills that you find useful for your particular difficulties and can use in the future to help you manage and stay well.
  • Based on an understanding of what has been contributing to your difficulties – the unhelpful ways of thinking and behaving. Your therapist will draw a vicious circle and probably other diagrams showing what is going on for you – and working out what is keeping the problem going, so those problem areas can be worked on
  • Generally about the current issues, the ‘here and now’ but acknowledging the impact of past experiences on how you feel now (work on the past is not recommended in the early stages of CBT and is often not necessary because many people end up feeling better by working on the current issues. However, the past can be addressed in later stages, if appropriate).
  • Based on your goals (what you want to get out of treatment) and CBT theory about how to help you get there.
  • Much more successful if you work on it outside of sessions so ‘Homework’ – trying out and practising things is crucial to make progress. A notebook/file will be useful. 
  • Structured – agreeing an agenda at the start of each session to look at your difficulties and begin trying to understand and tackle them (not just talking about how you’ve been).
  • A joint effort between you and your therapist – they may know more about CBT than you but you are the expert in how you feel and can report back about how the things you try are going. You are encouraged to take an active part – you can raise issues you want on the agenda, say what you want or don’t want to work on etc. Your opinions are important.
  • Based on trying things out – as experiments – sometimes in sessions, sometimes as homework. It doesn’t matter if something ‘doesn’t work’ – it still provides useful information about your difficulties, and others things can always be tried.
If you want to read more about CBT then I recommend: