What Is Cognitive Behavioral Therapy? How CBT Works to Change Your Behavior

Updated: Jun. 29, 2016

What CBT can do for emotional health issues, insomnia, pain, and more.

cognitive-behavior-therapyiStock/Martin Dimitrov

Cognitive behavioral therapy (CBT) focuses on discovering and changing the thoughts and feelings that trigger self-defeating actions. Unlike traditional “talking therapies,” CBT is usually brief (about 12 sessions, on average) and focused on finding solutions to specific problems.

CBT began in the 1960s, when a University of Pennsylvania psychiatrist realized that his depressed patients experienced onslaughts of spontaneous, negative thoughts about themselves and the world around them. Identifying and challenging the thoughts helped many of them feel better. Today, this well-researched therapy is practiced around the world and has been proven in research studies to ease a wide variety of conditions.

How CBT Works

The premise of CBT is that our perceptions influence our feelings and our behavior. Finding, challenging and changing negative, automatic thoughts (such as “I’m worthless” or “I’ll never get to sleep”) can actually change your reality.

Scientific research shows that CBT works—often better than medication alone. In a 2012 UK study of 469 people with treatment-resistant depression, those who received CBT plus medication were three times more likely to get at least a 50 percent improvement in their symptoms than those who received only antidepressants. In a Harvard University study that compared the short- and long-term effects of CBT to a prescription sleeping pill for 63 people with insomnia, CBT helped participants fall asleep faster and sleep with fewer interruptions. And they were still sleeping better a year later. CBT can even ameliorate chronic pain (such as back pain, cancer pain and joint pain) by improving coping skills.

Brain scans reveal that CBT may subtly change the brain. In a University of Pittsburgh study, functional MRI images showed that activity in the brain’s subgenual cingulate cortex (a region associated with mood regulation) was low in people with depression but increased after 12 weeks of CBT. Other research has uncovered beneficial increases in brain activity after CBT for people with post-traumatic stress disorder, obsessive-compulsive disorder and panic disorder, too.

What It’s Like to Visit a Cognitive Behavioral Therapist

A CBT session generally lasts 45 minutes to one hour. Your therapist will help you become aware of negative thoughts, emotions, and beliefs and pay attention to how they affect your actions. You will also be asked to challenge negative, distorted perceptions—a step that can be difficult at first as you question long-held ways of thinking, but that will become a valuable new skill over time. You will also most likely have homework to do between sessions, as you apply what you’ve learned.

Where to Find a Cognitive Behavioral Therapist

For more information about CBT or to find a therapist, visit the Association for Behavioral and Cognitive Therapies or ask your doctor or local clinic for a referral.

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Originally Published in Reader's Digest