Cognitive Behavioral Therapy (CBT) : A Beginner’s Guide


Cognitive behavioral therapy (CBT) is one of the most popular and effective forms of talk therapy. If you’re considering CBT to manage mental health issues like depression, anxiety, phobias or eating disorders, this comprehensive  guide will teach you everything you need to know to get started. You’ll learn what CBT is, how it works, its uses, types of techniques and how to find a therapist. With key facts and actionable advice, you’ll be well prepared to pursue CBT and experience its life-changing benefits. Let’s dive in!

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a goal-directed, problem-focused type of talk therapy. It’s based on the theory that unhelpful thoughts, emotions and behaviors interact and can trap someone in a cycle of negativity.

CBT aims to identify and reshape harmful thought patterns while teaching positive behavioral skills. This two-pronged approach reduces distressing symptoms and improves coping abilities.

Unlike some other forms of therapy that explore past experiences, CBT focuses on present life challenges. It combines cognitive restructuring techniques with behavioral interventions tailored to the individual.

Numerous studies support CBT’s effectiveness in treating mental illnesses including depression, anxiety disorders, eating disorders, bipolar disorder, schizophrenia and more. It’s considered the gold standard psychological treatment for many conditions.

How Does CBT Work?

CBT is based on these key principles:

  • Thoughts influence feelings and behaviors
  • Behaviors can influence thoughts and feelings
  • Changing thoughts or behaviors can improve emotional wellbeing

By identifying and adapting negative thoughts and maladaptive behaviors, people can break free from destructive thought patterns and make positive life changes.

The CBT process unfolds through assessment, goal-setting, skill-building and evaluation:

Assessment – The therapist conducts an evaluation to understand your presenting symptoms, diagnosis, background, strengths/weaknesses, and desired outcomes.

Goal-setting – You and your therapist collaboratively establish achievable short and long-term goals for therapy.

Skill-building – The therapist teaches you cognitive restructuring techniques, exposure therapy methods, problem solving skills and relapse prevention strategies relevant to your situation.

Evaluation – You review your progress and adjust goals or techniques as needed to maximize therapeutic gains.

CBT blends seamlessly with additional self-care like exercise, mindfulness practices and medication (if prescribed) to provide comprehensive treatment.

Conditions Treated with CBT

CBT is effective for a wide range of mental and behavioral health issues. It’s considered a first-line treatment for:

CBT can also help with anger management, decision making, grief and relationship issues.


It may be done one-on-one or in a group format. Individual CBT allows customization to your needs. Group CBT provides support from others facing similar challenges.

Main Techniques Used in CBT

CBT practitioners have a toolbox of techniques to draw from. The methods used depend on your specific problems, diagnosis and goals.

Here are some of the main CBT techniques and how they target unhelpful thoughts, emotions and behaviors:

Cognitive Restructuring – Identifies distorted thinking like catastrophizing or black-and-white thinking and replaces irrational beliefs with more realistic, positive mindsets.

Exposure Therapy – Gradually exposes you to a feared object, situation or memory in a controlled, safe way to decrease anxiety.

Activity Scheduling – Increases engagement in pleasurable activities to improve mood and combat depression.

Problem Solving – Enhances ability to cope with challenges and make decisions methodically step-by-step.

Assertiveness Training – Boosts communication and self-advocacy skills for improved relationships and self-esteem.

Relapse Prevention – Identifies your unique triggers and develops strategies to avoid relapsing into unhealthy patterns.

Psycho education – Provides information and resources about your disorder and teaches coping techniques.

CBT combines cognitive, behavioral and emotional interventions for comprehensive treatment. Your therapist will explain why they select specific techniques and how they address your goals.

The CBT Process Step-By-Step



The CBT process follows a structured framework while allowing customization to your unique situation. Typical steps include:

Initial Evaluation

  • The therapist asks about your symptoms, diagnosis, mental health history, important relationships and background to gain a holistic perspective.

Assessment and Goal Setting

  • Based on the evaluation, the therapist maps out your treatment priorities, trouble spots to work on and measurable goals.

Learning CBT Techniques

  • The therapist explains cognitive restructuring, exposure therapy and other techniques, providing examples of how they can help you.

Identifying Automatic Thoughts

  • You learn to identify problematic reflexive thoughts, beliefs and reactions that trigger distress.

Developing Balanced Thinking

  • You challenge distorted automatic thoughts using CBT techniques like evidence testing and reframing.

Putting Skills Into Practice

  • You practice CBT techniques between sessions through worksheets, self-monitoring, readings and other assignments.

Troubleshooting Setbacks

  • If you struggle applying CBT, the therapist helps problem-solve challenges and modifies the approach.

Evaluating and Adjusting

  • You periodically review progress and adjust goals or techniques as needed.

With its adaptable framework, CBT meets you where you’re at and guides you to where you want to be.

How Long Does CBT Take to Work?

CBT’s effects begin appearing within a few weeks, but developing mastery takes consistent practice over months.

A typical CBT treatment plan consists of:

  • 1 session per week for 3-6 months for mild conditions like mild depression or anxiety;
  • 2 or more sessions weekly for at least 3-6 months for more severe, complex mental illnesses like OCD.
  • Ongoing maintenance sessions are often helpful to prevent relapse and reinforce skills.

Sticking with the process allows time to implement changes fully. Initially, CBT alleviates symptoms. With practice, the skills become second nature so you can manage challenges independently long-term.

Self-Guided CBT Options

CBT therapists are the gold standard option, especially for severe conditions. But self-guided CBT materials can also be beneficial if you have mild to moderate symptoms or want to supplement in-person therapy.

Effective self-help CBT resources include:

  • Workbooks – CBT workbooks guide you through core techniques step-by-step like cognitive restructuring and exposure.
  • Online programs – Structured interactive online CBT courses allow self-paced learning with expert instruction.
  • Mobile apps – Apps like MoodKit teach CBT skills through activities, mood tracking and thought journals.
  • Online support groups – Connecting with others using CBT provides mutual encouragement and tips for applying techniques.

Self-guided CBT can kick start the learning process. But a therapist’s personalized guidance is key for optimal, deep healing.

How to Find a CBT Therapist

Choosing an experienced CBT therapist is the most important step. Look for these indicators of expertise:

  1. Lists CBT as a specialty
  2. Displays CBT-related credentials like “Certified Cognitive Therapist”
  3. Is a licensed mental health professional like a psychologist or counselor
  4. Has 5+ years practicing CBT
  5. Accepts your insurance if applicable
  6. Your comfort level with the therapist also affects results.
  7. Seek referrals from your primary doctor or friends.
  8. Meet potential therapists by phone or video call first. Choose someone you relate to well.

Once you identify promising therapists, have a consultation to ask:

  1. What CBT techniques do you use for my problems?
  2. How often would we meet and for how long?
  3. How do you monitor progress and adjust the approach if needed?
  4. Do you provide after-hours support if I’m in crisis?

Thoughtfully selecting the right CBT therapist leads to better outcomes.

How Much Does CBT Therapy Cost?

CBT costs vary based on your location, provider credentials and insurance coverage. The average ranges are:

  • $100-$250 per therapy session out-of-pocket without insurance.

Some options to reduce costs include:

  1. Seek referrals to community mental health clinics or counselors in training who offer lower rates.
  2. Check if your employer provides Employee Assistance Program visits.
  3. Use self-guided CBT workbooks or online programs in conjunction with occasional therapist sessions.
  4. Consider a CBT support group which divides therapist fees between members.
  5. Inquire about sliding scale fees or payment plans if the standard rate is unaffordable.

With some research, you can find affordable options to make CBT work within your budget.

Insurance Coverage for CBT

Most insurance plans cover some form of talk therapy. Steps to access coverage include:

  1. Verify your plan covers CBT for your diagnosis.
  2. Check session limits – plans often cap therapy at 20 visits annually.
  3. Ask about copays and deductibles so you can anticipate total costs.
  4. Get preauthorization if required.
  5. Seek in-network providers to maximize reimbursement.
  6. Have the therapist submit claims and follow up to resolve any issues.

If your insurer denies CBT, appeal the decision and emphasize CBT’s proven effectiveness for your condition.

Online CBT Therapy Options

Online CBT therapy through videoconferencing expanded greatly in recent years. Benefits include:

– Convenience – No need to commute to appointments.

– Flexibility – Schedule sessions outside typical office hours.

– Comfort – Talk from a familiar, comfortable space.

– Options – Online therapy gives you access to therapists worldwide.

– Cost savings – Virtual sessions are often cheaper.

– Accessibility – Removes barriers for those with limited mobility or without providers nearby.

– Anonymity – The distance can feel less exposing.

To find an online CBT therapist, search directories like GoodTherapy, VirtualTherapyConnect or eTherapi. Confirm the provider does video sessions before scheduling your initial meeting.

Group CBT

While individual CBT customizes treatment to you, group CBT offers benefits like:

  1. Cost savings from dividing therapist fees
  2. Peer support and accountability
  3. Learning from others’ experiences
  4. Practicing social skills in a safe setting

Ask your therapist or local mental health centers about group CBT options near you. Groups work best for general issues like managing stress. Individual CBT is preferable for specific or complex conditions.

How to Get the Most out of CBT

CBT requires effort between sessions to get results. Pro tips to maximize gains include:

  1. Attend consistently and don’t skip sessions
  2. Do homework assignments diligently
  3. Read recommended CBT books and worksheets
  4. Practice exercises like thought records and activity planning
  5. Use CBT skills in real-life, not just in sessions
  6. Share openly about symptoms, thoughts and behaviors
  7. Raise concerns promptly if having difficulty applying techniques
  8. Consider adding mindfulness and physical activity
  9. Remain patient – CBT takes time to master
  10. Stick with the process – early breakthroughs predict later success

Committing fully to CBT and practicing the techniques produces robust, lasting change.

Potential Barriers to Progress in CBT

It’s normal to hit some bumps in CBT. Common challenges and how to address them include:

  1. Limited motivation – Develop inspirational goals and emphasize progress, however small.
  2. Doubting CBT will help – Discuss your concerns and re-evaluate goals/methods. Review CBT’s proven effectiveness.
  3. Difficulty identifying or changing thoughts – Simplify techniques until they get easier with practice.
  4. Avoiding exposure exercises – Start very small to build tolerance gradually.
  5. Life stressors interfering – Problem-solve barriers and reduce obligations if needed.
  6. Forgetting to use CBT skills – Make reminders like phone alerts. Practice at set times daily to build habits.
  7. Lack of support system – Join a CBT peer support group. Enlist loved ones to prompt you.
  8. Strong emotions hijacking sessions– Learn distress tolerance and emotion regulation skills.

Don’t let challenges derail your CBT progress. Problem-solving barriers makes success more likely.

CBT Worksheets, Books and Online Resources

CBT resources help you implement techniques between sessions. Recommended materials include:


  1. Thought Records – Identify distorted thinking
  2. Behavioral Activation – Schedule rewarding activities
  3. Exposure Ladders – Incrementally face fears
  4. Coping Cards – Note coping strategies for quick reference


  1. “Cognitive Behavioral Therapy Made Simple” by Seth Gillihan
  2. “Cognitive Behavioral Therapy Workbook” by Lawrence Wallace
  3. “Retrain Your Brain” by Seth Gillihan

Online Resources

  • Academy of Cognitive Therapy – Certified CBT therapist directory
  • Beck Institute– Leading CBT training organization
  • Verywellmind.com – Extensive CBT education and worksheets

Access supplemental resources to maximize gains and become your own CBT expert.

Frequently Asked Questions About CBT:


Is CBT better than other types of therapy?

CBT is very effective for most mental illnesses. But challenges like trauma, distorted thinking patterns or avoidance may benefit more from psychodynamic therapy or EMDR. The best approach depends on your specific needs.

Are CBT results permanent?

CBT teaches lifelong skills, making results longer lasting than medication alone. But periodic “booster sessions” are often needed to reinforce skills and prevent relapse. Using CBT techniques consistently helps maintain gains.

Can I combine CBT with medications or other therapies?

Yes, CBT complements other treatments well, including medications, mindfulness and lifestyle changes. Integrated care under the guidance of a mental health professional produces the best results.

How do I know if CBT is working?

Progress isn’t always linear, but you should notice gradual improvements in mood, thinking and abilities to manage challenges. Track symptoms and discuss concerns promptly with your therapist.

Does CBT help with marriage or relationship problems?

Yes, CBT’s focus on communication, conflict resolution and changing thought patterns can benefit marriages and relationships. Couples counseling also helps.

Does CBT help kids and teens?

Yes, CBT is commonly used to help children and adolescents manage conditions like anxiety, depression, anger issues, OCD and more.


Cognitive behavioral therapy is researched extensively and proven highly effective for treating a wide range of mental illnesses from mood and anxiety disorders to eating disorders and addictions. Its cognitive and behavioral skill-building approach empowers you to manage problems independently long after therapy ends. Hundreds of studies support CBT’s lasting benefits.

Commit fully to the process by attending consistently, applying techniques outside of sessions and promptly addressing barriers with your therapist. Over time, CBT builds a toolkit to dismantle unhealthy thought and behavior patterns and develop self-efficacy. Relief from symptoms like depression and anxiety along with improved quality of life are attainable goals of CBT.







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