What is cognitive behavioural therapy (CBT) and how does it work?

20th November, 2020 • 6 min read

What is cognitive behavioural therapy?

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage a specific problem you’re facing, and it does so by changing the way you think and act.

It’s been shown to be particularly helpful at tackling mental health problems like:

  • anxiety
  • depression
  • post-traumatic stress disorder (PTSD)
  • eating disorders
  • phobias

But research also shows that CBT can be used to treat people with health conditions, like lower back pain and


It’s worth bearing in mind that CBT can’t cure physical symptoms, like pain, but it can help you cope with them better.

Unlike other types of talking therapies, like psychotherapy, CBT deals with your current problems, instead of issues from your past. It looks for practical ways to help you feel better about life on a daily basis.

How does CBT work?

CBT can help you make sense of problems that feel too big to handle. It does so by using a mix of techniques, including:

  • relaxation exercises
  • training on coping skills
  • education about how your thoughts affect how you act
  • stress management
  • training on how to be more confident

Certain thoughts, feelings and actions can trap you in a negative cycle or create new situations that make you feel worse about yourself.

CBT helps stop negative cycles by breaking down the things that make you feel bad, anxious or scared. By making your problems more manageable, CBT can help you change your negative thought patterns and improve the way you feel.

And unlike other talking therapies that can continue for months or years, CBT helps you get to a point where you can tackle your problems without a therapist, within a specific number of sessions.

What happens in a CBT session?

When you have CBT, it’s common to have sessions every week or every other week. You may have up to 20 sessions that last 30 to 60 minutes each.

You don’t always have to do CBT in person. Speak to your doctor about how to find a suitable online or computer CBT programme.

During your first session, the therapist will often ask you questions about yourself and the problem you’d like help with. This is to make sure CBT is right for you, and that you’re comfortable with the process.

With the help of your therapist, you'll break down your problem into its separate parts – the situation, thoughts, emotions, physical feelings and actions. To help with this, your therapist may ask you to keep a diary or write down your thoughts and how you respond to them.

You and your therapist will look at your thoughts, feelings and behaviours to work out if they're unrealistic or unhelpful, and to spot the effect they have on each other and on you. Your therapist will be able to help you work out how to change unhelpful thoughts and behaviours.

After working out what you can change, your therapist will ask you to practise these changes in your daily life. This may involve recognising unhelpful thoughts and actions, and swapping them for more helpful ones.

Your CBT therapist will usually give you ‘homework’ to do between your sessions. This lets you practise the techniques you’ve learned in the sessions in your daily life.

Facing things you’re worried about can be hard, so your therapist won’t ask you to do things you don’t want to do or move at a pace you’re not comfortable with. They’ll also check in with you to see how you feel about the progress you’re making.

One of the biggest benefits of CBT is that even after your course has finished, you can continue to use the skills you’ve learned in your daily life – making it less likely that your symptoms will return.

What are the advantages of CBT?

CBT isn’t suitable for everyone. A doctor can help you work out if it’s the right therapy for you, but weighing up the advantages and disadvantages may also help.

Advantages of CBT

  1. Research has shown CBT can be as effective as medicine in treating physical conditions, like
    low back pain
    , as well as mental health conditions, like
  2. CBT can be completed in a relatively short period of time compared with other types of talking therapies.
  3. Because CBT follows a structured format, it can be done in many ways, including in groups, and with self-help books or computer programs.
  4. The skills you learn in CBT can be added into your everyday life to help you cope better with future problems.

Disadvantages of CBT

  1. To benefit from CBT, you need to commit to the process – a therapist can advise you, but they can’t make your problems go away unless you do your part.
  2. CBT isn’t always suitable for people with more complex mental health needs or learning difficulties because it’s so structured.
  3. Because CBT only addresses current problems and focuses on specific issues, it doesn’t address the possible underlying causes of mental health conditions, like an unhappy childhood.
  4. CBT focuses on you changing yourself, but it doesn’t look at the impact of other factors on your health and wellbeing.

How effective is CBT?

CBT can help you manage certain problems and make them less likely to negatively affect your life.

Remember that CBT won’t cure physical problems, like low back pain, but it can help you cope better with them.

Even after you start feeling more in control of the problem, you’ll need to practise your CBT skills to help maintain the effects.

You can also do a ‘refresher’ CBT course if you feel you need to go through skills you learnt again.

Where can I try CBT?

If you think CBT may help you, speak to a doctor for advice. They'll usually be able to refer you to a registered therapist or tell you how to find a private CBT therapist.

Key points

  • CBT is a talking therapy that can help you manage your problems by changing the way you think and act
  • it’s been shown to help tackle mental health problems like anxiety, depression and PTSD
  • CBT is also useful for treating physical conditions, like low back pain, but it doesn’t cure the condition – it just helps you cope better with it
  • CBT aims to get you to a point where you can tackle your problems without a therapist, within a specific number of sessions.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.