Cognitive behavioral therapy (CBT): types, techniques, applications (2023)

Cognitive behavioral therapy (CBT) is a form of talk therapy that can be used to treat people with a wide range of mental health problems.

CBT is based on the idea that the way we think (cognition), how we feel (emotion), and how we act (behavior) all interact together. Specifically, our thoughts determine our feelings and our behavior.

Cognitive behavioral therapy (CBT): types, techniques, applications (1)

Therefore, unrealistic and negative thoughts can cause us distress and lead to problems. When a person suffers from psychological distress, the way he interprets situations is distorted, which, in turn, has a negative impact on the actions he takes.

CBT aims to help people realize when they make negative interpretations and behavior patterns that reinforce distorted thinking. Cognitive therapy helps people develop alternative ways of thinking and behaving to reduce their psychological distress.

Cognitive behavioral therapy is actually an umbrella term for many different therapies that share some common elements. Two of the earliest forms of Cognitive Behavioral Therapy were Rational Emotive Behavioral Therapy ( REBT ), developed by Albert Ellis in the 1950s, andCognitive therapy, developed by Aaron T. Beck in the 1960s.

See Dobson and Block (1988) for a review of the historical basis of cognitive behavioral therapy.


General premises

• The cognitive approach believes thatMental illnessit comes from faulty cognitions about others, our world, and ourselves. This faulty thinking may be due to cognitive deficiencies (lack of planning) or cognitive distortions (inaccurate information processing).

• These cognitions cause distortions in the way we see things; Ellis suggested that it is through irrational thinking, while Beck proposed the cognitive triad.

• We interact with the world through our mental representation of it. If our mental representations are inaccurate or our ways of reasoning are inadequate, our emotions and behavior can become disordered.

The cognitive therapist teaches clients to identify distorted cognitions through an assessment process. Clients learn to discriminate between their own thoughts and reality. They learn the influence cognition has on their feelings and are taught to recognize, observe, and monitor their own thoughts.

The behavioral part of therapy involves assigning tasks for the client (for example, keeping a thought journal). The therapist assigns tasks to the client to help him challenge her irrational beliefs.

The idea is for the client to identify their own unhelpful beliefs and then prove them wrong. As a result, his beliefs begin to change. For example, someone who is anxious in social situations might have an assignment to meet a friend at a bar for a drink.

Albert Ellis – REBT

RNational Emotive Behavioral Therapy (REBT)It is a type of cognitive therapy first used by Albert Ellis, which focuses on solving emotional and behavioral problems.

(Video) What is Cognitive Behavioral Therapy?

The objective of this therapy is to change irrational beliefs for more rational ones.

REBT encourages people to identify their general irrational beliefs (for example, 'I must be perfect') and subsequently convinces them to challenge these false beliefs through reality tests.

Albert Ellis (1957, 1962) proposes that each of us has a unique set of assumptions about ourselves and our world that guide us throughout life and determine our reactions to the various situations we face.

Unfortunately, some people's assumptions are largely irrational, causing them to act and react inappropriately, jeopardizing their chances for happiness and success. Albert Ellis calls itbasic irrational assumptions.

Some people irrationally assume they are a failure if they are not loved by everyone they meet: they constantly seek approval and repeatedly feel rejected. All of their interactions are affected by this assumption, so a big party can leave them feeling dissatisfied because they don't get enough praise.

According to Ellis, these are othercommon irrational assumptions:

• The idea that one should be fully competent in everything.

• The idea that it is catastrophic when things are not the way you want them to be.

• The idea that people have no control over their happiness.

• The idea that you need someone stronger to rely on.

• The idea that your history greatly influences your current life.

• The idea that there is a perfect solution to human problems and that it is a disaster if you don't find it.

Ellis believes that people often become attached to this illogical way of thinking and therefore employ highly emotive techniques to help them vigorously and forcefully change this irrational thinking.

The ABC model

A great help in cognitive therapy is what Albert Ellis (1957) calledABC Technique of Irrational Beliefs.

The first three steps look at the process by which a person developed irrational beliefs and can be recorded in a three column table.

Cognitive behavioral therapy (CBT): types, techniques, applications (2)

* A - Trigger event or objective situation.The first column records the objective situation, that is, an event that ultimately leads to some kind of heightened emotional response or negative dysfunctional thinking.

* B – Beliefs.In the second column, the client writes down the negative thoughts that occurred to him.

* C – Consequence.The third column is for the negative feelings and dysfunctional behaviors that followed. The negative thoughts in the second column are seen as a bridge between the situation and the distressing feelings. The third column, C, is explained below describing negative emotions or thoughts that the client believes are caused by A. This could be anger, sadness, anxiety, etc.

Ellis believes that it is not the triggering event (A) that causes negative emotional and behavioral consequences (C) but rather a person interprets these events unrealistically and therefore has an irrational belief system (B) that helps cause the consequences (C).

(Video) How Does Cognitive Behavioral Therapy Work?

Cognitive behavioral therapy (CBT): types, techniques, applications (3)

Example of TREC

Gina is upset because she got a low grade on a math test. The Trigger event, A, is that she failed the test. The Belief, B, is that she must have good grades or she is worthless. The Consequence, C, is that Gina feels depressed.

After identifying the irrational beliefs, the therapist will usually work with the client to challenge the negative thoughts based on evidence from the client's experience.rephrasingthis, that is, reinterpret it in a more realistic way. This helps the client develop more rational beliefs and healthy coping strategies.

A therapist would help Gina realize that there is no evidence that you have to get good grades to be worth your while or that getting bad grades is horrible. She wants good grades and it would be nice to have them, but that hardly makes her useless.

If she perceives that getting bad grades is disappointing but not horrible, and that it means she's bad at math or studies but not as a person, she'll feel sad or frustrated but not depressed. Sadness and frustration are likely healthy negative emotions and can prompt you to study more from then on.

critical appraisal

Rational emotive behavior therapists have cited many studies in support of this approach. Most of the early studies were done in people with experimentally induced anxiety or nonclinical problems, such as a mild fear of snakes (Kendall & Kriss, 1983).

However, several recent studies have been conducted on actual clinical subjects and have also found that rational emotive behavior therapy (REBT) is often useful (Lyons & Woods 1991).

Aaron Beck – Cognitive Therapy

Beck's (1967) system of therapy is similar to Ellis's, but has been more widely used in cases ofdepression. Cognitive therapists help clients recognize the negative thoughts and logic errors that lead to depression.

The therapist also guides clients to question and challenge their dysfunctional thoughts, experiment with new interpretations, and ultimately apply alternative ways of thinking to their daily lives.

Aaron Beck believes that a person's reaction to specific disturbing thoughts may contribute to the abnormality. As we face the many situations that arise in life, both comforting and disturbing thoughts come to mind. Beck calls these spontaneous cognitions automatic thoughts.

When a person's automatic thought stream is very negative, you can expect them to become depressed (for example, 'I'll never finish this essay, my girlfriend likes my best friend, I'm getting fat, I have no money, my parents hate it, having Have you ever felt like this?').

Often these negative thoughts will persist despite evidence to the contrary.

Beck (1967) identified three mechanisms that he thought were responsible for depression:

  1. The cognitive triad (of automatic negative thinking)
  2. negative self schemas
  3. Errors in logic (i.e. faulty information processing)

The cognitive triad

The cognitive triad is made up of three forms of negative thinking (ie, helpless and critical) that are typical of people with depression: that is, negative thoughts about oneself, the world, and the future. These thoughts tended to be automatic in depressed people, since they occurred spontaneously.

As these three components interact, they interfere with normal cognitive processing, leading to problems with perception, memory, and problem solving, and the person becomes obsessed with negative thoughts.

Cognitive behavioral therapy (CBT): types, techniques, applications (4)

negative self schemas

Beck believed that people prone to depression develop a negative self-schema.

They have a set of beliefs and expectations about themselves that are essentially negative and pessimistic.

Beck stated that negative schemas can be acquired in childhood due to a traumatic event. Experiences that can contribute to negative schemas include:

(Video) Introduction to Cognitive-Behavioral Techniques

  • Death of a parent or sibling.
  • Rejection, criticism, overprotection, neglect or abuse of parents.
  • Bullying at school or exclusion from a peer group.

People with negative self-schemas become prone to logical errors in their thinking and tend to selectively focus on certain aspects of a situation, ignoring equally relevant information.

Cognitive distortions

Beck (1967) identifies several illogical thought processes (i.e.,distortions of thought processes). These illogical thought patterns are counterproductive and can causegreat anxietyor depression for the individual.

arbitrary interference: Drawing conclusions based on insufficient or irrelevant evidence: for example, thinking that you are worthless because it rained on an outdoor concert that you were going to see.

selective abstraction: Focusing on one aspect of a situation and ignoring the others: for example, you feel responsible for your team losing a soccer game, even though you are only one of the players on the field.

expansion: exaggerate the importance of undesirable events. For example, if he scratches the paint on your car a bit and therefore considers himself a terrible driver.

minimization: underestimating the importance of an event. For example, your teachers praise you for an excellent semester paper, but you see it as trivial.

overgeneralization: Drawing broad negative conclusions based on a single insignificant event. For example, you get a D on a test when you normally get an A, and therefore you think you're stupid.

Personalization: Attributing to oneself the negative feelings of others. For example, your teacher looks very angry when he enters the room, so he must be angry with you.

critical appraisal

Butler and Beck (2000) reviewed 14 meta-analyses investigating the efficacy of Beck's cognitive therapy and concluded that approximately 80% of adults benefited from the therapy.

The therapy was also found to be more successful than drug therapy and had a lower relapse rate, supporting the proposition that depression has a cognitive basis.

This suggests that knowledge of the cognitive explanation can improve people's quality of life.

REBT vs. cognitive therapy

• Albert Ellis views the therapist as a teacher and does not consider a warm personal relationship with the client essential. In contrast, Beck emphasizes the quality of the therapeutic relationship.

REBTis often very directive, persuasive and confrontational. Beck places more emphasis on the client discovering misconceptions for himself.

• REBT uses different methods depending on the personality of the client; in Beck's cognitive therapy, the approach is based on the specific disorder.

strengths ofTCC

1. The model has great appeal because it focuses on human thought. Human cognitive abilities have been responsible for our many achievements, so they might as well be responsible for our problems.

2. Cognitive theories lend themselves to testing. When experimental subjects are manipulated into unpleasant assumptions or thoughts, they become more anxious and depressed (Rimm & Litvak, 1969).

3. Many people with psychological disorders, particularly depressive, anxiety, and sexual disorders, have been found to exhibit maladaptive thinking and assumptions (Beck et al., 1983).

4. Cognitive therapy has been highly effective in treating depression (Hollon & Beck, 1994) and moderately effective for anxiety problems (Beck, 1993).

limitations ofTCC

1. The precise role of cognitive processes has not yet been determined. It is not clear if faulty cognitions are a cause of
psychopathology or its consequences.

Lewinsohn (1981) studied a group of participants before any of them became depressed and found that those who subsequently became depressed were no more likely to have negative thoughts than those who did not develop depression. This suggests that negative and hopeless thinking may be the result of depression rather than its cause.

(Video) What a Cognitive Behavioral Therapy (CBT) Session Looks Like

2. The cognitive model is limited in scope: thinking is only one part of human functioning and broader issues need to be addressed.

3. Ethical issues: RET is a directive therapy designed to change cognitions, sometimes quite forcefully. For some, this could be considered an unethical approach.


Beck, A. T. (1967).Depression: causes and treatment. Filadelfia: University of Pennsylvania Press.

Beck, A.T., Epstein, N. & Harrison, R. (1983). Cognitions, attitudes and dimensions of personality in depression.British journal of cognitive psychotherapy.

Beck, AT y Steer, R.A. (1993).Beck's Anxiety Inventory Manual. San Antonio: Harcourt Brace and Company.

Butler, A.C. & Beck, J.S. (2000). Cognitive therapy outcomes: a meta-analysis review.Journal of the Norwegian Psychological Association, 37, 1-9.

Dobson, KS y Block, L. (1988).Historical and philosophical bases of cognitive-behavioral theories. Manual of cognitive-behavioral therapies.Guilford Press, Londres.

Ellis, A. (1957). Rational Psychotherapy and Individual Psychology.Journal of Individual Psychology, 13: 38-44.

Ellis, A. (1962).Reason and emotion in psychotherapy. . . . New York: Stuart.

Hollon, S.D., and Beck, A.T. (1994). Cognitive and cognitive-behavioral therapies. In A.E. Bergin & S.L. Garfield (Eds.),manual of psychotherapy and behavior change(pp. 428-466). New York: Willey.

Kendall, P.C. and Kriss, M.R. (1983). Cognitive-behavioral interventions. In: CE Walker, ed.The handbook of clinical psychology: theory, research and practice,págs. 770–819. Homewood, IL: Dow Jones-Irwin.

Lewinsohn, P.M., Steinmetz, J.L., Larson, D.W. and Franklin, J. (1981). Cognitions related to depression: antecedent or consequence?.diary of abnormal psychology, 90(3), 213.

Lyons, L.C. and Woods, P.J. (1991). The effectiveness of rational emotive therapy: a quantitative review of outcomes research.Clinical Psychology Review, 11(4), 357-369.

Rimm, DC, and Litvak, SB (1969). Self-verbalization and emotional arousal.Abnormal Psychology Journal, 74(2), 181.

Other information

BounceBack® – A free skills development program administered by the Canadian Mental Health Association (CMHA)

Cognitive Behavioral Therapy

Cognitive and behavioral therapies

An overview of psychopathology.

(Video) Cognitive Behavioral Therapy Exercises (FEEL Better!)

An evaluation of rational emotive therapy Making sense of cognitive behavioral therapy (CBT)

the ABC model


What is the technique used in cognitive behavioral therapy CBT )? ›

CBT treatment usually involves efforts to change thinking patterns. These strategies might include: Learning to recognize one's distortions in thinking that are creating problems, and then to reevaluate them in light of reality. Gaining a better understanding of the behavior and motivation of others.

What are the 3 CBT techniques? ›

Three well-known and successful types are thought records, exposure therapy and relaxation training.
  • Thought Records. One of the landmarks of CBT is that patients are given homework after every session. ...
  • Exposure Therapy. ...
  • Relaxation Training.
Jan 9, 2014

What are CBT applications used for? ›

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. It's most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.

What is CBT therapy examples? ›

What are examples of cognitive behavioral therapy? Examples of CBT techniques might include the following: Exposing yourself to situations that cause anxiety, like going into a crowded public space. Journaling about your thoughts throughout the day and recording your feelings about your thoughts.

What techniques are used in behavioral therapy? ›

Behavioral therapy techniques use reinforcement, punishment, shaping, modeling, and related techniques to alter behavior. These methods have the benefit of being highly focused, which means they can produce fast and effective results.

What are the best CBT techniques for anxiety? ›

Two strategies often used in CBT are Calm Breathing, which involves consciously slowing down the breath, and Progressive Muscle Relaxation, which involves systematically tensing and relaxing different muscle groups.

What are the 5 steps of CBT? ›

5 Easy Steps to Changing Your Thinking Using Cognitive Behavioral Therapy (CBT)
  • Step One – Make A List.
  • Step Two – Record Unproductive Thoughts.
  • Step Three – Create Replacement Thoughts.
  • Step Four – Read Your List Often.
  • Step Five – Notice And Replace.
Oct 12, 2017

What are the 5 stages of CBT? ›

The steps of CBT begin with an assessment by a licensed therapist who recommends CBT treatment.
  • Step 1: Initial Assessment. ...
  • Step 2: Development of New Concepts. ...
  • Step 3: Acquirement of New Skills. ...
  • Step 4: Applying New Skills to Stressful Situations. ...
  • Step 5: Maintenance. ...
  • Step 6: Follow-up Treatment.
Sep 1, 2022

What are the 5 types of therapy? ›

Approaches to psychotherapy fall into five broad categories:
  • Psychoanalysis and psychodynamic therapies. ...
  • Behavior therapy. ...
  • Cognitive therapy. ...
  • Humanistic therapy. ...
  • Integrative or holistic therapy.

How many CBT techniques are there? ›

The nine techniques and tools listed below are some of the most common and effective CBT practices.
  • Journaling. ...
  • Unraveling cognitive distortions. ...
  • Cognitive restructuring. ...
  • Exposure and response prevention. ...
  • Interoceptive exposure. ...
  • Nightmare exposure and rescripting. ...
  • Play the script until the end. ...
  • Progressive muscle relaxation.
Mar 20, 2017

Where is CBT mostly used? ›

CBT can be a very helpful tool ― either alone or in combination with other therapies ― in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder.

How is CBT used in everyday life? ›

CBT skills help us create a map from our behavioral problem to our core thinking problem, to our core believing problem. This can assist us in making our own informed decisions about how we want to feel and think, and act, as well as what we want to believe.

How do you use CBT on yourself? ›

Common behavioral techniques include:
  1. Scheduling activities that bring you enjoyment and a sense of accomplishment.
  2. Recognizing how your actions influence your thoughts and emotions.
  3. Making the best use of your time.
  4. Breaking down daunting tasks into more manageable ones.
  5. Facing your fears gradually so they diminish.
Nov 1, 2016

How many therapy techniques are there? ›

The Most Common Types of Therapy. There are more than fifty types of therapeutic approaches.

What is an example of a technique used in classical conditioning therapy? ›

Aversion therapy is another way to use the classical conditioning is to reduce the frequency of the undesirable behavior, such as smoking or over eating, by teaching the client to pair an unpleasant stimulus that results in undesirable response.

Why are the techniques of behavior therapy important? ›

Behavioral therapy is an umbrella term for types of therapy that treat mental health disorders. This form of therapy looks to identify and help change potentially self-destructive or unhealthy behaviors. It's based on the idea that all behaviors are learned and that behaviors can be changed.

What are the main techniques of treating social anxiety in CBT? ›

  • Changing Perceptions in Social Anxiety (Cognitive Restructuring) ...
  • Mindfulness for Social Anxiety. ...
  • Behavioral Experiments (Exposures) for Social Anxiety. ...
  • Assertiveness and Problem-Solving for Social Anxiety. ...
  • Changing Attitudes in Social Anxiety (Core Beliefs and Personal Rules)

When is CBT most effective? ›

Research shows that CBT is the most effective form of treatment for those coping with depression and anxiety. CBT alone is 50-75% effective for overcoming depression and anxiety after 5 – 15 modules. Medication alone is effective, however, science still does not understand the long-term effects on the brain and body.

How is CBT used to treat social anxiety? ›

Through CBT for social anxiety, people learn different ways of reacting to thoughts and feelings, and they learn to engage in different behaviors that result in decreased fear. CBT also helps people learn and practice social skills when there is a deficit.

What are the key elements of CBT? ›

CBT is a treatment approach that provides us with a way of understanding our experience of the world, enabling us to make changes if we need to. It does this by dividing our experience into four central components: thoughts (cognitions), feelings (emotions), behaviors and physiology (your biology).

What are the main components of CBT? ›

There are threee main components of cognitive behavioral therapy: cognitive therapy, behavioral therapy, and mindfulness-based therapies. Cognitive therapy focuses mainly on thought patterns as responsible for negative emotional and behavioral patterns.

What are the 4 goals of therapy? ›

Goal Setting in Therapy
  • Changing Behaviors.
  • Establishing and Maintaining Relationships.
  • Enhancing Your Ability to Cope.
  • Facilitating Decision-Making.
  • Development.
Dec 21, 2020

What therapy is most used? ›

The most common type of therapy right now may be cognitive behavioral therapy (CBT). As mentioned above, CBT explores the relationship between a person's feelings, thoughts, and behaviors. It often focuses on identifying negative thoughts and replacing them with healthier ones.

Which technique is most widely used by therapists? ›

Psychodynamic Counseling is probably the most well-known counseling approach. Rooted in Freudian theory, this type of counseling involves building strong therapist–client alliances. The goal is to aid clients in developing the psychological tools needed to deal with complicated feelings and situations.

Who does CBT benefit the most? ›

Specifically, patients with greater capacity to identify and articulate thoughts and feelings and to share them in a nondefensive, focused way benefit most from CBT.

What are the 4 core elements of CBT? ›

CBT is a treatment approach that provides us with a way of understanding our experience of the world, enabling us to make changes if we need to. It does this by dividing our experience into four central components: thoughts (cognitions), feelings (emotions), behaviors and physiology (your biology).

What is Step 3 cognitive Behavioural therapy? ›

Step 3 treatments are for mild to moderate and severe mental health difficulties, such as anxiety and depression, panic disorder, post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD), that have not responded to low intensity intervention.

What is the most effective CBT? ›

Research shows that CBT is the most effective form of treatment for those coping with depression and anxiety. CBT alone is 50-75% effective for overcoming depression and anxiety after 5 – 15 modules. Medication alone is effective, however, science still does not understand the long-term effects on the brain and body.

What are the key principles of CBT? ›

The focus of CBT is problem-oriented, with an emphasis on the present. Unlike some of the other talking treatments, it focuses on 'here and now' problems and difficulties. Instead of focusing on the causes of distress or symptoms in the past, it looks for ways to improve a patient's current state of mind.

How to do CBT on yourself? ›

Common behavioral techniques include:
  1. Scheduling activities that bring you enjoyment and a sense of accomplishment.
  2. Recognizing how your actions influence your thoughts and emotions.
  3. Making the best use of your time.
  4. Breaking down daunting tasks into more manageable ones.
  5. Facing your fears gradually so they diminish.
Nov 1, 2016

How many principles of CBT are there? ›

Although treatment should be tailored to each individual's problems, CBT has 10 underlying principles that are for everyone. This includes being structured, time-based, and educative.

How many levels of CBT are there? ›

The CBT model is built on a two-way relationship between thoughts (“cognitions”) and behaviours. Each can influence the other. There are three levels of cognition: Conscious thoughts: Rational thoughts and choices that are made with full awareness.

Can I do CBT by myself? ›

Can I do CBT by myself? You might be able to do CBT by yourself, including through a computer or workbook. This could be useful to try if you are waiting for treatment. Or it might remind you of some good techniques, if you've had CBT in the past.

How long is a CBT session? ›

CBT takes from 6 to 8 hours including breaks.

How long does it take for CBT therapy to work? ›

A highly effective psychotherapy called cognitive behavioral therapy (CBT) focuses on how our thoughts, beliefs, and attitudes can affect our feelings and behavior. Traditional CBT treatment usually requires weekly 30- to 60-minute sessions over 12 to 20 weeks.


1. Cognitive Behavior Therapy Techniques and Application
2. An introduction to Cognitive Behavioural Therapy - Aaron Beck
3. What is the Cognitive Behavioral Therapy (CBT) Triangle?
(The Lukin Center)
4. Psychotherapy:Types, techniques, CBT, Behavioural therapy, Cognitive therapy, Psychoanalytic therapy
5. Psychodynamic, Humanistic, Cognitive and Behavioral Therapy (Approaches to Therapy)
(Daniel Storage)
6. Cognitive Restructuring Techniques - FREE CBT 9
(Qualia Counselling Services)
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