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Cognitive behaviour therapy (CBT)

What is cognitive behaviour therapy (CBT)?

Cognitive behaviour therapy (CBT) is a type of psychotherapy (talking therapy) based on the idea that how you think and act affects how you feel. It can help in many different situations — with both mental and physical health problems.

How does CBT work?

If you are thinking negatively about yourself or a situation and that is causing you problems, CBT might be able to help.

In CBT, you work with a therapist to recognise the patterns of thinking (cognition) and behaviour that cause you problems. Then CBT teaches you practical ways to learn or re-learn more helpful and healthy habits. Basically, the aim is to challenge and break the habit of negative thinking. Negative and unhelpful thinking can show itself in different ways. Some examples are catastrophising, where you always assume the worst possible outcome, and personalisation, where you take everything personally.

CBT is a practical therapy — it focusses on goals and is specific to an individual. It doesn’t look back over your past, it centres on solving current problems.

CBT has been around for many years. It’s the basis of other therapies such as acceptance and commitment therapy, mindfulness-based cognitive therapy, schema therapy and dialectical behaviour therapy (DBT).

What can CBT help with?

CBT can help children, teenagers and adults with emotional, psychological and psychiatric issues such as anxiety and depression.

CBT has also been shown to help people with:

anxiety issues like generalised anxiety disorder, panic disorder, social anxiety disorder, health anxiety and phobias
obsessive compulsive disorder
post-traumatic stress disorder
depression and bipolar disorder
eating disorders
relationship issues
anger and stress
problem gambling
substance abuse
schizophrenia

CBT can also help people with physical problems, such as:

chronic pain
fibromyalgia
migraines
chronic fatigue syndrome
insomnia

Who can provide CBT?

Psychologists, psychiatrists, some GPs with training in mental health, mental health nurses, some counsellors and other therapists may provide CBT. You may be eligible for a mental health plan by your doctor to access Medicare rebates for CBT.

CBT can be conducted in private or group sessions — it may be in person or via telehealth or be an online course/ online (e-therapy). Your doctor can refer you to a CBT therapist, or help you find a counsellor or psychologist experienced in it.

There are several online CBT programs (some free) that you can access or that your GP can refer you to, including moodgym.

What can I expect from CBT?

CBT helps you to understand how your thinking affects your mood and behaviour.

You’ll learn skills that will help with your current problems and that you can apply to future problems.

It relies on a close professional relationship with your therapist. They will help you to recognise the difference between helpful and unhelpful thoughts, and teach you how to challenge and let go of the unhelpful thoughts.

CBT is structured and usually has a set end point.

CBT usually involves a session lasting an hour once a week. In addition, there is usually some homework to do between sessions. You’ll work with your therapist to set some tasks to practise what you talk about. CBT can be used at the same time as relaxation techniques, breathing techniques, medication or supportive counselling.

What are the stages of CBT?

First you will work with your therapist to understand what are the most troubling problems for you.
Then you work out what your thoughts, emotions and beliefs are about these situations.
You will identify which of these thoughts, emotions and beliefs are negative or inaccurate.
Working with your therapist, you find ways to challenge them. You might ask yourself: is that true? Or you might ask yourself: so what?
You then also identify what behaviours are you doing based on these negative beliefs that you could change.
Then you can find ways to think and act that are less harmful to you.

When doesn’t CBT work?

CBT may be difficult for people with learning difficulties and for those with complex mental health problems.

Also, CBT does not explore the underlying reasons for a person’s negative thoughts and unhelpful thought patterns — it focusses on improving the present problem.