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Cognitive behavioural therapy (CBT)


Expert reviewer, Carly Francis, Onsite Mental Health Practitioner and Dr Angana Nankani, Bupa Clinics GP
Next review due April 2024

Cognitive behavioural therapy (CBT) is a type of talking therapy that can help to improve your mental health. It aims to change negative thoughts and beliefs you may have that can affect how you feel and behave. You’ll learn skills in CBT that may help you for the rest of your life.

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What does cognitive behavioural therapy (CBT) involve?

CBT is based on the idea that your thoughts and feelings, your physical symptoms, and your actions and behaviour are all linked. It aims to stop the cycle of negative thoughts and behaviour. You’ll learn how to recognise negative patterns in how you think or behave and how to change them. This means you can cope with these situations better. CBT is a combination of:

  • cognitive therapy, where you look at unhelpful or negative patterns of thinking
  • behavioural therapy, which examines how you behave in response to those thoughts

There are different ways of having CBT. You can have sessions with a professional therapist on your own or in a group. This might be face-to-face or on a phone or video call. Or you can learn how to do CBT by yourself using self-help books or a computer programme (usually online). However, it’s usually most effective if you’re supported by a therapist.

Some mental health teams and GP surgeries may be able to offer you access to interactive online CBT programmes. See our FAQs for more information.

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What can cognitive behavioural therapy (CBT) help with?

CBT has been recommended as an effective treatment for many mental health problems, including:


You may also be offered it to help with:

  • anger issues
  • sleep problems
  • sexual or relationship issues
  • drug and alcohol addiction

CBT can also help you to cope better with certain physical problems that might have a psychological element. Examples include chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, tinnitus and chronic pain.

Depending on what you’re having it for, you may have CBT on its own or alongside any medicines prescribed for you.

What happens in cognitive behavioural therapy (CBT)?

If you’re having CBT with a therapist, you’ll have an initial assessment on your first session. Your therapist will ask you a few questions about your background and the problems you’re currently dealing with. CBT focuses on problems that you’re dealing with right now, but you might look at how events from your past impact your thoughts and beliefs.

You’ll agree with your therapist what you want to focus on over your treatment course. In each session, you may discuss any new problems, review any ‘homework’ tasks you agreed to do and discuss new techniques to try. CBT works best if you work on things between your sessions as well as during them. This will allow you to practise the techniques you’ve discussed in the sessions. Your therapist won’t ask you to do anything you don’t feel comfortable with.

How long you’ll have CBT depends on why you’re having it, but it’s designed to be a short-term therapy. You’ll usually have between six and 20 weekly or fortnightly sessions, with each session lasting around an hour. Sometimes, you might start with six sessions and have a review to see how you’re getting on.

CBT is all about learning specific skills that you’ll be able to continue using throughout your life. You continue to practise what you’ve learnt once you finish the series of sessions. But if you start to have difficulties again, you can request more sessions.

Cognitive behavioural therapy (CBT) techniques

Here are some example CBT techniques your therapist may try with you. If you’re doing CBT via an online or computer programme, you’ll work through these on your own.

  • Techniques to break down problems into how you think and feel, your physical feelings and your actions. You’ll start to see how these are connected and how they affect you.
  • Keeping a diary of when you feel distressed or anxious. You may include what’s triggered the feeling together with your mood, thoughts and any physical symptoms at the time. This can help you identify any unrealistic or unhelpful thoughts, feelings or behaviour.
  • Challenging negative thoughts and beliefs. This includes identifying where these may be wrong, and where there may be more rational alternatives.
  • Relaxation techniques, such as breathing exercises, which you can put into practice when you’re feeling anxious.
  • Distraction techniques, to change your focus on a problem.
  • Behavioural experiments. This is when you work with your therapist to confront situations that make you distressed or anxious and learn how you respond to them.

Where can I find a cognitive behavioural therapist?

There are different ways to access CBT.

CBT is freely available on the NHS, although services can be limited and waiting lists long in some areas. Your GP will be able to tell you what mental health services are available in your area, and refer you for assessment if appropriate. In many areas, you can also self-refer yourself for NHS talking therapy (without going through your GP). This is through an NHS service called Improving Access to Psychological Therapies (IAPT).

You can also access CBT privately, which means you’ll need to pay for appointments. If you’re looking for a private therapist, it’s important to ensure that your therapist is trained and qualified to deliver CBT. Many different healthcare professionals are trained in CBT. These include clinical psychologists, psychiatrists, counsellors, mental health nurses and social workers. Check that they are registered by a reputable body, like the British Association for Behavioural and Cognitive Psychotherapies (BABCP) or the British Association for Counselling and Psychotherapy.

If you have private health insurance, contact your insurance provider to see what you may be covered for.

Deciding on cognitive behavioural therapy (CBT)

CBT is something you need to actively participate in. If you’re having sessions with a therapist, the idea is to work together, rather than the therapist telling you what to do. Some people can find it quite challenging. You must feel ready to actively change your thoughts and behaviour for CBT to be successful. You’ll also need to be committed to practising the exercises. CBT isn’t a quick fix and it takes time to work at it.

If you’re not getting on with your CBT course, talk to your therapist, your GP or the organisation providing the therapy. You might be able to try a different therapist or a different type of treatment that might work better for you.

Frequently asked questions

  • The strongest evidence for CBT is in the treatment of depression, anxiety and eating disorders, especially bulimia and binge eating disorder. CBT is at least as helpful as taking medicines for mild-to-moderate depression. It may also help to reduce your risk of experiencing these problems again (known as a relapse). If you have severe depression, CBT can be effective if you take it in addition to medication for depression.

    There are a number of other conditions for which there is evidence suggesting CBT can be helpful. These include OCD and persistent pain. For more information, see our section: What can cognitive behavioural therapy (CBT) help with?

    Self-help CBT can be effective on its own, but it usually works better if you have the support of a healthcare professional.

  • Yes, children and teenagers can have CBT. CBT is often the first treatment a doctor will offer children and teenagers with certain mental health disorders. These include anxiety, depression, post-traumatic stress disorder and obsessive-compulsive disorder (OCD). Children and teenagers can have CBT individually or in groups. It might involve teaching skills for dealing with social situations that they normally find difficult. If you’re a parent of a child having CBT, you may be asked to join in sessions too – particularly if you have a young child.

    You can access mental health support and treatments for children via your local Child and Adolescent Mental Health Services (CAMHS) team. Your GP can refer you to CAMHS or you may be referred through a school or social worker. There are sometimes long waiting times for CAMHS services. If this is the case, ask your doctor if there are other support services you can access while you wait. There are many organisations offering support specifically for children’s and teenagers’ mental wellbeing.

  • An accredited CBT therapist will treat your sessions as completely confidential. Medical professionals follow a code of medical practice to make sure your details are kept confidential. This means your details can only be passed to people involved in your care. What you discuss in your CBT sessions won’t be discussed with anyone else unless you give your therapist specific permission to do so.

    The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the only organisation providing accreditation for health professionals offering CBT in the UK. CBT therapists who are accredited by the BABCP must follow the Standards of Conduct and Ethics when they provide CBT as a treatment. This includes maintaining confidentiality.

  • Yes, you can do CBT using online programmes or self-help books. There are also free-to-access websites providing information on CBT techniques.

    You may find computerised CBT helpful if you’re waiting for further treatment or to remind yourself of some techniques. CBT does work better with support from a therapist though. So be sure to contact an accredited therapist or talk to your GP if you’re having difficulties such as anxiety or low mood. If you do decide to try an online programme, there are certain ones approved for use in the NHS. Your GP or other professional may be able to recommend one that’s suitable for you.



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Related information

    • Cognitive behavioural therapy (CBT). Mind. mind.org.uk, published October 2017
    • Psychotherapy. Oxford Handbook of Psychiatry. Oxford Medicine Online. oxfordmedicine.com, published online June 2019
    • Mental health. Oxford Handbook of General Practice. Oxford Medicine Online. oxfordmedicine.com, published online June 2020
    • CBT | therapy worth talking about. British Association for Behavioural and Cognitive Psychotherapies (BABCP). babcp.com, last accessed 4 February 2021
    • Cognitive behavioural therapy (CBT). Mind. mind.org.uk, published October 2017
    • Generalised anxiety disorder and panic disorder in adults: management. National Institute for Health and Care Excellence (NICE), last updated July 2019. nice.org.uk
    • Depression in adults: recognition and management. National Institute for Health and Care Excellence (NICE), published October 2009. nice.org.uk
    • Obsessive-compulsive disorder and body dysmorphic disorder: treatment. National Institute for Health and Care Excellence (NICE), published November 2005. nice.org.uk
    • Post-traumatic stress disorder. National Institute for Health and Care Excellence (NICE), published December 2018. nice.org.uk
    • Bipolar disorder: assessment and management. National Institute for Health and Care Excellence (NICE), last updated February 2020. nice.org.uk
    • Psychosis and schizophrenia in adults: prevention and management. National Institute for Health and Care Excellence (NICE), last updated March 2014. nice.org.uk
    • Mental health and support services information. British Association for Behavioural and Cognitive Psychotherapies (BABCP). babcp.com, last accessed 4 February 2021
    • Accreditation – core professions. British Association for Behavioural and Cognitive Psychotherapies (BABCP). babcp.com, last accessed 4 February 2021
    • Costa MB, Melnik T. Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane Systematic Reviews. Einstein (São Paulo). 2016; 14(2):235–77. doi: 10.1590/S1679-45082016RW3120
    • Cognitive Behavioural Therapy (CBT): for parents and young people. Royal College of Psychiatrists, November 2020. www.rcpsych.ac.uk
    • Depression in children and young people: identification and management. National Institute for Health and Care Excellence (NICE), June 2019. nice.org.uk
    • Social anxiety disorder: recognition, assessment and treatment. National Institute for Health and Care Excellence (NICE), May 2013. nice.org.uk
    • Understanding CAMHS – for young people. Mind. mind.org.uk, published June 2019
    • Standards of conduct, performance and ethics. British Association for Behavioural and Cognitive Psychotherapies (BABCP), September 2017. babcp.com
  • Reviewed by Pippa Coulter, Freelance Health Editor, April 2021
    Expert reviewer, Carly Francis, Onsite Mental Health Practitioner and Dr Angana Nankani, Bupa Clinics GP
    Next review due April 2024

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