Cognitive behavioural therapy (CBT)

Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
Next review due, October 2021

CBT is a type of talking therapy that can help to change negative patterns in how you think, feel and behave. It’s an effective therapy for many types of mental health problems, including depression and anxiety. You’ll learn skills in CBT that may help you for the rest of your life.

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About cognitive behavioural therapy (CBT)

Talking therapies cover a wide range of different therapies, all of which involve talking to a trained professional about your thoughts and feelings. Sometimes people refer to talking therapy as counselling or psychotherapy. There are some specific types of talking therapies, which are based on slightly different approaches.

CBT is based on the idea that your thoughts and feelings, your physical symptoms, and your actions and behaviour are all linked. CBT teaches you to recognise negative patterns in how you think or behave and how to change them, so that you feel better.

CBT is a combination of:

  • cognitive therapy, where you focus on patterns of thinking
  • behavioural therapy, which focuses on how you behave in response to those thoughts

CBT helps you to deal with problems that are happening right now, rather than focusing on things from your past. You can have CBT with a therapist on your own or in a group, or you can do it yourself using self-help books or via a computer programme (usually online). Some mental health teams and GP surgeries may be able to offer you access to interactive online CBT programmes. See FAQ for more information.

If you need help now

This page is designed to provide general health information. If you need help now, please use the following services.

  • Samaritans
    116 123 (UK and ROI) This helpline is free for you to call and talk to someone.
  • NHS Services has a list of where to get urgent help for mental health.
  • Mind website. Click on the yellow ‘Get help now’ button at the top left of the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999.

What can CBT help with?

CBT has been recommended in the treatment of many mental health disorders and physical conditions, including:

There’s also some evidence CBT may help with certain other conditions, including:

  • eating disorders
  • chronic fatigue syndrome
  • anger issues
  • sleep problems
  • persistent pain
  • sexual or relationship issues
  • drug and alcohol addiction

You can have CBT on its own or alongside any medicines you’re taking.

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What happens during CBT?

If you’re having CBT with a therapist, on your first session, they will ask you a few questions about your background and the problems you’re currently dealing with. Together, you’ll agree what you want to focus on over your treatment course. In each session, you may discuss any new problems that have come up, review any ‘homework’ tasks you’ve agreed to do and discuss new techniques to try with your therapist.

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

  • Teaching you how problems can be broken down 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, what’s triggered this and 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, and identifying where these may be wrong, and there are 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, in which you work with your therapist to confront situations that make you distressed or anxious and learn how you respond to them.

Your CBT therapist will usually suggest some ‘homework’ for you to do between your sessions. This will allow you to practise the techniques you’ve discussed in the sessions in your daily life. You won’t be asked to do anything you don’t feel comfortable with.

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 on your own once you finish the series of sessions. But if you do start to have difficulties again, you can go back to the therapist for some more sessions.

How long would I have CBT for?

This depends on what it is you’re having CBT for. You’ll usually have between six and 20 weekly or fortnightly sessions, with each session lasting around an hour. Your treatment course may last for two or three months for something like mild-to-moderate depression or panic attacks. You might have it for up to nine months for something like generalised anxiety, severe depression or obsessive-compulsive disorder (OCD).

Where can I find a CBT therapist?

If you see your GP because you’re having problems with your mental health, they may refer you to local mental health services for further assessment. You’ll be assessed by a specialist in mental health, who will recommend whether CBT – or another therapy – is right for you.

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). Availability for NHS treatment varies between different area – there may be a waiting list for treatment.

You can also access CBT privately. It’s important that your therapist is trained and qualified to use CBT. A number of different healthcare professionals are specially trained to use this type of therapy. These include clinical psychologists, psychiatrists (doctors who specialise in identifying and treating mental health conditions), counsellors, mental health nurses and social workers. The British Association for Behavioural and Cognitive Psychotherapies (BABCP) holds a register of accredited therapists, allowing you to find your own therapist.

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

Deciding on CBT

CBT can be a challenging treatment. You must feel ready to actively change your thoughts and behaviour for it to be successful. It isn’t a quick fix. It takes time and you have to work at it. You may find it difficult to concentrate and stay motivated at first, especially if you’ve been feeling low. You may also feel a bit anxious. But the right therapist will put you at ease and make sure you take the sessions at the right pace for you.

CBT isn’t for everyone. If you don’t get on with it, you may find another treatment that works better for you. Your doctor will be able to discuss your treatment options with you.

Frequently asked questions

  • The strongest evidence for CBT is in the treatment of depression, anxiety and eating disorders. 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 good evidence CBT can be helpful. These include OCD and persistent pain. See, What can CBT help with? above for more information.

    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, such as anxiety, depression, bipolar disorder and obsessive-compulsive disorder (OCD). Children and teenagers can have CBT individually or in groups. It might involve teaching a child 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.

    If your child has mental health problems and sees their GP , their GP may refer them to local Child and Adolescent Mental Health Services (CAMHS) for further assessment. CAMHS can organise appropriate therapy for your child, which may be CBT.

  • An accredited CBT therapist will treat your sessions as completely confidential. Medical professionals follow a code of medical practice to ensure your details are kept confidential and are only passed on 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 programmes you can access online, or with self-help books. There are also websites providing information on CBT techniques, which are free to access.

    You may find computerised CBT helpful if you have mild symptoms or don’t want to see a therapist. 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 a low mood.

    Two computer-based CBT programmes have been approved for use in the NHS. Fear Fighter is specifically for people who have phobias or panic attacks. Beating the Blues is aimed at people who have depression. In some areas, access to these services may be offered free if you’ve had an assessment with mental health services. In other areas, you may need to pay a fee to access them. The Royal College of Psychiatrists also recommends the free online CBT course, Living Life to the Full.

    There are also a number of self-help books based around CBT. If you would like to try this approach, your CBT therapist or GP may be able to recommend a suitable one.

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Related information

    • CBT therapy worth talking about. British Association for Behavioural & Cognitive Psychotherapies., accessed 17th September 2018
    • Cognitive behavioural therapy. Royal College of Psychiatrists., last reviewed March 2018
    • Cognitive and behavioural therapies. PatientPlus., last updated 2 April 2014
    • Generalised anxiety disorder and panic disorder in adults: management. National Institute for Health and Care Excellence (NICE), January 2011.
    • Depression in adults: recognition and management. National Institute for Health and Care Excellence (NICE), October 2009.
    • Talking therapy and counselling. Mind., published June 2018
    • Psychotherapy. Oxford handbook of psychiatry. Oxford Medicine Online., updated December 2015
    • Cognitive behavioural therapy (CBT). Mind., published October 2017
    • Obsessive-compulsive disorder and body dysmorphic disorder: treatment. National Institute for Health and Care Excellence (NICE), November 2005.
    • Bipolar disorder: assessment and management. National Institute for Health and Care Excellence (NICE), September 2014.
    • Psychosis and schizophrenia in adults: prevention and management. National Institute for Health and Care Excellence (NICE), February 2014.
    • The improving access to psychological therapies manual. National Collaborating Centre for Mental Health, June 2018.
    • Cognitive Behavioural Therapy (CBT): information for young people and parents, carers or anyone working with children and young people. Royal College of Psychiatrists., March 2017
    • Depression in children and young people: identification and management. National Institute for Health and Care Excellence (NICE), September 2005.
    • Social anxiety disorder: recognition, assessment and treatment. National Institute for Health and Care Excellence (NICE), May 2013.
    • Depression in children. NICE Clinical Knowledge Summaries., published March 2016
    • Standards of conduct, performance and ethics. British Association for Behavioural & Cognitive Psychotherapies, September 2017.
    • Membership British Association for Behavioural & Cognitive Psychotherapies., accessed 17 September 2018
    • Mental health. Oxford handbook of general practice. Oxford Medicine Online., published online April 2014
  • Reviewed by Pippa Coulter, Freelance Health Editor, October 2018
    Expert reviewer Dr Rahul Bhattacharya, Consultant Psychiatrist
    Next review due October 2021