Cognitive Behavioral Therapy (CBT): What It Is and How It Works

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Geoffrey C. Whittaker

Published 07/22/2019

Updated 08/05/2023

Have you ever caught yourself telling lies to yourself about…yourself? We’ve all done it at some point, but if you do it regularly, it may be time for a little help.

Everyone sees themselves negatively from time to time. “You’re a failure,” “You’re unattractive and no one could possibly love you,” and “Your friends don’t really care about you,” are common internal monologues for people suffering from depression, anxiety and various other mental health issues. 

Thoughts like these can become so common that they go unnoticed. But you should notice them because this constant stream of insults is often an effect of depression or anxiety.

Learning to manage and rechannel these dysfunctional thoughts can be game-changing — and that’s what cognitive behavioral therapy is all about. 

Want to know more? Below, we’ll cover what cognitive behavioral therapy is, how it works, what it can treat and how to get started with this therapy method.

Cognitive behavioral therapy (CBT) is a form of psychotherapy.

It’s an effective form of therapy both alone and in conjunction with other treatment options, medications or other complementary therapies. In other words, CBT is good for pretty much all people who need help with their mental health.

The premise of CBT is that your psychological and emotional problems are caused by dysfunctional or unhelpful ways of thinking or behaviors. These problems feed into negative thoughts, which feed back into destructive emotions and behaviors. It’s one big, ugly psychological cycle.

Cognitive behavioral therapy aims to interrupt this cycle and build new patterns. It does this first by teaching you to recognize dysfunctional thoughts and behaviors. Second, by having you learn to correct them. 

With CBT, you learn healthy problem-solving skills and ways of speaking to yourself to start turning the ship of emotional dysfunction. You repeat this process again and again until the bad stuff becomes less frequent.

All of this sounds great in theory, but at this point, you’re probably asking the obvious question: How does it work? The answer is a little ambiguous because it’s a bit different for everyone.

Each person’s experience with CBT will eventually be tailored to their challenges, their needs, their daily conflicts and their goals for treatment. But we can make a few broad statements about shared experiences among most CBT patients.

Here’s what to expect from cognitive behavioral therapy:

  • You’ll be doing it with a professional. A licensed therapist assists with your cognitive behavioral therapy interventions and the CBT journey to work on your thought patterns and how they’re causing or worsening various mental health conditions.

  • Together, you’ll identify the negative self-talk, behavior problems and irrational thoughts that feed into your mental health problems. The therapist is there to teach you the skills to relearn a healthy way of thinking. It generally involves taking an introspective look at the questions bothering you and coming up with rational answers to address them.

  • Then, you’ll start making changes. As you identify the patterns causing your current problems, you’ll develop coping skills to address cognitive distortions in real time, stop catastrophizing and rebuild your self-esteem.

  • CBT can take a lot of forms. You may use role-playing, practice journaling or learn meditation techniques to help you gain control. CBT techniques often include self-help activities outside of therapy. More than anything, you’ll practice what you’re learning until it becomes a new way of life.

  • It’s going to take time and practice. CBT treatment is a process. Changing behavior patterns takes time, and exactly how long it takes varies. You can’t unlearn destructive behaviors in a day, and there’s no real definitive time frame for how long CBT takes to work.

  • You could see some initial results faster than you might think. For some people, feeling better in the short term can take just a few weeks of therapy sessions (typically an hour per day, one day a week). But for others, it can take months to start feeling any kind of relief or measurable progress.

CBT is a widely researched form of therapy. It has repeatedly been shown to be a superior form of therapy compared to other types, according to a paper published in the journal Frontiers In Psychiatry. Cognitive behavioral therapy is generally considered the “gold standard,” or the best currently available in the field. 

It’s used for a wide range of mental health problems, helping adults and adolescents cope with numerous emotional issues, including:

  • Depression

  • Phobias

  • Post-traumatic stress disorder (PTSD)

  • Anxiety disorders like generalized anxiety disorder (GAD) and panic disorder

  • Eating, sleep and sexual disorders

  • Obsessive-compulsive disorder (OCD) and substance use disorders

  • Bipolar disorders

  • Schizophrenia

Cognitive behavioral therapy is also used in things like marital counseling, insomnia and substance abuse counseling. If flawed or destructive thoughts could be at the root of your problem — or you’re just having a hard time coping with things properly — CBT is a potential solution.

You can also employ CBT to:

  • Manage symptoms or prevent relapses of mental illnesses

  • Identify better ways to manage emotions and expectations

  • Treat a mental illness when medications aren’t effective or not an ideal treatment option

  • Learn techniques for coping with stressful life situations

  • Cope with grief or loss

  • Cope with chronic pain and the negative thinking that can result from it

  • Resolve relationship conflicts and learn better ways to communicate

  • Overcome emotional trauma related to violence or abuse

  • Manage stress

Keep reading to learn how cognitive behavioral therapy compares to other types of psychotherapy.

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So how does CBT stack up against other types of therapy? This is hard to quantify, but honestly, if any type of therapy can prove its value, it’s CBT.

One reason is that CBT grew from older ways of looking at mental health. Cognitive behavioral therapy stemmed from what already existed in behavioral therapy. But it brought a new emphasis on cognition — the role of thought — in our behaviors and emotions.

The idea that human thought could be responsible for maladaptive human emotion — depression or anxiety — was further developed in the decades to come. This was happening as psychotherapy became more concerned with changing behaviors and emotions and modifying people’s ways of thinking and their beliefs about themselves and the world around them.

One thing that makes CBT superior is the volume of research behind it. It’s the first type of therapy that could be considered evidence-based. Why? Cognitive behavioral therapy was the first to be studied in scientifically stringent conditions, such as randomized trials, similar to the testing of pharmaceutical drugs.

A 2012 meta-analysis looked at the effectiveness of CBT in treating a wide range of problems. For each disorder, the researchers looked at a comprehensive representative sample of the available scientific literature on cognitive behavioral therapy. 

Another form of therapy called dialectical behavior therapy (DBT), for instance, was found less effective than CBT for problems like bulimia and borderline personality disorder.

So we’ve convinced you — now you’re wondering how to get therapy ASAP. Well, there are many ways to go about it. 

The easiest may be to start cold-calling therapists to see if they’re taking new patients and accept your insurance. That said, online therapy is a quick way around the potentially endless dead-ends in places where local, in-person therapists are scarce.

If you’re interested in getting started sooner than later, keep the following in mind: 

  • Finding the right cognitive behavioral therapist can take time — you need to feel like you can trust and be honest with your healthcare provider.

  • A mental health professional will need time to help you identify thinking patterns and develop a treatment plan — don’t expect magic on day one.

  • It can be expensive to get therapy without insurance — and even then, the pre-deductible cost may be significant.

  • Online options might be more convenient and more readily available.

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Cognitive behavioral therapy is a form of psychotherapy useful in the treatment of stress, anxiety, depression, eating disorders, serious mental disorders, substance abuse and more — like, much, much more. 

If you’re struggling to feel joy, find happiness or climb out of a rut, CBT treatment is a common pathway to do all those things.

  • CBT is a well-researched form of psychotherapy, with numerous studies demonstrating its effectiveness.

  • Cognitive behavioral therapy helps people identify the unhealthy and disordered thoughts that fuel negative emotions and behaviors. 

  • You’ll need a licensed CBT therapist to help you work through problems like social anxiety, depression and other disordered ways of thinking that reduce your quality of life.

  • CBT is one of the most effective ways to address the symptoms and habits associated with mental health issues.

Want to get started with CBT but aren’t sure where to start? We can help.

You can learn more about therapy benefits and the various forms of talk therapy used today in our blogs. We can also help you put these things into practice — check out our online psychiatry and other virtual mental health services today.

4 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive therapy and research, 36(5), 427–440.
  2. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Cognitive behavioral therapy. 2013 Aug 7 [Updated 2016 Sep 8]. Available from:
  3. David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in psychiatry, 9, 4.
  4. American Psychological Association. (n.d.). What is cognitive behavioral therapy?. American Psychological Association.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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