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Cognitive behavioral therapy

Overview

By Mayo Clinic Staff

Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.

CBT can be a very helpful tool in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. It can be an effective tool to help anyone learn how to better manage stressful life situations.

Why it's done

Cognitive behavioral therapy is used to treat a wide range of issues. It's often the preferred type of psychotherapy because it can quickly help you identify and cope with specific challenges. It generally requires fewer sessions than other types of therapy and is done in a structured way.

CBT is a useful tool to address emotional challenges. For example, it may help you:
Mental health disorders that may improve with CBT include:
In some cases, CBT is most effective when it's combined with other treatments, such as antidepressants or other medications.

Risks

In general, there's little risk in getting cognitive behavioral therapy. Because it can explore painful feelings, emotions and experiences, you may feel emotionally uncomfortable at times. You may cry, get upset or feel angry during a challenging session, or you may also feel physically drained.

Some forms of CBT, such as exposure therapy, may require you to confront situations you'd rather avoid — such as airplanes if you have a fear of flying. This can lead to temporary stress or anxiety.
However, working with a skilled therapist will minimize any risks. The coping skills you learn can help you manage and conquer negative feelings and fears.

How you prepare

You might decide on your own that you want to try cognitive behavioral therapy. Or a doctor or someone else may suggest therapy to you. Here's how to get started:

Check qualifications
Psychotherapist is a general term, rather than a job title or indication of education, training or licensure. Examples of psychotherapists include psychiatrists, psychologists, licensed professional counselors, licensed social workers, licensed marriage and family therapists, psychiatric nurses, or other licensed professionals with mental health training.
Before seeing a psychotherapist, check his or her:
The key is to find a skilled therapist who can match the type and intensity of therapy with your needs.

What you can expect

Cognitive behavioral therapy may be done one-on-one, or in groups with family members or with people who have similar issues. It often includes:

Your first therapy session
At your first session, your therapist will typically gather information about you and ask what concerns you'd like to work on. The therapist will likely ask you about your current and past physical and emotional health to gain a deeper understanding of your situation. Your therapist may discuss whether you might benefit from other treatment as well, such as medications.
The first session is also an opportunity for you to interview your therapist to see if he or she will be a good match for you. Make sure you understand:
It might take a few sessions for your therapist to fully understand your situation and concerns, and to determine the best course of action. If you don't feel comfortable with the first therapist you see, try someone else. Having a good "fit" with your therapist can help you get the most benefit from CBT.

During CBT
Your therapist will encourage you to talk about your thoughts and feelings and what's troubling you. Don't worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort.
CBT generally focuses on specific problems, using a goal-oriented approach. As you go through the therapy process, your therapist may ask you to do "homework" — activities, reading or practices that build on what you learn during your regular therapy sessions — and encourage you to apply what you're learning in your daily life.
Your therapist's approach will depend on your particular situation and preferences. Your therapist may combine CBT with another therapeutic approach — for example, interpersonal therapy, which focuses on your relationships with other people.

Steps in CBT
CBT typically includes these steps:

Length of therapy
CBT is generally considered short-term therapy — about 10 to 20 sessions. You and your therapist can discuss how many sessions may be right for you. Factors to consider include:

Confidentiality
Except in very specific circumstances, conversations with your therapist are confidential. However, a therapist may break confidentiality if there is an immediate threat to safety or when required by state or federal law to report concerns to authorities. These situations include:

Results

Cognitive behavioral therapy may not cure your condition or make an unpleasant situation go away. But it can give you the power to cope with your situation in a healthy way and to feel better about yourself and your life.

Getting the most out of CBT
CBT isn't effective for everyone. But you can take steps to get the most out of your therapy and help make it a success.


Clinical trials

Part of Mayo Clinic's commitment to its patients involves conducting medical research that helps people live longer, healthier lives. Clinical trials are research studies that involve volunteer participants. These human studies help doctors better understand diagnose, treat, and prevent diseases or conditions.
Mayo Clinic has thousands of active clinical trials and research studies; and coordinates national clinical trials with other medical centers. See Mayo's
clinical trials website and search for a study by condition, treatment or drug name.
Mayo Clinic researchers continually develop new studies, so ask your health care provider about clinical studies or visit
ClinicalTrials.gov to learn about additional research opportunities.