Cognitive behavioural therapy (CBT)

What is cognitive behavioural therapy (CBT)?

Cognitive behavioural therapy is one of the talking therapies available to treat mental health issues. The therapy can be broken down into two parts: cognition (what you think) and behaviour (what you do).

Because how you behave often depends on how you think, CBT aims to help you to understand your thoughts and to think more positively about certain things. Changing how you think can also change how you feel and act and relate to other people.

CBT focuses on your state of mind in the present and does not necessarily focus on finding out the causes of your problems. 

(Werry Workforce)

How does CBT work?

CBT works by breaking down your problem into smaller parts so that it is easier for you to make sense of how things are connected to each other and how they affect you. These smaller parts are:

• a situation – a problem, event or difficult situation
• thoughts or cognitions
• emotions
• physical feelings
• actions or behaviours.

What conditions it is helpful for?

It has been proven helpful for a range of mental health conditions, eg, anxiety, depression, panic disorder, phobias, stress, bulimia, obsessive-compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. It can also help if you have problems with anger management, low self-esteem or chronic pain and fatigue.

What is a therapy session like?

A CBT session is clearly structured, and you work together with a therapist. The session focuses on current issues and practical solutions. You may have homework to do in between sessions to reflect on the outcomes of each session and to try new ways of thinking and doing things.

How long does a course of therapy take?

It can take 6 weeks to 6 months, depending on your issue and how you are improving.

What are the different types of CBT?

You can attend CBT sessions individually or in a group, or by using self-help resources or a computer programme.

Where can I find a cognitive behavioural therapist?

You can ask your GP to recommend someone or find a therapist yourself.

CBT-based programmes

Beating the blues is the most widely used evidence-based online CBT (cognitive behavioural therapy) programme for relieving depression.
Just a thought Free online CBT and therapy for all New Zealanders. Courses for anxiety, depression and COVID related stress. 
depression.org.nz is a New Zealand-based website that uses CBT-based online self-help programmes for depression and anxiety.
auntydee.co.nz a CBT-based approach for wellbeing, anxiety and stress that has been adapted for Pasifika cultural groups by LeVa
SPARX is a New Zealand CBT-based online resource for young people. 
Getselfhelp.co.uk is a useful UK site using a CBT approach.
The Centre for Clinical Interventions in Australia has CBT-based resources on a range of mental health topics.

Learn more

Cognitive behavioural therapy Patient Info, UK, 2017
Cognitive behavioural therapy Royal College of Psychiatrists, UK, 2015
Cognitive behavioural therapy Mind UK 

References

1. Nakagawa A, Sado M, Mitsuda D, Fujisawa D, Kikuchi T, Abe T, Ono, Y. Effectiveness of cognitive behavioural therapy augmentation in major depression treatment (ECAM study) – study protocol for a randomised clinical trial BMJ Open, 2014;4(10), e006359.
2. Iacobucci, G. CBT is effective for treating patients with health anxiety, study shows BMJ, 2017;358, j4177. 
3. David D, Cristea I, Hofmann, SG. Why cognitive behavioral therapy is the current gold standard of psychotherapy Frontiers in Psychiatry, 2018;9(4). 
4. Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, & Fang, A. The efficacy of cognitive behavioral therapy – a review of meta-analyses Cognitive Therapy and Research. 2012;36(5), 427-440. 

Reviewed by

	Tina Earl is a clinical psychologist with over 20 years’ experience, currently in private practice and consultancy. She has been a clinical lead for psychological services in the DHB and primary care. Tina has authored resources at a national level for mental health clinical practice and service delivery, and is a subject matter consultant for psychological practice and mental health.