Learn / What CBT is

What CBT is

4 minute read

Cognitive behavioral therapy, usually shortened to CBT, is a practical, present-focused approach to psychological problems. Its central idea fits in a sentence. The way we interpret what happens to us shapes how we feel and what we do, and what we do then feeds back into what we believe.

Same event, different reading

Picture two people whose manager says "Can you come by my office at four?" One thinks "probably the schedule for next month" and gets on with the afternoon. The other thinks "I'm in trouble, I must have messed something up" and spends three hours with a knot in the stomach, rereading old emails. Both heard the same sentence. How each of them read it decided what the rest of the afternoon was like.

CBT grew out of Aaron Beck's work in the 1960s. Beck noticed that his depressed patients had streams of quick, believable thoughts they rarely stopped to examine, and that the thoughts leaned in predictable directions. They drew conclusions without much evidence, zeroed in on one bad detail, and turned single events into rules. He called these automatic thoughts, and he found that helping people notice and test them eased the depression.

The CBT triangle

Each corner feeds the other two. A thought record starts at the thoughts corner.

Most introductions draw the same picture: a triangle with thoughts at one corner, feelings at another, and behaviors at the third, with arrows running both ways along every side.

Thoughts are the interpretations and predictions that run through your head. Feelings are emotions and the body sensations that come with them. Behaviors are what you do, including small things like going quiet or checking your phone again.

The arrows matter more than the corners. "I'm in trouble" brings dread. Dread makes it hard to concentrate, so you get less done. Getting less done seems to confirm you're falling behind, which feeds the next worried thought. Change any corner and the others tend to shift with it.

Where a thought record fits

A thought record works at the thoughts corner. You catch one moment when your mood changed, name the feelings, find the thought that drove them, and look at the evidence for and against it. The aim is a more accurate thought, one you can actually believe, and some room to choose what you do next.

Behavioral experiments work from the other side, at the behavior corner. You test a prediction in real life and see what happens. The two tools are often used together, and our Behavioral Experiment app covers the second one.

Does it work?

CBT is one of the most thoroughly studied psychological treatments. Large reviews of many trials find it effective for depression, anxiety disorders, and a range of other problems. For depression, it performs about as well as other good psychotherapies and as antidepressant medication, and it's recommended as a first-line treatment by clinical guidelines in the United States, the United Kingdom, and elsewhere.

That doesn't mean it works for everyone, or that working through a worksheet on your own is the same as therapy. The article on working with a therapist covers what the research says about practice on your own.

What CBT isn't

It isn't positive thinking. The goal is accuracy. Sometimes a worrying thought turns out to be partly or fully true, and then the useful next step is solving the problem or making room for a hard feeling, not talking yourself out of it.

It also isn't a one-time fix. Thoughts that have been rehearsed for years usually loosen through repeated practice, which is why therapists ask clients to fill in records between sessions.

This site and the app are educational tools and a worksheet. It is not therapy, and it does not replace care from a qualified professional.

References

Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9(4), 324–333. doi.org/10.1001/archpsyc.1963.01720160014002
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
Beck, J. S. (2021). Cognitive behavior therapy: Basics and beyond (3rd ed.). Guilford Press.
Hofmann, S. G., Asnaani, A., Vonk, I. J. 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. doi.org/10.1007/s10608-012-9476-1
Cuijpers, P., Miguel, C., Harrer, M., Plessen, C. Y., Ciharova, M., Ebert, D., & Karyotaki, E. (2023). Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: A comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry, 22(1), 105–115. doi.org/10.1002/wps.21069

Helpful links

Educational content, not medical advice or a substitute for professional care. Ready to try one? Fill in a thought record online or print one.