Cognitive behavioural therapy (CBT) is a structured psychological treatment used for a range of mental-health conditions. The exact method differs by condition: effective CBT is not a single generic set of techniques.

How CBT works

Therapist and client develop a shared understanding of the problem, identify maintaining patterns and agree practical goals. Sessions may include monitoring thoughts and behaviour, behavioural activation, graded exposure, problem-solving, testing beliefs, coping strategies and planned work between sessions.

Condition-specific CBT matters

• For depression, CBT may focus on behavioural withdrawal, negative patterns of thinking and relapse prevention.
• For anxiety disorders, treatment commonly includes graded exposure and reducing avoidance or safety behaviours.
• For OCD, CBT should include exposure and response prevention (ERP).
• For psychosis or schizophrenia, CBT uses adapted methods to reduce distress, improve coping and functioning, and examine interpretations of experiences.

What to expect

CBT is usually goal-oriented and active. The therapist should explain the proposed approach, likely duration and how progress will be reviewed. Therapy can be modified for age, cognition, communication needs, comorbidity and clinical severity.

CBT and other treatments

Depending on the diagnosis and severity, CBT may be used alone or alongside medication, family intervention, rehabilitation or other psychiatric treatment. The choice should be based on assessment and patient preference.

What helps CBT work well

• Clear, agreed treatment goals.
• A shared formulation of what is maintaining the problem.
• Active participation during and between sessions.
• Condition-specific techniques rather than generic advice.
• Regular review of symptoms, functioning and progress.

Frequently asked questions

Is CBT only about thinking positively?

No. CBT examines patterns between thoughts, emotions, behaviour and context, then uses practical behavioural and cognitive methods to test and change unhelpful maintaining cycles.

Does CBT always involve exposure?

No. Exposure is important for some anxiety disorders and OCD, but CBT is adapted to the condition and the person’s goals.

Depression · Anxiety Disorders · OCD · Psychological Therapies · Editorial Policy

Clinical and regulatory sources

NICE NG222: Depression in adults
NICE CG178: Psychosis and schizophrenia in adults
NICE CG31: OCD and body dysmorphic disorder

This information is for general education. Suitability for treatment requires individual assessment, informed discussion and consideration of alternatives, risks and current clinical circumstances.