Without Obligation.
Discreet & Confidential.

How Does Cognitive Behavioral Therapy Work?

Discover how cognitive behavioral therapy works and the steps you can take to get started today.

What Is Cognitive Behavioral Therapy (CBT)?

Cognitive behavior therapy, or CBT, is a short-term, evidence-based psychological treatment that combines cognitive and behavioral therapy ideas. CBT focuses on methods that help individuals recognize and explore negative or faulty thought patterns and emotions contributing to distressing feelings and behaviors. These negative patterns are challenged and changed by implementing positive and healthy coping mechanisms and skills to improve the quality of life.

Is CBT Effective?

Cognitive behavioral theory is one of the most researched psychotherapies, and there is abundant evidence supporting its effectiveness. Multiple studies suggest CBT is an effective treatment option for a variety of disorders, including depression, anxiety, posttraumatic stress disorder, schizophrenia, eating disorders, and chronic pain, with some research showing its superiority over antidepressants in treating adults with depression.1

What Conditions Can Cognitive Behavioral Therapy (CBT) Treat?

Cognitive behavioral therapy techniques can address and treat various mental health conditions. Copious amounts of evidence support this therapeutic method as a valid treatment method for the following mental health conditions and concerns:


  • Addiction
  • Anger issues
  • Bipolar disorder
  • Eating disorders
  • Panic attacks
  • Personality disorders
  • Phobias

Additional Healing Opportunities of CBT

Cognitive therapy and behavioral therapy have also been proven effective for managing non-psychological issues, life challenges, and life changes, such as:

How Does Cognitive Behavioral Therapy (CBT) Work?

Cognitive behavior therapy is a psychotherapy that provides a supportive and non-judgemental approach, allowing individuals to talk openly with a trained cognitive behavioral therapist. The practice focuses on making cognitive and behavioral changes that are creating obstacles or causing distress in a person’s life. To do this, the cognitive therapist will:

Gain an Understanding of the Problem

During the first few cognitive behavioral interventions, the goal will be for the therapist to gain insight into the problem and reasons for you seeking treatment. It is important to provide the therapist with as much information as possible to help determine how they may best support you. At this stage, the therapist may also provide you with intake forms to better understand your history.

Ask a Series of Questions to Help You Recognize Problematic Thoughts and Behaviors

The cognitive behavioral therapist is also likely to ask a series of questions, often called Socratic questioning, to help open dialogue between you and the therapist. Socratic questioning utilizes specific and carefully sequenced questions to help identify thoughts, values, ideas, and beliefs that may be contributing to the problem. It may also help identify unhealthy emotions or behaviors related to those beliefs.

Work With You to Adjust Your Thoughts and Behaviors

Your cognitive therapist will help you find ways to change your perspective and work on skills that adopt more positive thought patterns.

What Are the Types of Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy encompasses a wide range of techniques that address the interaction between thoughts, feelings, and behaviors and treat cognitive behavioral disorders. As a result, there are several types of CBT approaches to treatment. These approaches will be detailed below.

Cognitive Therapy

The goal of cognitive therapy is to focus on challenging the negative thought patterns about self and the world in order to change unwanted behaviors.

Dialectical Behavior Therapy (DBT)

A well-known type of cognitive behavioral therapy is dialectical behavior therapy (DBT). DBT addresses intense emotions and destructive behaviors using mindfulness, emotion regulation, and distress tolerance strategies.

Multimodal Therapy

Multimodal therapy, also known as eclectic therapy, combines various techniques and approaches that address the whole person. Some examples of treatments used concurrently with multimodal therapy include cognitive therapy, psychoanalysis, DBT, acceptance and commitment therapy (ACT), and relaxation training.

Multimodal therapy commonly integrates cognition, behavioral, affective, and interpersonal approaches, as well as medication. One study found multimodal therapy to significantly reduce symptoms of depression and anxiety, with 46.9% of patients with depression and 50% with anxiety entering remission after thirty-nine days.3

Rational Emotive Behavior Therapy (REBT)

According to rational emotive behavior therapy (REBT), it is our thinking about events that leads to emotional and behavioral disturbances. As a result, REBT aims to help people cope with and overcome adversity, reach goals, and develop healthy skills to improve their overall quality of life.

Cognitive Behavioral Therapy Techniques

Cognitive behavioral therapy utilizes five techniques to achieve the goal of an improved life. These techniques are:

Identifying Negative Thoughts

The idea of CBT is that our thoughts, feelings, and situations can contribute to unhealthy behaviors. Therefore, the ability to identify negative thoughts can be the first step in learning how to address and change those thoughts to improve feelings and behaviors.

Practicing New Skills

Another cognitive-behavioral method includes learning and practicing new skills that can be used in real-life situations to avoid falling into negative patterns and routines. These coping skills can include deep breathing, progressive muscle relaxation, listing pros and cons, and becoming more involved in pleasurable activities.


Setting goals is an integral part of cognitive-based therapy. Part of the goal-setting technique is to work with the therapist to identify your goals, distinguish between short-term and long-term goals, and determine the steps to achieve your goals.


Another large part of cognitive behavioral approaches is learning how to identify and solve problems. The key to problem-solving is learning how to identify problems, list potential solutions, evaluate these solutions, and then choose and implement the best solution.


The fifth cognitive behavioral technique is self-monitoring, which involves diary work or journaling. Self-monitoring is a helpful way to keep track of thoughts, feelings, behaviors, and experiences. Research has shown that self-monitoring can increase positive behaviors and improve the effects of treatment.2

How Long Is Cognitive Behavioral Therapy?

Several factors can determine the number of sessions needed. Typically, cognitive behavioral intervention is short-term, requiring between five and twenty sessions. Sessions often range from thirty to sixty minutes and occur once a week.

Nevertheless, some factors that may determine how long treatment lasts include:

  • Type of Disorder or Situation: A more severe disorder or situation may require more prolonged treatment.
  • Severity and Length of Symptoms: The severity of the symptoms and the length of time the individual has been dealing with the symptoms are additional key factors. More severe or longer-lasting symptoms may require a lengthier treatment plan to address and treat the issue fully.
  • Speed of Progress: Every person progresses through treatment differently, so the length of treatment may be determined by how quickly an individual is achieving goals and progressing.
  • Amount of Stress: If an individual experiences a significant amount of stress, that may determine a longer length of treatment to help deal with and manage that stress.
  • Support: Support from family or friends can help progress treatment more quickly than those without support.

Benefits of Cognitive Behavioral Therapy

CBT offers many benefits and positive outcomes that can improve symptoms and various aspects of life. The benefits of cognitive behavioral therapy will be discussed below.


Cognitive-based therapy provides a safe and supportive environment for individuals to focus on themselves and improve their quality of life.

Raise Self-Esteem

One of the most important goals of cognitive behavioral therapy is to help individuals raise their self-esteem. Behavioral psychologists help patients identify their strengths and achieve goals, empowering them to continue improving and gain more confidence in themselves.

Creation of Positive Thought

By challenging negative thoughts, the cognitive behavioral model reinforces the creation of positive thoughts to adopt more healthy behaviors.

Anger Management

Cognitive behavioral psychology teaches individuals to identify thoughts and feelings that provide adverse or unfavorable outcomes and implement coping mechanisms, skills, and techniques for more positive results. These methods can help people manage anger by learning to think before acting.

Better Communication Skills

Individuals learn better communication skills when they can accurately identify their feelings.

Coping Skills Improve

Using cognitive behavioral strategies in everyday life can help improve coping skills.

Relapse Prevention

Learning how to identify thoughts, feelings, and behaviors while using healthy coping skills can also prevent relapse. One study found that patients with major depressive disorder who received CBT paired with medication experienced significantly reduced relapse rates (36%) than those who only received medication treatment (62%) during a seventy-eight-week period. Additionally, CBT lengthened the chance of relapse by three months.4

How to Get Started With Cognitive Behavioral Therapy

There are many advantages to cognitive therapy. Consider the following to get started with cognitive behavioral therapy:

Consult With Your Physician

If you are considering CBT, you can consult your physician for resources and referrals to find experienced therapists.

Consider Your Personal Preferences

Consider what type of treatment might work best for you. This can include whether or not you want to receive treatment in person or online, how often you would like to attend treatment, and your preferences for a therapist.

Contact Your Health Insurance

Call your health insurance provider to learn more about the treatment types and number of sessions your plan covers. You can also request a list of mental health offices and therapists who accept your insurance.

Expect Your Initial Experience to Be Similar to a Doctor’s Appointment

Cognitive behavioral therapy steps often involve completing an initial intake, which may feel similar to a doctor’s appointment as you will be asked a series of questions regarding personal and family history.

Be Prepared to Answer Questions

Be prepared to answer questions openly and honestly. The best treatment outcomes involve working collaboratively with the therapist and allowing them to get to know you so treatment can be individualized to your needs.

Get Cognitive Behavioral Therapy at San Diego Detox

Are you or your loved one suffering from an addiction or other mental health condition and believe cognitive behavioral therapy could help? At San Diego Detox, our dedicated and compassionate mental health professionals use evidence-based practices, like CBT, to promote long-lasting recovery. For more information, contact San Diego Detox today at 619-433-6560.

Things to Consider and Potential Challenges of Cognitive Behavioral Therapy

Before deciding whether cognitive behavioral therapy is right for you, there are some things to consider:

Change Can Be Difficult

The cognitive behavioral therapy process can be difficult, as it is challenging to become aware of ourselves and our issues. In addition, symptoms may worsen before they improve because identifying negative thoughts and feelings can result in adverse emotions.

CBT Is Very Structured

Cognitive behavioral approaches are very structured and require individuals to actively participate in their treatment by completing assignments. Some do not effectively respond to highly structured environments, so this is a factor to consider.

Willingness to Change

The basis of the cognitive behavior theory is that a willingness to change must be present, as the treatment requires active participation, readiness to analyze thoughts and feelings, and being open and honest with the therapist. These factors can be difficult for those unwilling to change.

Progress Can Be Slow

People may not see progress immediately as progress is often gradual. For example, in cognitive behavioral therapy for anxiety, behavior change often occurs in progressive steps, starting with imagining the anxiety-provoking situation, then moving towards the larger goal of addressing the anxiety.