Written by Dr Sara Tookey
Cognitive Behavioural Therapy (CBT): Understanding How Thoughts, Feelings, and Behaviours Connect
Cognitive Behavioural Therapy (CBT) is one of the most extensively researched and effective forms of psychotherapy. Developed by Dr. Aaron Beck in the 1960s, CBT is based on the understanding that our thoughts, feelings, behaviours, and physical sensations are all interconnected, and that changing one aspect can positively impact the others.
What is Cognitive Behavioural Therapy?
CBT is a structured, time-limited approach that focuses on identifying and changing unhelpful patterns of thinking and behaviour. It emphasises the importance of the present while acknowledging how past experiences shape our current ways of thinking and behaving.
The Science Behind CBT
Research consistently shows that CBT is effective in treating various mental health conditions. Key findings include:
Significant reduction in depression symptoms (Cuijpers et al., 2023)
Lasting improvement in anxiety disorders (Carpenter et al., 2018)
Effective treatment for PTSD (Lewis et al., 2020)
Helpful in managing chronic pain (Williams et al., 2020)
Core Principles of CBT
The Cognitive Triangle
CBT works with the interconnection between:
Thoughts (cognitions)
Feelings (emotions)
Behaviours (actions)
Physical sensations (body responses)
Key Concepts
Thoughts influence feelings and behaviours
Behaviours can change thoughts and feelings
Physical sensations affect and are affected by thoughts and emotions
All these elements can be modified through conscious awareness and practice
Who Can Benefit from CBT?
CBT has proven effectiveness for:
Depression and anxiety
Panic disorder
OCD
PTSD
Eating disorders
Sleep problems
Chronic pain
Substance use disorders
What to Expect in CBT Sessions
A typical course of CBT includes:
Assessment and goal setting
Learning to identify thoughts, feelings, and behaviours
Understanding how these elements interact
Developing and practicing new skills
Regular homework assignments
Progress review and maintenance planning
Key CBT Techniques
Cognitive Techniques
Thought records
Cognitive restructuring
Identifying cognitive distortions
Balanced thinking exercises
Behavioural Techniques
Behavioural activation
Exposure therapy
Activity scheduling
Problem-solving training
Relaxation Methods
Progressive muscle relaxation
Controlled breathing
Mindfulness practices
Grounding techniques
The Evidence Base
CBT's effectiveness is supported by extensive research:
Recent meta-analyses show:
CBT outperforms wait-list and placebo controls for most conditions (Cuijpers et al., 2023)
Effects are maintained at follow-up (Hans & Hiller, 2013)
CBT works across different delivery formats (in-person, online, group) (Carlbring et al., 2018)
Specific findings include:
50-75% response rate for anxiety disorders (Carpenter et al., 2018)
Significant reduction in depression relapse rates (Zhang et al., 2019)
Comparable effectiveness to medication for many conditions (Dunlop et al., 2019)
What Makes CBT Different?
CBT is:
Structured and goal-oriented
Present-focused
Skills-based and practical
Collaborative between therapist and client
Evidence-based and regularly evaluated
Time-limited with clear endpoints
Recommended Resources
Books
"Mind Over Mood" by Dennis Greenberger and Christine Padesky
"Feeling Good" by David Burns
"The CBT Toolbox" by Jeff Riggenbach
Online Resources
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalized guidance.
For specific concerns or to discuss whether CBT might be right for you, please book an INITIAL CONSULTATION with one of our experienced therapists.
Initial Therapy Consultation
We welcome your thoughts and reflections on this therapeutic perspective.
Subscribe to our newsletter to keep up to date on the latest news, events, resources and features from True North Psychology
References
Carlbring, P., Andersson, G., Cuijpers, P., Riper, H., & Hedman-Lagerlöf, E. (2018). Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis. Cognitive Behaviour Therapy, 47(1), 1-18. https://www.tandfonline.com/doi/full/10.1080/16506073.2017.1401115
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and Anxiety, 35(6), 502-514. https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22728
Cuijpers, P., Miguel, C., Ciharova, M., Aalten, P., Batelaan, N., & Salemink, E. (2023). Cognitive behavior therapy for depression and anxiety: A meta-analysis of long-term effects. Behavior Therapy, 54(2), 264-276. https://pubmed.ncbi.nlm.nih.gov/23870719/
Dunlop, B. W., LoParo, D., Kinkead, B., Mletzko-Crowe, T., Cole, S. P., Nemeroff, C. B., ... & Craighead, W. E. (2019). Benefits of sequentially adding cognitive-behavioral therapy or antidepressant medication for adults with nonremitting depression. American Journal of Psychiatry, 176(4), 275-286. https://adaa.org/sites/default/files/2019_AJP_SequentialComboPReDICT.pdf
Hans, E., & Hiller, W. (2013). Effectiveness of and dropout from outpatient cognitive behavioral therapy for adult unipolar depression: A meta-analysis of nonrandomized effectiveness studies. Journal of Consulting and Clinical Psychology, 81(1), 75. https://pubmed.ncbi.nlm.nih.gov/23379264/
Lewis, C., Roberts, N. P., Andrew, M., Starling, E., & Bisson, J. I. (2020). Psychological therapies for post-traumatic stress disorder in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), 1729633. https://orca.cardiff.ac.uk/id/eprint/129819/
Williams, A. C. D. C., Fisher, E., Hearn, L., & Eccleston, C. (2020). Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, (8). https://discovery.ucl.ac.uk/id/eprint/10108717/1/Williams_et_al-2020-Cochrane_Database_of_Systematic_Reviews.pdf
Zhang, Z., Zhang, L., Zhang, G., Jin, J., & Zheng, Z. (2019). The effect of CBT and its modifications for relapse prevention in major depressive disorder: A systematic review and meta-analysis. BMC Psychiatry, 19(1), 1-14. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1610-5
Comments