What is CBT?
Cognitive Behavioural Therapy, commonly known as CBT, is an evidence-based psychological therapy that explores the connections between our thoughts, emotions and behaviours. One of its key ideas is that the way we interpret a situation can influence how we feel and what we do next. This does not mean that difficult experiences are simply a matter of “thinking positively”. Instead, CBT helps people notice patterns that may be contributing to distress and develop more realistic, flexible and helpful ways of responding.
CBT is typically collaborative, practical and goal-focused. The psychologist and client work together to understand current difficulties, identify what may be keeping them going and practise strategies that can be used both inside and outside the therapy room.
Where did CBT come from?
The ideas behind CBT have a long history, but modern CBT developed during the twentieth century as psychologists began moving away from the view that therapy always needed to be lengthy and primarily focused on the past. Two important figures in its development were Albert Ellis and Aaron Beck. Ellis promoted a more active approach to therapy in the 1950s, while Beck’s work with people experiencing depression during the 1950s and 1960s highlighted how recurring patterns of thinking could influence emotional distress.
These ideas contributed to an approach that was more structured, focused on current problems and open to scientific evaluation. CBT has continued to develop over time and now includes a broad range of cognitive, behavioural and emotional strategies.
How does CBT understand our thoughts, feelings and behaviours?
A central CBT principle is that situations, thoughts, emotions and behaviours influence one another. Two people can experience a similar event but respond very differently depending on what the situation means to them. For example, receiving no reply to a message might lead one person to think, “They must be busy,” while another might think, “I’ve done something wrong.” Those different interpretations can lead to very different emotional and behavioural responses.
CBT can help people become more aware of automatic thoughts; the quick thoughts or interpretations that can appear with little conscious effort. Therapy may also explore deeper assumptions or beliefs about ourselves, other people and the world when these appear to be influencing difficulties across different situations. Importantly, the aim is not to assume every negative thought is wrong. Instead, thoughts can be examined for how accurate, balanced and useful they are.
What does CBT look like in a therapy session?
CBT sessions tend to have some structure, although therapy is still tailored to the individual. A session might include checking in on how things have been since the previous appointment, agreeing on what would be useful to focus on, working through one or more concerns and reviewing what has been learned. The psychologist and client may also agree on a strategy to practise between sessions so that new skills can be tested in everyday life.
One common CBT approach involves taking a specific situation and exploring what happened, what went through the person’s mind, how they felt and what they did. The psychologist may use guided questions to help the client consider the evidence for a thought, explore other possible explanations or ask whether a particular way of thinking is helping them move towards their goals.
Depending on the person and the difficulty being addressed, CBT may use strategies such as thought records, behavioural experiments, coping statements, role-play, problem-solving, exposure or activity planning. Behavioural experiments, for example, allow a person to test a prediction in real life rather than simply accepting it as true. For some anxiety difficulties, gradual exposure may involve safely approaching situations that have been avoided so the person can develop new learning and greater confidence in their ability to cope.
Is CBT just about changing negative thoughts?
No. Although thoughts are an important part of CBT, the approach also pays close attention to behaviour, emotions and the person’s broader circumstances. Psychological distress can sometimes lead people to withdraw, avoid activities, reduce social contact or stop doing things that previously gave them a sense of enjoyment or achievement. Behavioural strategies can therefore be used to gradually increase helpful activity, strengthen coping skills and reduce patterns of avoidance.
CBT also places importance on the therapeutic relationship. The approach is designed to be collaborative, with the client and psychologist sharing responsibility for goals, reviewing progress and deciding which strategies are worth trying. Warmth, empathy, genuineness and feedback remain important alongside the practical techniques used in therapy.
Who can CBT help?
CBT has been used with a wide range of psychological and health-related concerns, including depression, generalised anxiety, social anxiety, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), eating disorders and substance-use difficulties. CBT approaches have also been applied to interpersonal and personality difficulties, psychosis and physical health concerns such as chronic pain, headaches and chronic fatigue.
CBT can be adapted for different ages and circumstances and has been delivered in individual, group, couple and family settings. The exact strategies used will depend on the person’s concerns, goals and individual formulation rather than following a single identical approach for everyone.
Is CBT evidence-based?
Yes, CBT is an extensively researched psychological therapy and has been evaluated across many different presentations of mental health conditions. Its strong evidence base is one reason CBT is widely used in psychological practice. Research has also examined CBT across different ages, cultural backgrounds, education levels and socioeconomic groups.
Another important feature of CBT is its focus on helping clients gradually become more independent in using what they learn. Rather than relying only on what happens during an appointment, clients are encouraged to practise skills, notice patterns and test new ways of responding in everyday situations. Later stages of therapy may therefore focus on consolidating these strategies and recognising how to respond if difficulties begin to return.
What is the overall goal of CBT?
Ultimately, CBT aims to give people a clearer understanding of the patterns that may be contributing to their difficulties and practical tools for responding differently. By learning to recognise unhelpful thinking and behaviour patterns, consider alternative perspectives and practise new responses, people can develop skills that continue to be useful beyond therapy.
At Graham Psychology, all of our psychologists are equipped to use CBT with clients and will determine based on the clients concerns, history with therapy and mental health presentation whether its the most suitable therapeutic modality to use in sessions.
If this modality sounds like it would be helpful for you, explore our team of experienced and compassionate psychologists based in Melbourne to find one you think you would pair well with. Alternatively, our Admin team are excellent at matching clients with suitable clinicians, based on support needs and availability - they can be contacted at reception@grahampsychology.com.au or via phone at (03) 8838 8687.