What is Cognitive Behavioural Therapy?  

Cognitive Behavioural Therapy (CBT) is a talking therapy – and is considered one of the most effective treatments for conditions which are anxiety and depression based. These include eating disorders, recurring panic attacks, post traumatic stress disorder, social phobia and general stress.

It assumes that how we think and feel can influence how we behave – and vice versa.

CBT can help you identify the past causes of your problems. However, its main focus is on helping you think through what you can do about your problems here and now.   

How does it work? 

Here is a brief summary from the Royal College of Psychiatristsexplanation: 

CBT can help you break down what seems to be an overwhelming problem in to smaller parts, each of which can affect the other. The starting point is usually a situation - a problem, event or difficult situation. From this can follow:

  • Thoughts
  • Emotions
  • Physical feelings
  • Actions

As an Example: You've had a bad day and feel fed up, so go out shopping. As you walk down the road, someone you know walks by and, apparently, ignores you. This starts a cascade of: 





He/she ignored me - they don't like me

He/she looks a bit wrapped up in themselves - I wonder if there's something wrong?


Low, sad and rejected

Concerned for the other person, positive


Stomach cramps, low energy, feel sick

None - feel comfortable


Go home and avoid them

Get in touch to make sure they're OK

So how you think can affect how you feel and what you do. If you always focus on the negative, this then becomes a ‘vicious cycle. ’ Negative thoughts and actions are reinforced. CBT can help an individual break this ‘vicious cycle’. Once you are aware of and understand the behaviours and thoughts, a different way of thinking and different actions can be taken.

CBT aims to get you to a point where you can 'do it yourself', and work out your own ways of tackling problems. This can help you develop your coping skills - including stress management, problem solving, relaxation, challenging negative thoughts and letting go of worries – and so help improve your quality of life.

A small study published in 2019 suggested that CBT may work by causing changes in the body's nervous system - at least for people suffering from panic disorder and agoraphobia. 

How is CBT provided?

CBT can be practised:

  • As a group
  • Individually with a therapist - in person or over the phone
  • Via self help books
  • Via a computer programme, or
  • Via apps.

Individual sessions usually involve meeting with a therapist to discuss the issues and to set targets or goals. You’ll discuss these goals with the therapist and aim to achieve them over a number of weeks. ‘Homework’ may be set after a session – so you can practise what was discussed. And the therapist may make suggestions to help you move forward. 

In England and Wales, there are two computer aided CBT programmes approved by the NHS. Fear Fighter is for individuals with phobias or panic attacks and Beating the Blues is for individuals with mild to moderate depression. 

Is CBT available through the NHS?

The NHS is aiming to make increasing use of CBT, assisted by a government funded programme 'Improved Access to Psychological Therapies' (IAPT).

Access to treatment has been patchy in some parts of the UK but access to CBT and other talking therapies appears to be improving. You would normally be referred by your GP. However some areas are piloting self referral. 

In Scotland, telephone based CBT is available through the Living Life service.  Following an initial assessment a series of self help workbooks are used with self help coaches to guide you over the phone and discuss the reasons you are feeling low. These sessions are usually between 4 – 8 weeks, at a time suitable to you. 

A CBT therapist can also be hired privately at a cost of £40 - £100 per session.

Points to bear in mind

One advantage of CBT is that there aren’t usually the same side effects as with some medications.

To benefit from CBT, you need to be committed to the process. A therapist can help and advise you. But they can’t make your problems go away without your full co-operation. Some people may also experience increased anxiety for a short time while confronting their issues.

CBT may not be suitable for people with more complex mental health needs or learning difficulties. For severe depression, CBT is usually used alongside antidepressant medication. That’s because when you are feeling very low, you may find it hard to change the way you think until the antidepressants have started to make you feel better. 


  • How you think can affect how you feel and what you do.
  • CBT helps you think about the problems you face in a different and more positive way – and so improve your coping skills and your quality of life.
  • This can help you work out your own way of tackling problems over time, without the side effects possible with some medications.
  • You can access CBT as an individual or part of a group – and also though self help books, apps and computer programmes.
  • Access to CBT seems to be improving within the NHS.

Reviewed and updated by Miguel Rodrigues, March 2019.  Next review date February 2023.