Developed in the 1960s by psychologists Aaron Beck and Albert Ellis, cognitive behavioral therapy is one of the most common types of therapy today.
Its core premise is that our thoughts influence our feelings, which then influence our behaviors—and vice versa. Therefore, if we change our thoughts, we can change our feelings and behaviors, and if we change our behaviors, we can change our feelings and thoughts.
Here’s a look at 10 mental health conditions CBT can help with—and how I carry out CBT with clients throughout my career.
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CBT is well known to help anxiety. Using CBT, I encourage anxious clients to identify thoughts and beliefs that increase anxiety and inspire self-defeating behaviors like avoidance.
I also help anxious clients find evidence that disproves anxiety-inducing thoughts and encourage them to engage in behaviors that increase self-efficacy.
For example, if a socially anxious client assumes everyone thinks he's an "idiot," I challenge him to find instances where he's felt informed. Then we identify confidence-building activities he can participate in.
» Develop actionable mental health strategies through online therapy for anxiety.
2. Obsessive-Compulsive Disorder (OCD)
I work with OCD clients through "exposure," a CBT component where clients gradually face triggers without engaging in compulsions, thereby learning to tolerate that trigger's presence.
Sometimes, we visualize a trigger, monitor their body's reaction, and deploy coping skills like deep breathing until the reaction's intensity subsides.
3. Panic Disorder
Panic disorder entails recurrent episodes of panic attacks. This is one of the most common symptoms of anxiety, involving abrupt surges of fear that can make you feel like you're suffocating, having a heart attack, or losing your mind.
CBT targets the beliefs and thoughts that precipitate panic attacks, e.g., "Everyone will see me lose control," or "I'll be trapped without escape."
I help my clients identify these automatic assumptions, challenge their veracity, and deploy effective ways to manage panic attacks to bring their bodies into a calmer, non-panicked state.
Depression often involves rumination (rehashing negative thoughts), fatigue, and feelings of hopelessness and sadness. If you relate to these symptoms, there are plenty of online help resources for depression you can try.
In addition to challenging negative thoughts, I engage clients with depression in "behavioral activation," a component of CBT that involves scheduled mood- and energy-boosting activities.
Think: meeting a friend for coffee, exercising for 10-15 minutes, or getting sunlight while waking.
» Take steps to improve your well-being through online therapy for depression.
5. Attention Deficit Hyperactivity Disorder (ADHD)
ADHD can contribute to social and professional setbacks, making those afflicted feel defeated.
Symptoms of ADHD include difficulty concentrating and sitting still, frequently losing things, not attending to detail, being easily sidetracked, often not seeming present, and struggling to wait for one's turn.
When I carry out CBT with clients with ADHD, we challenge the negative beliefs they've formed about themselves. We also rehearse ways to manage time, prioritize tasks, and draw focus back to objectives in spite of distractions.
CBT for insomnia teaches clients about sleep hygiene, such as how caffeine, screen time, napping, and a lack of exercise can increase sleeplessness. It also attunes them to associations they've made with bedtime that fuel insomnia.
When I do CBT with insomniacs, we identify racing thoughts that arise at bedtime and practice strategies to gain distance from them.
These insomnia strategies include journaling, keeping a to-do list by their bed, and observing thoughts like passing clouds.
People with anorexia have distorted body images, irrational fears of weight gain, and ritualistic behaviors around food with severe caloric restriction, often resulting in extremely low weight.
CBT can help clients with anorexia challenge unhelpful body image or food beliefs while also teaching them strategies to tolerate the discomfort of increasing their caloric intake.
CBT for anorexia is shown to prevent relapse following weight regain, reduce ritualistic food behaviors, and improve distorted body-image beliefs.
8. Personality Disorders
Personality disorders involve chronic cognitive, social, behavioral, and emotional impairments that severely impact one's personal, professional, and interpersonal functioning. They often entail dysfunctional beliefs, which CBT can help address.
I've utilized CBT with clients diagnosed with borderline personality disorder (BPD) to help them question automatic assumptions—say, that others will always abandon them—and find evidence to disprove beliefs that they don't matter.
This is a frequent thought of people with BPD, who struggle with suicidal ideation, unstable self-concepts, and impulsive behaviors.
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Schizophrenia is a condition characterized by hallucinations, delusions, and disorganized behavior.
When I previously worked with adults struggling with schizophrenia, I utilized a specific version of CBT for psychosis. It helped them identify automatic thoughts that influence their interpretations of various events and fuel negative feelings and behaviors.
While clients did sometimes maintain their delusions, they were often able to re-frame everyday occurrences to see them in a less nefarious light. For example, when a neighbor waves "hello," I invite them to think: "the neighbor is being friendly." Not "the neighbor is plotting against me."
10. Anger Management
Anger arises when we believe a boundary or rule has been violated. Therefore, people who struggle with anger management often perceive violations where others may not.
CBT supports anger management by helping clients reframe interpretations of situations they assume are offensive. It also helps to develop communication skills and arousal reduction techniques, like breathing exercises and progressive muscle relaxation.
A helpful reframing tactic I've practiced with clients is encouraging them to envision the people they're mad at as small children. This can cue empathy and reduce aggression.
Is CBT Right For You?
One misunderstanding about CBT is that it's mechanical and devoid of empathy. This can be true if it's carried out in a by-the-book fashion with no adaptation to a client's individual needs and concerns.
Be sure to voice any hesitations you may have about CBT with a therapist, and inform them if you need more supportive listening. If CBT doesn't feel like it's helping, don't give up.
There are many other therapeutic modalities backed by evidence that help with the conditions outlined above, such as:
Acceptance and Commitment Therapy (ACT)
ACT is designed around values-based living and gaining distance from troublesome thoughts.
Dialectical Behavior Therapy (DBT)
DBT is a skills-based approach that aims to increase emotional regulation and communication skills while reducing suicidal ideation.
Try CBT Online Today
CBT does have broad appeal, however, and many therapists are trained in it. If convenience is your priority, online cognitive behavioral therapy is a great place to start.
Many online mental health professionals versed in CBT can also be found on most of the top online therapy platforms.