Cognitive behavioral therapy (CBT) is a talking therapy designed to help people manage problems by changing the thought processes and ultimately behavior. It is a structured, time-sensitive form of psychotherapy.

CBT is based on the concept that a person’s thoughts, feelings, physical sensations and actions are all connected, and negative thoughts and feelings can trigger and trap individuals in a vicious cycle.

CBT is most commonly used to treat emotional health conditions such as depression or anxiety, but can also be used for other mental and physical health problems.

In some cases, CBT has helped in treating addiction. Its purpose is to solve current problems and teach patients how to change adverse thoughts, feelings and actions. The skills that patients learn also help them throughout life to relate to others and prevent relapse.

CBT tends to focus on making behavior changes, which some have found successful. But it doesn’t typically address the underlying core mental and emotional issues that cause the behavior.

CBT Theory

Those who ask, “What is cognitive behavioral therapy?” may be curious about the theory behind it. The basis of CBT is that the way people grasp situations influences how they act and feel.

For instance, people who walk past a storefront display might feel excitement from what they see. However, others may get upset. It’s not the window display itself that makes them feel this way. Their thoughts when they see it influence a certain reaction.

Sometimes people with addiction can have inaccurate perceptions. CBT helps them identify these patterns and evaluate the reality of their thoughts. During the process, they learn to change how they think, which improves how they feel and act.

CBT Components

CBT integrates two key components. Functional analysis helps therapists and patients identify high-risk triggers that can lead to drug use. Knowing these triggers allows patients to avoid them. Therapists usually ask a series of questions to help patients identify these triggers.

Basic skills training helps patients change unhealthy habits by substituting them with healthier activities. They also improve how patients tolerate negative feelings such as anger and depression. Furthermore, the skills help them identify and cope with urges to use drugs.

CBT Session Structure

When answering, “What is cognitive behavioral therapy?” many therapists give an example of its structure.

Patients usually go to about 16 sessions over the course of 5 – 20 weeks. However, the actual duration of CBT varies according to each patient’s needs.

Although the sessions aren’t the same for everyone, they follow a general guideline. The goal is to focus on and accomplish as much as possible within the typical 60 minutes.

For instance, the first 20 minutes may involve an assessment of the time between sessions. The assessment will include urges and triggers that patients experienced since the previous session. Therapists usually listen to patients’ concerns. They also review the homework assigned at the end of the last meeting.

During the second 20 minutes, therapists introduce the topic of the current session. As the discussion progresses, they relate the topic to the patients’ current concerns.

The final 20 minutes involves exploring how the patients understand and respond to the topic. Therapists review the patients’ plans and preparedness for possible triggers over the coming days. Then, they assign homework for patients to complete before the next session.

Pros and Cons of Cognitive Behavior Therapy

Like most conseling strategies, there are pros and cons with CBT. It can be helpful in treating some mental health problems, but may not be successful or suitable for everyone. Let’s explore a few of the advantages and disadvantages.

Pros of CBT

  • CBT may be helpful in cases where medication alone hasn’t worked
  • It can be completed in a relatively short period of time (5 – 20 wks) compared to other talking therapies
  • Format flexible: since CBT is highly structured, it can be delivered in differerent formats, including 1:1 counseling, group counseling or sessions, books, or videos
  • Provides tools and strategies that many find helpful to apply to everyday life, even after completing treatment

Cons of CBT

  • CBT may not be suitable or appropriate for people with complex mental health or emotional health conditions
  • It may not be suitable or appropriate for people with deep trauma and scarring that hasn’t been resolved
  • CBT doesn’t address the deeper underlying core issues that are driving the faulty thinking and behavior in the first place
  • Since underlying core issues have not been addressed, it requires sheer willpower to sustain – which is a finite resource that eventually can run out.
  • It involves confronting emotions and anxieties – can be uncomfortable for many