What Is Cognitive Behavioral Therapy?

In an initial CBT session, the therapist will ask you several background questions about yourself, your overall health, and the mental health concerns you’re currently experiencing, says Sarah Gleason, who is a licensed professional counselor and licensed chemical dependency counselor at the Taylor Counseling Group in The Woodlands, Texas. They’ll also ask what your goals for therapy are and explain what you can expect to achieve over time.

Every therapist is somewhat different in how they conduct their sessions, but with a CBT therapist, Gleason explains, you will be learning tools that you can utilize when not in the therapy room.

One of the most common CBT tools is called the cognitive model, which involves identifying a situation that triggers an automatic thought that is then followed by an emotional, physiological, and/or behavioral reaction. Applying this model to one’s own experiences helps patients evaluate those patterns on a deep level, Gleason says.

Gleason offers an example of how to apply the cognitive model: “Susie” was not invited to “Jackie’s” party with her other friends, a situation she found hurtful. Susie’s automatic thought was, “They must not want to be my friend anymore.” This caused Susie to feel sad and have a stomachache — examples of emotional and physiological reactions to a situation. As a result, Susie decides not to talk to her friends next time she sees them — an example of a behavioral reaction.

Using the cognitive model to assess the situation could help Susie learn to recognize and interrupt similar negative automatic thoughts in the future and to practice replacing them with more constructive thoughts, says Gleason. “Instead of Susie thinking her friends don’t want to be friends anymore, she might instead think something like, ‘Jackie knew that I was busy with my family on the night of her party, which must be why I wasn’t invited.’”

And instead of deciding she’ll no longer talk to her friends, Susie could reach out to Jackie and calmly communicate how not being invited to the party made her feel. Then Jackie, upon learning she inadvertently hurt Susie’s feelings, could explain why it happened and together they could agree on how to avoid future misunderstandings.

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