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Cognitive behavioural therapy (CBT) explained

Published: 13 May 2025

Cognitive behavioural therapy or CBT is a type of therapy that changes the way you think about your problems and how you behave. It can be used to treat a wide range of mental health conditions. It's very effective for treating anxiety and depression.

In this guide, we explain what CBT is, how it works and what it can be used for. We’ll also clarify what you can expect during a CBT session how a private medical insurance can help you access treatments when you need them.

What is CBT therapy?

Cognitive behavioural therapy (CBT) is a talking therapy that helps you cope with your thoughts and feelings. It investigates how your thoughts about a problem affect how you feel and behave.

Cognitive therapy focuses on what you think, and behaviour therapy looks at what you do.

For example, if you have negative thoughts about a situation, you may also have negative feelings towards that situation. This in turn leads you to behave in a certain way.

CBT provides you with the skills to challenge your negative thoughts and change your behaviour in a positive way. It breaks down your problems into manageable chunks and helps you find practical ways to deal with each one. CBT tends to deal with current issues rather than focus on what’s happened in the past.

Read more: Types of therapy and how they can help you

What conditions can cognitive behavioural therapy treat?

Cognitive behavioural therapy (CBT) is a recommended treatment for many mental health problems, such as1:

  • depression, including postnatal depression
  • anxiety, including social anxiety, phobias and obsessive compulsive disorder (OCD)
  • post-traumatic stress disorder (PTSD)
  • eating disorders, including anorexia and bulimia
  • bipolar disorder
  • personality disorders

CBT can also help with other conditions including1:

  • sleep problems, such as insomnia
  • problems with alcohol and drugs
  • long-term pain
  • irritable bowel syndrome (IBS)
  • chronic fatigue syndrome (CFS)

Using CBT to treat anxiety

Feeling anxious is part of being human. But when it starts to affect your everyday life, it’s time to seek help. Cognitive behavioural therapy is one way to manage your anxious thoughts and feelings. It can help you examine what causes your anxiety and take steps to modify your response to feel less anxious. 2

For example - you get anxious when faced with social situations. You develop negative feelings towards socialising, so you stop going out to meet your friends. Avoiding socialising may make you feel better in the short term. But it doesn't stop the anxiety happening again next time you’re asked out. 

CBT helps you to unpick why you feel anxious and challenges your thinking. It makes you look objectively at a situation and reframe how you feel about it. You can then put these techniques into practice by taking part in the activity that makes you anxious. Over time, your anxiety should lessen as you realise that your greatest worries are unlikely to happen.

Using CBT to treat depression

CBT can be effective when treating mild to moderate cases of depression3. The techniques used help patients understand their negative thinking patterns. Such as dismissing positive experiences and automatically having a negative reaction to events.

When thinking patterns are identified, CBT can help patients modify their distorted thoughts. It teaches a patient how to reframe their situation in a positive rather than negative light. Eventually patients are able to recognise a depressive thought and manage it effectively. 

CBT for ADHD

Attention deficit hyperactivity disorder is a condition that affects the way the brain works. In children, ADHD is linked to a lack of concentration, being hyperactive or impulsive.

CBT for ADHD focuses on reshaping unhelpful thought patterns and developing practical skills to manage the everyday challenges associated with the condition. CBT exercises for ADHD are designed to address the specific challenges ADHD brings, such as difficulty maintaining focus, managing time, or completing tasks.4

CBT teaches practical techniques to help individuals manage their time more effectively and improve their organisational skills. It helps individuals identify and challenge negative thought patterns that can contribute to emotional distress, teaching techniques to pause, reflect, and respond more thoughtfully. Also, CBT empowers individuals by giving them practical strategies to manage their symptoms, leading to increased confidence and a sense of accomplishment.4

CBT for IBS

Irritable bowel syndrome (IBS) is a gastrointestinal disorder that is linked to how your gut and brain work together.

CBT can help reduce physical symptoms of IBS as well as reducing anxiety and depression.5. When people with IBS experience stress, they can also suffer a flare up of their IBS. It’s not a cure for IBS, but CBT can be used as a tool to reduce stress and therefore reduce the severity of a flare up.

CBT for insomnia

People with insomnia can often develop anxious thoughts about getting to sleep.

Cognitive behavioural therapy for insomnia (CBT-I) is the first line treatment for long term insomnia in adults of any age. This focuses on exploring the connection between the way we think, the things we do, and how we sleep. This treatment helps to identify thoughts, feelings and behaviours that are contributing to the symptoms of insomnia.6

CBT for teenagers and younger children

Cognitive behavioural therapy is suitable for a wide range of ages, including children. CBT has been found to help young people with a wide range of problems, including: low self-esteem, depression, anxiety problems, obsessive-compulsive disorder (OCD), post–traumatic stress disorder (PTSD). There is increasing evidence that CBT can work well for other problems like sleep disorders.7

CBT helps to replace negative thoughts with more positive ones. Children are given the skills to identify unhealthy thoughts and behaviours and the tools to change that behaviour.

Adolescence is a particularly difficult time for children. A change in hormones and intensive social pressures can increase anxiety levels. Teenagers can be taught coping techniques to deal with mood swings and boost their self-esteem.

How does CBT therapy work?

CBT recognises that your thoughts, emotions, physical symptoms and actions are all connected. It deals with your current thoughts and feelings to challenge negative thoughts and change behaviours.

Although CBT focuses on a specific problem, such as anxiety, that anxiety will manifest itself in various ways. You’ll be taught techniques that will help you tackle each problem that arises because of the anxiety. These problems are broken down into goals you need to achieve. You and your therapist will work together to put these goals in place, but it’s up to you to do the work involved.

Some of this work will be done outside of your therapy sessions. Then when you meet up again, your therapist will help you work through how you felt and what you can do next to progress your treatment. 

What happens in CBT therapy?

When you start CBT sessions you’ll be assessed by your therapist. They’ll ask about your life and background and if you’ve been treated previously for your condition. And they’ll ask you to talk about what’s troubling you. From this initial assessment they can make sure CBT is the right option for you and form a treatment plan.

During follow up sessions, you’ll work with your therapist to understand the thought processes around your problems. You’ll assess each problem and try to break it down into manageable sections. Your therapist will help you identify the thoughts and feelings that are impacting your day-to-day life. Once you’ve identified these, you can work on changing those negative thoughts and behaviours.

You’ll be given techniques you can use in your daily life. These techniques will often involve challenging negative thoughts and focusing on positive ones. And recognising unhelpful behaviours so you can stop yourself doing them.

Away from each session you’ll be expected to put these techniques into practice. You may also be asked to keep a journal about the times you needed to use the techniques. At your next session, you and your therapist can use this record to discuss how you got on. Depending on the outcome your therapist will suggest next best steps. They won’t make you do anything you’re not comfortable with.

Sessions usually last from 30-60 minutes and happen once a week. Depending on how you progress you could see a significant change in six sessions. But it’s not uncommon to have up to 20 sessions.

CBT therapy techniques

There are a range of techniques used in CBT, from keeping a journal about your negative thoughts, to exposure therapy. Common techniques include:

  • Journaling to help identify thought patterns
  • Challenging distorted thinking as the thoughts arise
  • Relaxed breathing techniques
  • Muscle relaxation and mindfulness
  • Reframing upsetting thoughts to change behaviours
  • Exposure therapy

Exposure therapy is where your fears are tested in a controlled environment. It can help you face your fears step by step. You and your therapist will come up with different scenarios that you’ll need to face. You’ll start with a situation that makes you anxious but is tolerable. When you’re confident in this situation, you’ll progress to a more difficult situation until you feel you’re able to cope.

What are the pros and cons of cognitive behavioural therapy?

Pros

  • Widely available and very effective
  • You can often see results quite quickly
  • Helps you to help yourself
  • Techniques can be used in everyday life

Cons

  • Not suitable for everyone
  • You need to commit time and energy to changing your thoughts and behaviours
  • You may feel out of your comfort zone for a time as you progress
  • Focuses on one problem, not wider mental health or family issues

How can I get CBT?

You can speak to your GP or refer yourself to NHS talking therapies. There are services right across the country.

Self-help support is also available. There are many resources online, but make sure you use a trusted source, like Every Mind Matters.

Does private health insurance cover CBT?

You can also access CBT through your private health insurance. Most plans include a certain number of online or face-to-face therapy sessions. At Vitality, we provide up to 8 talking therapy sessions each plan year which includes CBT. You can refer yourself for treatment and choose the mental health professional you want to see from a list of approved providers. We also include a subscription to Headspace which provides CBT-based self-help for anxiety.

Plus, you can choose enhanced mental health cover when you take out your plan. This includes full talking therapies cover, in-patient, day-patient and out-patient cover.

Find out more about

Vitality mental health cover

Why choose Vitality health insurance?

Want to know more about private health insurance or thinking about taking out a policy? Here are some of the benefits of taking out health insurance with Vitality: 

  • Get video GP appointment quickly
  • Avoid lengthy hospital waiting lists
  • Get specialist drugs and treatments
  • See a consultant fast
  • Refer yourself for physiotherapy
  • Get mental health support fast and without a GP referral
  • Get menopause support
  • Get discounts from top brands. And rewards for getting healthy.
Get your health insurance quote today

Cognitive behavioural therapy FAQs

What is CBT group therapy?

Group therapy allows a group of patients with a similar mental health problem to come together for CBT. It provides a safe place for people to practice the CBT techniques they’ve learned in the sessions. And it provides a ready-made support network.

How to prepare for CBT therapy?

Your therapist will tell you what they expect you to do between sessions. But it’s usually a good idea to keep a note of how you’re feeling each day and any upsetting thoughts you have. You can use this information to work on during your next session.

How does CBT differ from different forms of therapy?

CBT is different to other psychotherapies because it’s not just talking about your feelings. It’s about changing behaviours. It deals with the here and now and doesn’t dwell on your past life. It takes a pragmatic approach that expects you to work hard on changing your intrusive thoughts and behaviours.

How long is CBT therapy?

Sessions usually last from 30-60 minutes and happen once a week. Depending on how you progress you could see a significant change in six sessions. But it’s not uncommon to have up to 20 sessions.

What is the difference between talk therapy and CBT?

CBT is a type of talking therapy, but unlike traditional talk therapy it requires you to make a concerted effort to change how you think and behave. It’s very structured, so you can see results quite quickly. Talk therapy allows you to express your thoughts in a safe environment. CBT teaches you to recognise negative thoughts and change how you deal with them.

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  • Does health insurance cover mental health?

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  • How does private health insurance work?

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  • How much does health insurance costs?

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