Cognitive Behavioral Therapy (CBT) is today the most widely studied psychotherapeutic approach in the world. Hundreds of randomized clinical trials confirm its effectiveness for a wide range of psychological disorders. Here's what you need to know.
What is CBT?
CBT is a form of psychotherapy founded on the link between thoughts, emotions, and behaviors. It rests on a central principle: our thoughts influence our emotions, which influence our behaviors — and this cycle can become self-perpetuating, both positively and negatively.
Born in the 1960s with the work of Aaron Beck (cognitive therapy) and Albert Ellis (REBT), CBT has evolved to integrate new approaches such as ACT (Acceptance and Commitment Therapy) and schema therapy.
How does a CBT session proceed?
Typical structure
- Duration: 10 to 20 sessions on average (vs. years for some psychoanalytic therapies)
- Frequency: typically weekly
- Format: active and collaborative — the therapist doesn't interpret, but guides
- Homework: practical exercises between sessions (thought journals, exposures)
The phases
- Assessment: identify target problems, automatic thoughts, and beliefs
- Psychoeducation: understand the cognitive model (why we think what we think)
- Cognitive restructuring: identify and modify dysfunctional thoughts
- Behavioral work: gradual exposures, behavioral activation
- Consolidation: relapse prevention, self-management
Key concepts of CBT
Automatic thoughts
These are thoughts that arise instantly in response to a situation, without conscious effort. They are often negative, rapid, and seem very true. Examples: "I'm going to fail", "They hate me", "I'm useless".
Cognitive distortions
These are systematic thinking biases that distort reality:
- Black-and-white thinking: all or nothing ("If I'm not perfect, I'm a failure")
- Catastrophizing: amplifying negative consequences
- Personalization: feeling responsible for everything
- Mind reading: assuming you know what others are thinking
- Overgeneralization: "it always fails", "I never succeed"
- Minimization: ignoring successes, amplifying failures
Core beliefs (schemas)
Behind automatic thoughts lie deeper beliefs, formed since childhood: "I am fundamentally incompetent", "I am unlovable", "The world is dangerous". Advanced CBT (schema therapy developed by Jeffrey Young) works on these deeper layers.
What disorders is CBT effective for?
CBT has the highest level of evidence (meta-analyses) for:
- Depression (as effective as antidepressants, with fewer relapses)
- Anxiety disorders: GAD, social phobia, panic disorder, agoraphobia
- OCD (with exposure and response prevention)
- PTSD / post-traumatic stress disorder
- Chronic insomnia (CBT-I, first-line treatment before sleeping pills)
- Eating disorders: bulimia, binge eating
- Chronic pain
- Substance use disorders (alcohol, drugs)
CBT vs other therapies
| Criterion | CBT | Psychoanalysis |
|---|---|---|
| Duration | 10-20 sessions | Several years |
| Approach | Present / future | Past / unconscious |
| Validation | Very high (RCT) | Limited |
| Homework | Yes (essential) | No |
Can you do CBT online or with AI?
CBT is particularly well-suited to digital formats, as it relies on structured techniques, reproducible exercises, and measurable progress. Studies show that computer-guided CBT produces outcomes comparable to face-to-face CBT for moderate disorders.
Tools like Sophie PSY allow you to practice CBT techniques (thought journals, PHQ-9 / GAD-7 questionnaires, psychoeducation) between sessions or as a first-line option, with the advantage of 24/7 availability.
How to get started?
If you want to explore CBT:
- Consult a psychologist trained in CBT (check professional directories or the American Psychological Association)
- Use structured resources while waiting for professional support
- Start by keeping a journal of automatic thoughts — this is the first universal CBT exercise