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Depression

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11 effective cognitive behavioral therapy techniques and how professionals use them

Written by Saya Des Marais

Published: Jan 3, 2024

Medically Reviewed by Dr. Geralyn Dexter

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Cognitive-behavioral therapy, or CBT, is a type of psychotherapy (talk therapy) based on the theoretical foundation that thoughts, feelings, and behaviors are all connected. It assumes most emotional distress results from dysfunctional thinking patterns and/or behaviors. It’s the most widely used and studied among the types of therapy.  

In this article, we dive into specific cognitive behavioral therapy techniques that mental health professionals use and how they might benefit you.

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How effective is CBT in treating mental health issues?

According to the Beck Institute, named after CBT’s founder, there are more than 2,000 research studies show that CBT is effective for a wide range of mental and physical health conditions, including:

CBT has earned the title of the “gold standard of psychotherapy” for good reason. A meta-analysis of studies of CBT originally published in Cognitive Behavioral Therapy confirmed CBT as an evidence-based approach that’s effective for treating a variety of conditions.

Types of cognitive behavioral therapy

The term “cognitive-behavioral therapy” is an umbrella term that describes a number of specific mental health treatments that use the principles of CBT. These treatments are stand-alone treatment methods on their own but fall within the cognitive-behavioral family of treatments. Many of these types of CBT are used to address specific mental health disorders.

Following are some of the most widely used therapy methods generally considered to be types of CBT.

Acceptance and commitment therapy (ACT)

Acceptance and commitment therapy (ACT) uses mindfulness and CBT principles to help you accept painful emotions instead of pushing them away. While traditional CBT encourages you to change negative thinking patterns, ACT encourages acceptance and nonjudgment. By doing this, you can have a less stressful relationship with your internal experiences and find mental peace.

Dialectical behavior therapy (DBT)

Dialectical behavior therapy (DBT) also combines principles of CBT with mindfulness. DBT was created to help suicidal women with complex problems. It’s now considered the most effective treatment for people with borderline personality disorder or suicidal thoughts and behaviors.

Exposure and response prevention (ERP)

Exposure and response prevention (ERP) is the type of CBT that is most effective for people with obsessive-compulsive disorder (OCD). Rather than focusing on changing thoughts, which often doesn’t work for people with OCD, ERP helps people with OCD expose themselves to their scariest thoughts without responding with an OCD compulsion. In this way, ERP is more behavioral therapy than cognitive therapy.

Rational emotive behavior therapy (REBT)

Rational emotive behavior therapy (REBT) came before CBT and is considered the pioneering form of CBT. Just like the broader form of CBT, REBT helps you challenge irrational thoughts. But REBT and CBT have some key differences, one being that REBT helps you tell the difference between helpful negative emotions and self-destructive (unhelpful) negative emotions. In addition, REBT dives more deeply into the life philosophies that lead you to have the thoughts to begin with.

There are many other types of therapies that fall under the CBT umbrella. CBT techniques may also be used with any number of CBT therapies. CBT therapists use specific therapeutic techniques to help you change thoughts and behaviors  (to reach the ultimate goal of overcoming mental health problems and feeling better).

11 effective cognitive behavioral therapy techniques

Within the various CBT treatment methods, therapists use specific techniques or strategies. Here are 11 effective cognitive behavioral therapy techniques and strategies used within several different types of CBT.

1. Behavioral activation

Depression is often accompanied by low energy, low motivation, and a lack of interest in life activities. Behavioral activation is a CBT technique that tackles depression-related sluggishness and helps improve mood. It has you identify and engage in activities that bring joy and a sense of accomplishment, even when (or, perhaps, especially when) you are not motivated to.

For example, behavioral activation might help you exercise even when depressed. Exercise is one of the most effective strategies to cope with depression, but when you’re depressed, it can be difficult to get yourself to work out.

2. Mindfulness techniques

Mindfulness is a practice used in several different CBT-based therapies, including DBT and mindfulness-based cognitive therapy (MBCT). Mindfulness is about staying present in the here and now, even when the present is painful. This lets you have a less conflicted relationship with your thoughts, feelings, and experiences.

Although mindfulness originates from Eastern spirituality, it’s now used secularly as a component of several different CBT methods. Mindfulness techniques like meditation have been shown to reduce symptoms of depression, anxiety, and PTSD.

3. Cognitive restructuring

Cognitive restructuring is one of the main strategies used in CBT. It helps you to identify and challenge unhelpful thoughts and replace them with more balanced and realistic ones. By practicing this skill over time, you get better at preventing negative thinking patterns from controlling you.

For example, you might often have the thought, “I’m a failure. Everyone can see through me.” Using cognitive restructuring, your therapist might help you identify that these aren’t helpful or accurate thoughts. They can help you recognize that the thoughts are irrational and replace them with thoughts that make you feel more positive.

4. Exposure 

If you live with anxiety, you likely try to avoid the things that trigger it. But avoiding your fears doesn’t make them go away. CBT therapists help you expose yourself to your fears gradually and safely.

Exposure is the most effective strategy for certain mental health conditions, such as phobias and social anxiety disorder. It involves gradual and controlled exposure to the fear, whether that’s social situations or spiders. To put it simply, exposure therapy is about facing your fears. It helps you build resilience and conquer your anxieties.

5. Stress management techniques

Stress is an unavoidable part of life. CBT therapists help you equip yourself with coping skills to handle stressful situations that may occur in the future. 

With your therapist, you explore what triggers your stress, learn coping skills that you can use in moments of high stress, and plan how to manage stressful situations when they arise. Your CBT therapist can also teach you new stress management strategies to cope with times of stress.

6. Problem-solving

Problem-solving is a technique often used with CBT that helps you take action to solve problems. Your therapist may teach you techniques for thinking through a problem and brainstorming solutions. This strategy focuses on identifying problems that get in your way, looking at all possible solutions without judgment, and choosing the solution that’s ultimately the best for you and your life. 

For example, if you struggle with procrastination and know it’s a problem in your life, your CBT therapist can help you brainstorm possible solutions to the problem and weigh their pros and cons without judgment. Potential solutions could be hiring an assistant, time-blocking your calendar, and/or getting evaluated for ADHD. With the support of your therapist, you can choose and follow through with the solution that works for you.

7. Relaxation training

Relaxation training is a form of behavior therapy often thought of as a CBT technique. With relaxation training, therapists teach you techniques like deep breathing exercises and progressive muscle relaxation, which are shown to help relax your body’s stress response. After teaching you these relaxation strategies, your CBT therapist guides you in practicing them on a regular basis. This can help decrease stress and make you more resilient to life’s challenges.

8. Goal setting

CBT uses goal-setting to help you set goals for your treatment process as well as in your life. In CBT, setting goals is about creating clear, achievable objectives. Together with your therapist, you can examine what your deepest life values are and set goals that bring you closer to living those values. Goal-setting in CBT provides direction and motivation and keeps you moving forward, even when times get tough.

9. Assertiveness training

Being assertive is a challenge for people who live with mental health conditions like depression or anxiety. Assertiveness training is a CBT technique that teaches effective communication and helps you express your needs and feelings confidently and respectfully. Your CBT therapist might practice assertiveness skills in sessions or give you homework to practice with others.

10. Journaling and thought logs

Journaling, when used as part of CBT, is done a certain way. For example, simply writing about your day isn’t a CBT technique. With CBT journaling, your therapist has you write about unhealthy thoughts and behaviors that you notice during the day, as well as keep logs of the coping skills you use. This is sometimes called a thought log.

For example, you might combine journaling and behavioral activation by writing about how you felt before, during, and after doing an enjoyable activity. You bring this journal log into a therapy session, and go over insights you gained with your therapist.

11. Cognitive distraction techniques

Cognitive distractions are often used in DBT. They involve redirecting your thoughts away from emotional pain. They can be very helpful for people feeling suicidal. Cognitive distraction on its own won’t help you overcome mental health problems. It’s important to address symptoms directly. Distraction can be a great technique to practice getting your mind away from thoughts that cause intense emotional pain.

In session, you and your therapist discuss healthy distractive strategies. For example, you might watch a funny movie, call a friend, or stick your hands in ice water. The next time you feel emotionally overwhelmed, you can try these distraction strategies and report back to your therapist on their effectiveness.

Look into CBT by finding a therapist on Klarity today

On Klarity, get connected with a qualified cognitive-behavioral therapist who can use one or more of these techniques to help you overcome mental health challenges and negative thoughts. Get started and find a mental health professional on Klarity today.

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