What is Cognitive Behavioral Therapy? - Definition & Explanation

Instructor: Alyssa Gilston
Cognitive behavioral therapy is a short-term approach to treatment in which a client and therapist work together to identify and restructure the client's negative thoughts. The key tenet is that our thoughts influence our behaviors and feelings.

Cognitive Behavioral Therapy: Definition

Cognitive behavioral therapy (CBT) is a short-term, structured form of psychotherapy that focuses on the client's present. In this model of therapy, the clinician and the client work as a team to identify the client's dysfunctional and distorted thoughts and beliefs, and both challenge and modify those thoughts and attitudes. Using this model, the client is educated on the relationship between his or her thoughts, feelings, and behaviors. Current research supports the use of CBT for the treatment of anxiety disorders, mood disorders, substance abuse, and personality disorders, just to name a few.

During CBT, the clinician will identify and challenge a client's negative thought patterns. She will also help the client understand the impact those thoughts have on his behavior and feelings. By doing this, the clinician and the client will be able to come up with alternative thoughts that lead to more positive feelings and behaviors.


Principles of CBT

There are 10 principles of CBT that clinicians follow.

  1. CBT is based on an evolving formulation of the client in cognitive terms. From the initial session, the therapist will develop a case conceptualization, which is basically an understanding of how the disorder developed, and continue to expand on this throughout treatment.
  2. For CBT to be effective, the therapist and the client must establish a strong therapeutic alliance. The therapist needs to be both supportive and empathetic with the client, and establishing rapport from the beginning is very important.
  3. The client's active participation and collaboration are emphasized. The client and therapist will work together to set goals and develop the treatment plan, and some clients will even create their own homework assignments.
  4. CBT is problem-focused. By remaining focused on the list of problems the client and therapist identify, clear treatment goals and objectives may be produced.
  5. Since CBT is present-focused, current problems are discussed. While there may be some mention of past behaviors or thoughts, therapy takes place with a focus on the here and now.
  6. The clinician educates the client about relapse prevention and helps to empower the client to be his or her own therapist. Empowering the client is vital for effective treatment.
  7. CBT is short-term, usually between 4 and 14 sessions, as opposed to say psychodynamic approaches which can last for years.
  8. Therapy sessions are highly structured. The structure of sessions will remain relatively fixed for the duration of treatment. The therapist and client will set an agenda and address all items on the list each week.
  9. CBT helps clients identify, evaluate and respond to their dysfunctional thoughts or beliefs. This is accomplished using a wide variety of techniques.
  10. Homework is a central component of CBT. Homework can consist of virtually any assignment that can monitor and assist the client in seeing the connections between his thoughts and his feelings and behaviors.

Components of CBT

Two key components of CBT are core beliefs and automatic thoughts.

Core beliefs are the most central beliefs that people have about themselves, others and the world around them. A client will begin to develop these ideas in childhood as he interacts with others in his world. Some cognitive therapists also use the word schemas to describe core beliefs.

Core beliefs can be positive or negative. Positive core beliefs would include thoughts like 'I am likeable' or 'I am competent and in control,' and these clients are not usually seen in treatment. Negative core beliefs tend to fall into two categories: helplessness and unlovability. Examples of helpless core beliefs include 'I am helpless,' 'I am weak,' or 'I am a failure.' Examples of core beliefs that fall in the unlovable category are 'I am bad,' 'I am unlovable,' or 'I am unworthy.'

Automatic thoughts are the thoughts that just pop into the client's head in any given scenario. They are different from core beliefs in that they relate to the thinking that the client engages in on a regular basis and is likely not aware of at all. Automatic thoughts are quite brief and most people are usually more aware of the emotion that goes along with the thought rather than the thought itself.

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