View source for Cognitive behavioral therapy

{{Short description|Type of therapy to improve mental health}}
{{about|therapy|the journal|Cognitive Behaviour Therapy (journal){{!}}''Cognitive Behaviour Therapy'' (journal)|other uses of the acronym 'CBT'|CBT (disambiguation){{!}}CBT}}
{{Use American English|date=October 2020}}
{{Use dmy dates|date=July 2022}}
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<div class="skin-invert-image">{{Infobox medical intervention
|image=Cognitive behavioral therapy - basic tenets.svg
|caption=The triangle in the middle represents CBT's tenet that all humans' core beliefs can be summed up in three categories: self, others, future.
|ICD10=GZ58ZZZ
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|MeshID=D015928
|OPS301=
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'''Cognitive behavioral therapy''' ('''CBT''') is a form of [[psychotherapy]] that aims to reduce symptoms of various mental health conditions, primarily depression, and disorders such as [[PTSD]] and [[anxiety disorder]]s. This therapy focuses on challenging unhelpful and irrational negative thoughts and beliefs, referred to as 'self-talk' and replacing them with more rational positive self-talk. This alteration in a person's thinking produces less anxiety and depression. It was developed by [[psychoanalyst]] [[Aaron Beck]] in the 1950's.<ref name=Handbook6>{{Cite book|vauthors=Hollon SD, Beck AT| veditors = Lambert MJ |title=Bergin and Garfield's Handbook of Psychotherapy}}</ref><ref name=CBT>{{citation|vauthors=Beck JS|year=2011|title=Cognitive behavior therapy: Basics and beyond|edition=2nd|pages=19–20|location=New York|publisher=The Guilford Press}}</ref><ref name=ABCs>{{citation|title=The New ABCs: A Practitioner's Guide to Neuroscience-Informed Cognitive-Behavior Therapy|vauthors=Field TA, Beeson ET, Jones LK|year=2015|journal=Journal of Mental Health Counseling|volume=37|issue=3|pages=206–20|doi=10.17744/1040-2861-37.3.206|url=http://www.n-cbt.com/uploads/7/8/1/8/7818585/n-cbt_researchpacket_newabcsmanuscript_advancecopy.pdf|access-date=6 July 2016|archive-url=https://web.archive.org/web/20160815153718/http://www.n-cbt.com/uploads/7/8/1/8/7818585/n-cbt_researchpacket_newabcsmanuscript_advancecopy.pdf|archive-date=15 August 2016}}</ref> 

Cognitive behavioral therapy focuses on challenging and changing [[cognitive distortion]]s (thoughts, beliefs, and attitudes) and their associated behaviors in order to improve [[emotional regulation]] and help the individual develop [[Coping|coping strategies]] to address problems.<ref name="CBT" /><ref name="Benjamin">{{citation |title=History of cognitive-behavioral therapy in youth |vauthors=Benjamin CL, Puleo CM, Settipani CA |journal=Child and Adolescent Psychiatric Clinics of North America |volume=20 |issue=2 |pages=179–189 |year=2011 |doi=10.1016/j.chc.2011.01.011 |pmc=3077930 |pmid=21440849 |display-authors=et al}}</ref> Though originally designed as an approach to treat [[Major depressive disorder|depression]], CBT is often prescribed for the evidence-informed treatment of many [[mental health]] and other conditions, including [[Obsessive–compulsive disorder|OCD]],<ref>{{cite journal | vauthors = McKay D, Sookman D, Neziroglu F, Wilhelm S, Stein DJ, Kyrios M, Matthews K, Veale D | display-authors = 6 | title = Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder | journal = Psychiatry Research | volume = 225 | issue = 3 | pages = 236–246 | date = February 2015 | pmid = 25613661 | doi = 10.1016/j.psychres.2014.11.058 | s2cid = 1688229 | url = https://kclpure.kcl.ac.uk/portal/en/publications/efficacy-of-cognitivebehavioral-therapy-for-obsessivecompulsive-disorder(a4cc99db-c558-472b-ab4a-548bd9c08f29).html }}</ref> [[generalized anxiety disorder]],<ref>{{cite journal | vauthors = Zhu Z, Zhang L, Jiang J, Li W, Cao X, Zhou Z, Zhang T, Li C | display-authors = 6 | title = Comparison of psychological placebo and waiting list control conditions in the assessment of cognitive behavioral therapy for the treatment of generalized anxiety disorder: a meta-analysis | journal = Shanghai Archives of Psychiatry | volume = 26 | issue = 6 | pages = 319–331 | date = December 2014 | pmid = 25642106 | pmc = 4311105 | doi = 10.11919/j.issn.1002-0829.214173 }}</ref> substance use disorders, marital problems, [[ADHD]], and [[eating disorder]]s.<ref name="Agras">{{cite journal | vauthors = Agras WS, Bohon C | title = Cognitive Behavioral Therapy for the Eating Disorders | journal = Annual Review of Clinical Psychology | volume = 17 | issue = 1 | pages = 417–438 | date = May 2021 | pmid = 33962536 | doi = 10.1146/annurev-clinpsy-081219-110907 | s2cid = 233998712 |s2cid-access=free | doi-access = free }}</ref><ref name="Powell">{{cite journal | vauthors = Powell K |title=Searching for a better treatment for eating disorders |journal=Knowable Magazine |date=16 December 2021|doi-access=free |doi=10.1146/knowable-121621-1 |url=https://knowablemagazine.org/article/mind/2021/searching-better-treatment-eating-disorders |access-date=23 December 2021 |language=en |url-status=live |archive-url=https://web.archive.org/web/20211222204950/https://knowablemagazine.org/article/mind/2021/searching-better-treatment-eating-disorders |archive-date= Dec 22, 2021|url-access=subscription }}</ref><ref name=":4">{{Cite web|title=What is Cognitive Behavioral Therapy? |author=((APA Div. 12 (Society of Clinical Psychology))) |date=2017 |url=https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral |access-date=10 May 2021 |publisher=[[American Psychological Association]]}}</ref><ref name="KnouseLE" /> CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.<ref>{{cite journal | vauthors = Johansson R, Andersson G | title = Internet-based psychological treatments for depression | journal = Expert Review of Neurotherapeutics | volume = 12 | issue = 7 | pages = 861–869; quiz 870 | date = July 2012 | pmid = 22853793 | doi = 10.1586/ern.12.63 | s2cid = 207221630 | doi-access = free }}</ref><ref>{{cite journal | vauthors = David D, Cristea I, Hofmann SG | title = Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy | journal = Frontiers in Psychiatry | volume = 9 | article-number = 4 | date = 29 January 2018 | pmid = 29434552 | pmc = 5797481 | doi = 10.3389/fpsyt.2018.00004 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Hofmann SG, Asmundson GJ, Beck AT | title = The science of cognitive therapy | journal = Behavior Therapy | volume = 44 | issue = 2 | pages = 199–212 | date = June 2013 | pmid = 23611069 | doi = 10.1016/j.beth.2009.01.007 }}</ref>

CBT is a common form of talk therapy based on the combination of the basic principles from [[Behaviorism|behavioral]] and [[cognitive psychology]].<ref name=CBT/> It is different from other approaches to psychotherapy, such as the [[psychoanalytic]] approach, where the therapist looks for the unconscious meaning behind the behaviors and then formulates a diagnosis. Instead, CBT is a "problem-focused" and "action-oriented" form of therapy, meaning it is used to treat specific problems related to a diagnosed [[mental disorder]]. The therapist's role is to assist the client in finding and practicing effective strategies to address the identified goals and to alleviate symptoms of the disorder.<ref name=Schacter>{{citation|vauthors=Schacter DL, Gilbert DT, Wegner DM|year=2010|title=Psychology|edition=2nd|page = 600|location=New York|publisher=Worth Pub}}</ref> CBT is based on the belief that [[Cognitive distortion|thought distortions]] and [[maladaptive]] behaviors play a role in the development and maintenance of many [[psychological disorder]]s and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.<ref name="ABCs" /><ref name=Handbook6/><ref name=Schacter/><ref>{{cite journal | vauthors = Brewin CR | title = Theoretical foundations of cognitive-behavior therapy for anxiety and depression | journal = Annual Review of Psychology | volume = 47 | pages = 33–57 | year = 1996 | pmid = 8624137 | doi = 10.1146/annurev.psych.47.1.33 }}</ref>

When compared to [[psychoactive medication]]s, review studies have found CBT alone to be as effective for treating less severe forms of depression,<ref>{{cite journal | vauthors = Gartlehner G, Wagner G, Matyas N, Titscher V, Greimel J, Lux L, Gaynes BN, Viswanathan M, Patel S, Lohr KN | display-authors = 6 | title = Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews | journal = BMJ Open | volume = 7 | issue = 6 | article-number = e014912 | date = June 2017 | pmid = 28615268 | pmc = 5623437 | doi = 10.1136/bmjopen-2016-014912 }}</ref> and [[borderline personality disorder]].<ref>{{cite journal | vauthors = Davidson K, Tyrer P, Gumley A, Tata P, Norrie J, Palmer S, Millar H, Drummond L, Seivewright H, Murray H, Macaulay F | display-authors = 6 | title = A randomized controlled trial of cognitive behavior therapy for borderline personality disorder: rationale for trial, method, and description of sample | journal = Journal of Personality Disorders | volume = 20 | issue = 5 | pages = 431–449 | date = October 2006 | pmid = 17032157 | pmc = 1847748 | doi = 10.1521/pedi.2006.20.5.431 }}</ref> Some research suggests that CBT is most effective when combined with medication for treating mental disorders such as major depressive disorder.<ref name="pmid15315995">{{cite journal | vauthors = March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J | collaboration =  Treatment for Adolescents With Depression Study (TADS) Team | display-authors = 6 | title = Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial | journal = JAMA | volume = 292 | issue = 7 | pages = 807–820 | date = August 2004 | pmid = 15315995 | doi = 10.1001/jama.292.7.807 | doi-access = free }}</ref> CBT is recommended as the first line of treatment for the majority of psychological disorders in children and adolescents, including aggression and [[conduct disorder]].<ref name=Handbook6/><ref name=Benjamin/> Researchers have found that other ''[[bona fide]]'' therapeutic interventions were equally effective for treating certain conditions in adults.<ref name="Baardseth_2013" >{{cite journal | vauthors = Baardseth TP, Goldberg SB, Pace BT, Wislocki AP, Frost ND, Siddiqui JR, Lindemann AM, Kivlighan DM, Laska KM, Del Re AC, Minami T, Wampold BE | display-authors = 6 | title = Cognitive-behavioral therapy versus other therapies: redux | journal = Clinical Psychology Review | volume = 33 | issue = 3 | pages = 395–405 | date = April 2013 | pmid = 23416876 | doi = 10.1016/j.cpr.2013.01.004 }}</ref><ref name=Shedler>{{cite journal | vauthors = Shedler J | title = The efficacy of psychodynamic psychotherapy | journal = The American Psychologist | volume = 65 | issue = 2 | pages = 98–109 | year = 2010 | pmid = 20141265 | doi = 10.1037/a0018378 | url = http://efpp.org/texts/shedler.pdf | access-date = 26 October 2017 | citeseerx = 10.1.1.607.2980 | s2cid = 2034090 | archive-url = https://web.archive.org/web/20170809002222/http://efpp.org/texts/shedler.pdf | archive-date = 9 August 2017 }}</ref> Along with [[interpersonal psychotherapy]] (IPT), CBT is recommended in treatment guidelines as a psychosocial treatment of choice.<ref name=Handbook6/><ref name = "Barth_2013">{{cite journal | vauthors = Barth J, Munder T, Gerger H, Nüesch E, Trelle S, Znoj H, Jüni P, Cuijpers P | display-authors = 6 | title = Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis | journal = PLOS Medicine | volume = 10 | issue = 5 | article-number = e1001454 | year = 2013 | pmid = 23723742 | pmc = 3665892 | doi = 10.1371/journal.pmed.1001454 | doi-access = free }}</ref> It is recommended by the [[American Psychiatric Association]],<ref>{{Cite journal |date=1998 |title=Practice guidelines for the treatment of patients with panic disorder |journal=[[American Journal of Psychiatry]] |pages=1–34}}</ref> the [[American Psychological Association]],<ref>{{Cite journal |last1=Chambless |last2=Baker |last3=Baucom |last4=Beutler |last5=Calhoun |last6=Crits-Christoph |date=1998 |title=Update on empirically validated therapies |journal=[[The Clinical Psychologist]] |pages=51, 3–16}}</ref> and the [[National Health Service|British National Health Service]].<ref>{{Cite book |last1=McIntosh |first1=A. |title=Clinical guidelines and evidence review for panic disorder and generalized anxiety disorders |last2=Cohen |first2=A. |last3=Turnbull |first3=N. |last4=Esmonde |first4=L. |last5=Dennis |first5=P. |last6=Eatock |first6=J. |date=2004 |publisher=Sheffield, UK: University of Sheffield/London: National Collaborating Centre for Primary Care}}</ref>  Critics argue CBT's benefits are overstated, citing small or declining effects, high dropouts, [[Neoliberalism|neoliberal]] influences, and methodological flaws, though it remains widely used and considered safe.

==History==

=== Philosophy ===
Precursors of certain fundamental aspects of CBT have been identified in various ancient philosophical traditions, particularly [[Stoicism]].<ref>{{Cite book |author=Donald Robertson |url=https://books.google.com/books?id=XsOFyJaR5vEC&pg=PR19 |title=The Philosophy of Cognitive-Behavioural Therapy: Stoicism as Rational and Cognitive Psychotherapy |publisher=Karnac |year=2010 |isbn=978-1-85575-756-1 |location=London |page=xix}}</ref> Stoic philosophers, particularly [[Epictetus]], believed logic could be used to identify and discard false beliefs that lead to destructive emotions, which has influenced the way modern cognitive-behavioral therapists identify cognitive distortions that contribute to depression and anxiety. [[Aaron T. Beck]]'s original treatment manual for depression states, "The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers".<ref>{{cite book |title=Cognitive Therapy of Depression |vauthors=Beck AT, Rush AJ, Shaw BF, Emery G |publisher=Guilford Press |year=1979 |isbn=978-0-89862-000-9 |location=New York |page=8}}</ref> Another example of Stoic influence on cognitive theorists is the influence of Epictetus on [[Albert Ellis]].<ref name="Engler">{{cite book |title=Personality theories |vauthors=Engler B |publisher=Houghton Mifflin Company |year=2006 |edition=7th |location=Boston |page=424}}</ref> A key philosophical figure who influenced the development of CBT was [[John Stuart Mill]] through his creation of [[Associationism]], a predecessor of [[classical conditioning]] and behavioral theory.<ref>{{cite journal |vauthors=Bistricky SL |date=June 2013 |title=Mill and mental phenomena: critical contributions to a science of cognition |journal=Behavioral Sciences |volume=3 |issue=2 |pages=217–231 |doi=10.3390/bs3020217 |pmc=4217623 |pmid=25379235 |doi-access=free}}</ref><ref name="Robinson">{{cite book |url=https://archive.org/details/intellectualhist00robeho |title=An intellectual history of psychology |vauthors=Robinson DN |date=1995 |publisher=University of Wisconsin Press |edition=3rd |location=Madison, WI |url-access=registration}}</ref>

Principles originating from [[Buddhism]] have significantly impacted the evolution of various new forms of CBT, including [[dialectical behavior therapy]], [[mindfulness-based cognitive therapy]], spirituality-based CBT, and [[compassion-focused therapy]].<ref>{{Cite book |title=The compassionate mind: a new approach to life's challenges |vauthors=Gilbert P |date=2009 |publisher=Constable |isbn=978-1-84529-713-8 |edition=1st |location=London}}</ref>

The modern roots of CBT can be traced to the development of [[behavior therapy]] in the early 20th century, the development of [[cognitive therapy]] in the 1960s, and the subsequent merging of the two.<ref>{{Cite journal |last1=Nakao |first1=Mutsuhiro |last2=Shirotsuki |first2=Kentaro |last3=Sugaya |first3=Nagisa |date=2021-10-03 |title=Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies |journal=BioPsychoSocial Medicine |volume=15 |issue=1 |page=16 |doi=10.1186/s13030-021-00219-w |doi-access=free |issn=1751-0759 |pmc=8489050 |pmid=34602086}}</ref>

===Behavioral therapy===
[[File:John Broadus Watson.JPG|thumb|[[John B. Watson]]]]
Groundbreaking work in [[behaviorism]] began with [[John B. Watson]] and [[Rosalie Rayner]]'s studies of conditioning in 1920.<ref name="Trull">{{cite book |title=Clinical psychology |vauthors=Trull TJ |date=2007 |publisher=[[Thomson/Wadsworth]] |edition=7th |location=Belmont, CA}}</ref> Behaviorally-centered therapeutic approaches appeared as early as 1924<ref name="Rachman_1997">{{Cite book |title=Science and practice of cognitive behaviour therapy |vauthors=Rachman S |publisher=Oxford University Press |year=1997 |isbn=978-0-19-262726-1 |veditors=Clark D, Fairburn CG, Gelder MG |location=Oxford |pages=1–26 |chapter=The evolution of cognitive behaviour therapy}}</ref> with [[Mary Cover Jones]]' work dedicated to the unlearning of fears in children.<ref>{{Cite journal |vauthors=Jones MC |year=1924 |title=The Elimination of Children's Fears |journal=Journal of Experimental Psychology |volume=7 |issue=5 |pages=382–390 |doi=10.1037/h0072283}}</ref> These were the antecedents of the development of [[Joseph Wolpe]]'s behavioral therapy in the 1950s.<ref name="Trull" /> It was the work of Wolpe and Watson, which was based on [[Ivan Pavlov]]'s work on learning and conditioning, that influenced [[Hans Eysenck]] and [[Arnold Lazarus]] to develop new behavioral therapy techniques based on classical conditioning.<ref name="Trull" /><ref name="Corsini">{{cite book |title=Current psychotherapies |date=2008 |publisher=Thomson Brooks/Cole |veditors=Corsini RJ, Wedding D |edition=8th |location=Belmont, CA}}</ref>

During the 1950s and 1960s, behavioral therapy became widely used by researchers in the United States, the United Kingdom, and South Africa. Their inspiration was by the behaviorist learning theory of Ivan Pavlov, John B. Watson, and [[Clark L. Hull]].<ref name="Rachman_1997" />

In Britain, Joseph Wolpe, who applied the findings of animal experiments to his method of [[systematic desensitization]],<ref name="Trull" /> applied behavioral research to the treatment of neurotic disorders. Wolpe's therapeutic efforts were precursors to today's fear reduction techniques.<ref name="Rachman_1997" /> British psychologist Hans Eysenck presented behavior therapy as a constructive alternative.<ref name="Rachman_1997" /><ref>{{cite journal |vauthors=Eysenck HJ |date=October 1952 |title=The effects of psychotherapy: an evaluation |journal=Journal of Consulting Psychology |volume=16 |issue=5 |pages=319–324 |doi=10.1037/h0063633 |pmid=13000035}}</ref>

At the same time as Eysenck's work, [[B. F. Skinner]] and his associates were beginning to have an impact with their work on [[operant conditioning]].<ref name="Trull" /><ref name="Corsini" /> Skinner's work was referred to as [[radical behaviorism]] and avoided anything related to cognition.<ref name="Trull" /> However, [[Julian Rotter]] in 1954 and [[Albert Bandura]] in 1969 contributed to behavior therapy with their works on [[social learning theory]] by demonstrating the effects of cognition on learning and behavior modification.<ref name="Trull" /><ref name="Corsini" /> The work of [[Claire Weekes]] in dealing with anxiety disorders in the 1960s is also seen as a prototype of behavior therapy.<ref>{{cite news |date=26 March 2020 |title=Desperately Seeking Hope and Help for Your Nerves? Try Reading 'Hope and Help for Your Nerves' |work=[[The New York Times]] |agency=The New York Times |url=https://www.nytimes.com/2020/03/26/books/hope-help-for-your-nerves-claire-weekes-virus.html |access-date=21 January 2021 |vauthors=Kelly H}}</ref>

The emphasis on behavioral factors has been described as the "first wave" of CBT.<ref name="Wilson">{{cite book |title=Current psychotherapies |vauthors=Wilson GT |date=2008 |publisher=Thomson Brooks/Cole |veditors=Corsini RJ, Wedding D |edition=8th |location=Belmont, CA |pages=63–106 |chapter=Behavior therapy}}</ref>

===Cognitive therapy===
One of the first therapists to address cognition in psychotherapy was [[Alfred Adler]], notably with his idea of [[Classical Adlerian psychology|basic mistakes]] and how they contributed to creation of unhealthy behavioral and life goals.<ref name="AP">{{cite book |title=Current psychotherapies |vauthors=Mosak HH, Maniacci M |date=2008 |publisher=Thomson Brooks/Cole |veditors=Corsini RJ, Wedding D |edition=8th |location=Belmont, CA |pages=63–106 |chapter=Adlerian psychotherapy}}</ref>[[Abraham Low]] believed that someone's thoughts were best changed by changing their actions.<ref>{{Cite web |title=The truth is indeed sobering A Response to Dr. Lance Dodes (Part Two) > Detroit Legal News |url=https://legalnews.com/detroit/1403173 |access-date=2022-11-18 |website=legalnews.com}}</ref> Adler and Low influenced the work of Albert Ellis,<ref name="AP" /><ref>{{Cite web |title=The truth is indeed sobering A Response to Dr. Lance Dodes (Part Two) |url=http://legalnews.com/detroit/1403173 |access-date=16 May 2020 |website=legalnews.com |publisher=Detroit Legal News}}</ref> who developed the earliest cognitive-based psychotherapy called [[Rational emotive behavior therapy|rational emotive behavioral therapy]], or REBT.<ref>{{cite book |title=Current psychotherapies |vauthors=Ellis A |date=2008 |publisher=Thomson Brooks/Cole |veditors=Corsini RJ, Wedding D |edition=8th |location=Belmont, CA |pages=63–106 |chapter=Rational emotive behavior therapy}}</ref> The first version of REBT was announced to the public in 1956.<ref>{{Cite journal |last=Ellis |first=Albert |date=1989 |title=Rational Psychotherapy |journal=TACD Journal |volume=17 |issue=1 |pages=67–80 |doi=10.1080/1046171x.1989.12034348 |issn=1046-171X}}</ref>

In the late 1950s, Aaron Beck was conducting [[Free association (psychology)|free association]] sessions in his [[Psychoanalysis|psychoanalytic]] practice.<ref name="Beck_2021">{{Cite book |url=https://books.google.com/books?id=J_iAUcHc60cC |title=Cognitive Behavior Therapy, Third Edition: Basics and Beyond |vauthors=Beck JS |publisher=Guilford Press |year=2021 |isbn=978-1-60918-506-0 |page=6 |language=en}}</ref><ref name="EABH">{{cite book |title=Emotions: A brief history |vauthors=Oatley K |date=2004 |publisher=Blackwell Publishing |location=Malden, MA |page=53}}</ref> During these sessions, Beck noticed that thoughts were not as unconscious as [[Sigmund Freud|Freud]] had previously theorized, and that certain types of thinking may be the culprits of emotional distress.<ref name="EABH" /> It was from this hypothesis that Beck developed [[cognitive therapy]], and called these thoughts "automatic thoughts".<ref name="EABH" /> He first published his new methodology in 1967, and his first treatment manual in 1979.<ref name="Beck_2021" /> Beck has been referred to as "the father of cognitive behavioral therapy".<ref>{{cite book |title=The Medical Basis of Psychiatry |vauthors=Folsom TD, Merz A, Grant JE, Fatemi N, Fatemi SA, Fatemi SH |date=2016 |publisher=Springer |isbn=978-1-4939-2527-8 |location=New York |pages=925–1007 |chapter=Profiles in History of Neuroscience and Psychiatry |doi=10.1007/978-1-4939-2528-5_42}}</ref>

It was these two therapies, rational emotive therapy, and cognitive therapy, that started the "second wave" of CBT, which emphasized cognitive factors.<ref name="Wilson" />

===Merger of behavioral and cognitive therapies===
Although the early behavioral approaches were successful in many so-called [[neurotic disorders]], they had little success in treating [[Major depressive disorder|depression]].<ref name="Trull" /><ref name="Rachman_1997" /><ref>{{cite book |title=Behavior therapy: Concepts, procedures, and applications |vauthors=Thorpe GL, Olson SL |date=1997 |publisher=Allyn & Bacon |edition=2nd |location=Boston, MA}}</ref> Behaviorism was also losing popularity due to the [[cognitive revolution]]. The therapeutic approaches of [[Albert Ellis (psychologist)|Albert Ellis]] and [[Aaron T. Beck]] gained popularity among behavior therapists, despite the earlier behaviorist rejection of [[Mentalism (psychology)|mentalistic]] concepts like thoughts and cognitions.<ref name="Trull" /> Both of these systems included behavioral elements and interventions, with the primary focus being on problems in the present.<ref>{{Cite web |last=Checklist |first=Anxiety |title=Understanding CBT for Anxiety: An Evidence-Based Approach to Mental Wellness {{!}} Anxiety Checklist |url=https://anxietychecklist.com/understanding-cbt-anxiety |access-date=2025-03-15 |website=anxietychecklist.com |language=en}}</ref><ref>{{Cite journal |last=Rachman |first=S. |date=2015-01-02 |title=The evolution of behaviour therapy and cognitive behaviour therapy |journal=Behaviour Research and Therapy |volume=64 |pages=1–8 |doi=10.1016/j.brat.2014.10.006 |issn=1873-622X |pmid=25462876}}</ref>

In initial studies, cognitive therapy was often contrasted with behavioral treatments to see which was most effective. During the 1980s and 1990s, cognitive and behavioral techniques were merged into cognitive behavioral therapy. Pivotal to this merging was the successful development of treatments for [[panic disorder]] by [[David M. Clark]] in the UK and [[David H. Barlow]] in the US.<ref name="Rachman_1997" />

Over time, cognitive behavior therapy came to be known not only as a therapy, but as an umbrella term for all cognitive-based psychotherapies.<ref name="Trull" /> These therapies include, but are not limited to, [[Rational emotive behavior therapy|REBT]], [[cognitive therapy]], [[acceptance and commitment therapy]], [[dialectical behavior therapy]], [[metacognitive therapy]], [[metacognitive training]], [[reality therapy]]/[[Glasser's choice theory|choice theory]], [[cognitive processing therapy]], [[Eye movement desensitization and reprocessing|EMDR]], and [[multimodal therapy]].<ref name="Trull" />

This blending of theoretical and technical foundations from both [[Behaviour therapy#"Third generation"|behavior]] and cognitive therapies constituted the "third wave" of CBT.<ref>{{cite journal |vauthors=Hayes SC, Hofmann SG |date=October 2017 |title=The third wave of cognitive behavioral therapy and the rise of process-based care |journal=World Psychiatry |volume=16 |issue=3 |pages=245–246 |doi=10.1002/wps.20442 |pmc=5608815 |pmid=28941087}}</ref><ref name="Wilson" /> The most prominent therapies of this third wave are [[dialectical behavior therapy]] and [[acceptance and commitment therapy]].<ref name="Wilson" /> Despite the increasing popularity of third-wave treatment approaches, reviews of studies reveal there may be no difference in the effectiveness compared with non-third wave CBT for the treatment of depression.<ref>{{cite journal |display-authors=6 |vauthors=Hunot V, Moore TH, Caldwell DM, Furukawa TA, Davies P, Jones H, Honyashiki M, Chen P, Lewis G, Churchill R |date=October 2013 |title='Third wave' cognitive and behavioural therapies versus other psychological therapies for depression |journal=The Cochrane Database of Systematic Reviews |issue=10 |article-number=CD008704 |doi=10.1002/14651858.CD008704.pub2 |pmid=24142844 |pmc=12107518 |s2cid=1872743 |collaboration=Cochrane Common Mental Disorders Group}}</ref>

In the late 1990s, [[Melanie Fennell]] published a refined model in ''Behavioural and Cognitive Psychotherapy'' on a cognitive approach to low self-esteem. In line with Beck's 1976 general cognitive approach, it proposed that life experiences interact with temperament in the development of beliefs about the self.<ref>{{Cite journal |last1=Rimes |first1=Katharine A. |last2=Smith |first2=Patrick |last3=Bridge |first3=Livia |date=November 2023 |title=Low self-esteem: a refined cognitive behavioural model |journal=Behavioural and Cognitive Psychotherapy |language=en |volume=51 |issue=6 |pages=579–594 |doi=10.1017/S1352465823000048 |issn=1352-4658 |doi-access=free |pmid=37170762 }}{{Creative Commons text attribution notice|cc=by4|from this source=yes}}</ref>

==Medical uses==
In adults, CBT has been shown to be an effective part of treatment plans for [[anxiety disorder]]s,<ref name="OtteC">{{cite journal | vauthors = Otte C | title = Cognitive behavioral therapy in anxiety disorders: current state of the evidence | journal = Dialogues in Clinical Neuroscience | volume = 13 | issue = 4 | pages = 413–421 | year = 2011 | pmid = 22275847 | pmc = 3263389 | doi = 10.31887/DCNS.2011.13.4/cotte }}</ref><ref name="plosone.org">{{cite journal | vauthors = Robinson E, Titov N, Andrews G, McIntyre K, Schwencke G, Solley K | title = Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance | journal = PLOS ONE | volume = 5 | issue = 6 | article-number = e10942 | date = June 2010 | pmid = 20532167 | pmc = 2880592 | doi = 10.1371/journal.pone.0010942 | bibcode = 2010PLoSO...510942R | veditors = García AV | doi-access = free }}</ref> [[body dysmorphic disorder]],<ref name="MetaNSUE">{{cite journal | vauthors = Harrison A, Fernández de la Cruz L, Enander J, Radua J, Mataix-Cols D | title = Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials | journal = Clinical Psychology Review | volume = 48 | pages = 43–51 | date = August 2016 | pmid = 27393916 | doi = 10.1016/j.cpr.2016.05.007 | s2cid = 19454310 | url = https://kclpure.kcl.ac.uk/portal/en/publications/cognitivebehavioral-therapy-for-body-dysmorphic-disorder-a-systematic-review-and-metaanalysis-of-randomized-controlled-trials(0fe73d16-d299-4d3a-a96b-68254931ac92).html | type = Submitted manuscript }}</ref> [[Depression (mood)|depression]],<ref name="DriessenE">{{cite journal | vauthors = Driessen E, Hollon SD | title = Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators | journal = The Psychiatric Clinics of North America | volume = 33 | issue = 3 | pages = 537–555 | date = September 2010 | pmid = 20599132 | pmc = 2933381 | doi = 10.1016/j.psc.2010.04.005 }}</ref><ref name="biomedcentral.com">{{cite journal | vauthors = Foroushani PS, Schneider J, Assareh N | title = Meta-review of the effectiveness of computerised CBT in treating depression | journal = BMC Psychiatry | volume = 11 | issue = 1 | article-number = 131 | date = August 2011 | pmid = 21838902 | pmc = 3180363 | doi = 10.1186/1471-244X-11-131 | doi-access = free }}</ref><ref name="INSERM">{{cite report|author1=INSERM Collective Expertise Centre|year=2000|title=Psychotherapy: Three approaches evaluated |pmid=21348158 |url=https://www.ncbi.nlm.nih.gov/books/NBK7123/ |publisher=[[Institut national de la santé et de la recherche médicale]] |publication-place=Paris, France |id=[[NCBI bookshelf]] [https://www.ncbi.nlm.nih.gov/books/NBK7123/ NBK7123]}}</ref> [[eating disorder]]s,<ref name="Agras" /><ref name="MurphyR">{{cite journal | vauthors = Murphy R, Straebler S, Cooper Z, Fairburn CG | title = Cognitive behavioral therapy for eating disorders | journal = The Psychiatric Clinics of North America | volume = 33 | issue = 3 | pages = 611–627 | date = September 2010 | pmid = 20599136 | pmc = 2928448 | doi = 10.1016/j.psc.2010.04.004 | author-link4 = Christopher Fairburn }}</ref><ref name="INSERM" /> chronic [[low back pain]],<ref name="GatchelRJ">{{cite journal |vauthors=Gatchel RJ, Rollings KH |year=2008 |title=Evidence-informed management of chronic low back pain with cognitive behavioral therapy |journal=The Spine Journal |volume=8 |issue=1 |pages=40–44 |doi=10.1016/j.spinee.2007.10.007 |pmc=3237294 |pmid=18164452}}</ref> [[personality disorder]]s,<ref name="MatusiewiczAK">{{cite journal | vauthors = Matusiewicz AK, Hopwood CJ, Banducci AN, Lejuez CW | title = The effectiveness of cognitive behavioral therapy for personality disorders | journal = The Psychiatric Clinics of North America | volume = 33 | issue = 3 | pages = 657–685 | date = September 2010 | pmid = 20599139 | pmc = 3138327 | doi = 10.1016/j.psc.2010.04.007 }}</ref><ref name="INSERM" /> [[psychosis]],<ref name="GutierrezM">{{cite journal | vauthors = Gutiérrez M, Sánchez M, Trujillo A, Sánchez L | title = Cognitive-behavioral therapy for chronic psychosis | journal = Actas Españolas de Psiquiatría | volume = 37 | issue = 2 | pages = 106–114 | year = 2009 | pmid = 19401859 | url = http://www.actaspsiquiatria.es/repositorio//10/56/ENG/10-56-ENG-106-114-498857.pdf }}</ref> [[schizophrenia]],<ref name="RathodS">{{cite journal | vauthors = Rathod S, Phiri P, Kingdon D | title = Cognitive behavioral therapy for schizophrenia | journal = The Psychiatric Clinics of North America | volume = 33 | issue = 3 | pages = 527–536 | date = September 2010 | pmid = 20599131 | doi = 10.1016/j.psc.2010.04.009 | s2cid = 5798588 }}</ref><ref name="INSERM" /> [[substance use disorder]]s,<ref name="McHughRK">{{cite journal | vauthors = McHugh RK, Hearon BA, Otto MW | title = Cognitive behavioral therapy for substance use disorders | journal = The Psychiatric Clinics of North America | volume = 33 | issue = 3 | pages = 511–525 | date = September 2010 | pmid = 20599130 | pmc = 2897895 | doi = 10.1016/j.psc.2010.04.012 }}</ref><ref name="INSERM" /> and [[bipolar disorder]].<ref name="INSERM" /> It is also effective as part of treatment plans in the adjustment, depression, and anxiety associated with [[fibromyalgia]],<ref name="HassettAL">{{cite journal |vauthors=Hassett AL, Gevirtz RN |date=May 2009 |title=Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine |journal=Rheumatic Disease Clinics of North America |volume=35 |issue=2 |pages=393–407 |doi=10.1016/j.rdc.2009.05.003 |pmc=2743408 |pmid=19647150}}</ref> and as part of the treatment after [[Spinal cord injury|spinal cord injuries]].<ref name="MehtaS">{{cite journal | vauthors = Mehta S, Orenczuk S, Hansen KT, Aubut JA, Hitzig SL, Legassic M, Teasell RW | title = An evidence-based review of the effectiveness of cognitive behavioral therapy for psychosocial issues post-spinal cord injury | journal = Rehabilitation Psychology | volume = 56 | issue = 1 | pages = 15–25 | date = February 2011 | pmid = 21401282 | pmc = 3206089 | doi = 10.1037/a0022743 | author8 = Spinal Cord Injury Rehabilitation Evidence Research Team }}</ref>

In children or adolescents, CBT is an effective part of treatment plans for anxiety disorders,<ref name="SeligmanLD">{{cite journal | vauthors = Seligman LD, Ollendick TH | title = Cognitive-behavioral therapy for anxiety disorders in youth | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 20 | issue = 2 | pages = 217–238 | date = April 2011 | pmid = 21440852 | pmc = 3091167 | doi = 10.1016/j.chc.2011.01.003 }}</ref> body dysmorphic disorder,<ref name="PhillipsKA">{{cite journal | vauthors = Phillips KA, Rogers J | title = Cognitive-behavioral therapy for youth with body dysmorphic disorder: current status and future directions | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 20 | issue = 2 | pages = 287–304 | date = April 2011 | pmid = 21440856 | pmc = 3070293 | doi = 10.1016/j.chc.2011.01.004 }}</ref> depression and [[Suicidal ideation|suicidality]],<ref name="SpiritoA">{{cite journal | vauthors = Spirito A, Esposito-Smythers C, Wolff J, Uhl K | title = Cognitive-behavioral therapy for adolescent depression and suicidality | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 20 | issue = 2 | pages = 191–204 | date = April 2011 | pmid = 21440850 | pmc = 3073681 | doi = 10.1016/j.chc.2011.01.012 }}</ref> eating disorders<ref name="Agras" /> and [[obesity]],<ref name="WilfleyDE">{{cite journal | vauthors = Wilfley DE, Kolko RP, Kass AE | title = Cognitive-behavioral therapy for weight management and eating disorders in children and adolescents | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 20 | issue = 2 | pages = 271–285 | date = April 2011 | pmid = 21440855 | pmc = 3065663 | doi = 10.1016/j.chc.2011.01.002 }}</ref> [[obsessive–compulsive disorder]] (OCD),<ref name="BoileauB">{{cite journal | vauthors = Boileau B | title = A review of obsessive-compulsive disorder in children and adolescents | journal = Dialogues in Clinical Neuroscience | volume = 13 | issue = 4 | pages = 401–411 | year = 2011 | pmid = 22275846 | pmc = 3263388 | doi = 10.31887/DCNS.2011.13.4/bboileau }}</ref> [[post-traumatic stress disorder]] (PTSD),<ref name="KowalikJ">{{cite journal | vauthors = Kowalik J, Weller J, Venter J, Drachman D | title = Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: a review and meta-analysis | journal = Journal of Behavior Therapy and Experimental Psychiatry | volume = 42 | issue = 3 | pages = 405–413 | date = September 2011 | pmid = 21458405 | doi = 10.1016/j.jbtep.2011.02.002 }}</ref> [[tic disorder]]s, [[trichotillomania]], and other repetitive behavior disorders.<ref name="FlessnerCA">{{cite journal | vauthors = Flessner CA | title = Cognitive-behavioral therapy for childhood repetitive behavior disorders: tic disorders and trichotillomania | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 20 | issue = 2 | pages = 319–328 | date = April 2011 | pmid = 21440858 | pmc = 3074180 | doi = 10.1016/j.chc.2011.01.007 }}</ref> CBT has also been used to help improve a variety of childhood disorders, including depressive disorders and various anxiety disorders.<ref>{{Cite book |title=Cognitive therapy with children and adolescents: A casebook for clinical practice |date=2003 |publisher=Guilford Press |isbn=978-1-57230-853-4 |edition=2nd |location=New York |oclc=50694773}}</ref> CBT has shown to be the most effective intervention for people exposed to [[adverse childhood experience]]s in the form of abuse or neglect.<ref>{{cite journal | vauthors = Lorenc T, Lester S, Sutcliffe K, Stansfield C, Thomas J | title = Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews | journal = BMC Public Health | volume = 20 | issue = 1 | article-number = 657 | date = May 2020 | pmid = 32397975 | pmc = 7216383 | doi = 10.1186/s12889-020-08789-0 | doi-access = free }}</ref>

Criticism of CBT sometimes focuses on implementations (such as the UK [[Improving Access to Psychological Therapies|IAPT]]) which may result initially in low quality therapy being offered by poorly trained practitioners.<ref>{{cite press release|title = UKCP response to Andy Burnham's speech on mental health|publisher = UK Council for Psychotherapy|date = 1 February 2012|url = http://www.psychotherapy.org.uk/article1488.html|access-date = 26 April 2013|archive-url = https://web.archive.org/web/20130221020422/http://www.psychotherapy.org.uk/article1488.html|archive-date = 21 February 2013}}</ref><ref>{{cite web |url = http://www.psychologytoday.com/blog/anxiety-files/201111/cognitive-behavioral-therapy-proven-effectiveness| vauthors = Leahy RL |date = 23 November 2011|title = Cognitive-Behavioral Therapy: Proven Effectiveness|work = Psychology Today}}</ref> However, evidence supports the effectiveness of CBT for anxiety and depression.<ref name="pmid20948835">{{cite journal | vauthors = Titov N, Andrews G, Sachdev P | title = Computer-delivered cognitive behavioural therapy: effective and getting ready for dissemination | journal = F1000 Medicine Reports | volume = 2 | page = 49 | date = July 2010 | pmid = 20948835 | pmc = 2950044 | doi = 10.3410/M2-49 | doi-access = free }}</ref>

Evidence suggests that the addition of [[hypnotherapy]] as an adjunct to CBT improves treatment efficacy for a variety of clinical issues.<ref>{{cite journal | vauthors = Kirsch I, Montgomery G, Sapirstein G | title = Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a meta-analysis | journal = Journal of Consulting and Clinical Psychology | volume = 63 | issue = 2 | pages = 214–220 | date = April 1995 | pmid = 7751482 | doi = 10.1037/0022-006X.63.2.214 }}</ref><ref>{{cite journal | vauthors = Elkins G, Johnson A, Fisher W | title = Cognitive hypnotherapy for pain management | journal = The American Journal of Clinical Hypnosis | volume = 54 | issue = 4 | pages = 294–310 | date = April 2012 | pmid = 22655332 | doi = 10.1080/00029157.2011.654284 | s2cid = 40604946 }}</ref>

The United Kingdom's [[National Institute for Health and Care Excellence]] (NICE) recommends CBT in the treatment plans for a number of [[mental health]] difficulties, including PTSD, OCD, [[bulimia nervosa]], and [[clinical depression]].<ref>{{cite web|url = http://www.nice.org.uk/media/878/f7/cbtcommissioningguide.pdf|title = Cognitive behavioural therapy for the management of common mental health problems|publisher = National Institute for Health and Clinical Excellence|date = April 2008|access-date = 4 November 2013|archive-url = https://web.archive.org/web/20131105200545/http://www.nice.org.uk/media/878/f7/cbtcommissioningguide.pdf|archive-date = 5 November 2013}}</ref>

===Depression and anxiety disorders===
{{Further|Major depressive disorder#Talking therapies|Management of depression#Psychotherapy|Anxiety disorder#Treatment}}
Cognitive behavioral therapy has been shown as an effective treatment for clinical depression.<ref name="DriessenE" /> Among psychotherapeutic approaches for [[major depressive disorder]], cognitive behavioral therapy and [[interpersonal psychotherapy]] are recommended by clinical practice guidelines including The [[American Psychiatric Association]] Practice (APA) Guidelines (April 2000),<ref>{{cite book | vauthors = Hirschfeld RM |chapter = Guideline Watch: Practice Guideline for the Treatment of Patients With Bipolar Disorder, 2nd Edition|year = 2006|isbn = 978-0-89042-336-3|volume = 1|title=APA Practice Guidelines for the Treatment of Psychiatric Disorders: Comprehensive Guidelines and Guideline Watches| publisher=American Psychiatric Association |chapter-url=http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch.pdf |archive-url=https://web.archive.org/web/20170712204621/http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch.pdf |archive-date=2017-07-12 |url-status=live }}</ref> and the APA endorsed Veteran Affairs clinical practice guideline.<ref>{{Cite web |date=2022 |title=Veterans Affairs and Department of Defence Clinical Practice Guideline for the Management of Major Depressive Disorder |url=https://www.healthquality.va.gov/guidelines/MH/mdd/ |access-date=2025-01-01 |website=www.healthquality.va.gov |language=en}}</ref>

CBT has been shown to be effective in the treatment of adults with anxiety disorders.<ref>{{cite journal | vauthors = Hofmann SG, Smits JA | title = Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials | journal = The Journal of Clinical Psychiatry | volume = 69 | issue = 4 | pages = 621–632 | date = April 2008 | pmid = 18363421 | pmc = 2409267 | doi = 10.4088/JCP.v69n0415 }}</ref>  There is also evidence that using CBT to treat children and adolescents with anxiety disorders was probably more effective (in the short term) than wait list or no treatment and more effective than attention control treatment approaches.<ref>{{cite journal | vauthors = James AC, Reardon T, Soler A, James G, Creswell C | title = Cognitive behavioural therapy for anxiety disorders in children and adolescents | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | issue = 11 | article-number = CD013162 | date = November 2020 | pmid = 33196111 | pmc = 8092480 | doi = 10.1002/14651858.CD013162.pub2 | collaboration = Cochrane Common Mental Disorders Group }}</ref><ref name=":3">{{cite journal | vauthors = Leichsenring F | title = Comparative effects of short-term psychodynamic psychotherapy and cognitive-behavioral therapy in depression: a meta-analytic approach | journal = Clinical Psychology Review | volume = 21 | issue = 3 | pages = 401–419 | date = April 2001 | pmid = 11288607 | doi = 10.1016/S0272-7358(99)00057-4 }}</ref> Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression.<ref name="Tolin_2010">{{cite journal |vauthors=Tolin DF |date=August 2010 |title=Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review |journal=Clinical Psychology Review |volume=30 |issue=6 |pages=710–720 |doi=10.1016/j.cpr.2010.05.003 |pmid=20547435}}</ref><ref name="Cuijpers_2008">{{cite journal |vauthors=Cuijpers P, van Straten A, Andersson G, van Oppen P |date=December 2008 |title=Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies |journal=Journal of Consulting and Clinical Psychology |volume=76 |issue=6 |pages=909–922 |doi=10.1037/a0013075 |pmid=19045960 |s2cid=23341989}}</ref><ref name=":3" /> A 2013 meta-analysis suggested that CBT, [[interpersonal therapy]], and [[problem-solving therapy]] outperformed psychodynamic psychotherapy and [[behavioral activation]] in the treatment of depression.<ref name="Barth_2013" /> According to a 2004 review by [[INSERM]] of three methods, cognitive behavioral therapy was either proven or presumed to be an effective therapy on several [[mental disorder]]s.<ref name="INSERM" /> This included [[Depression (mood)|depression]], [[panic disorder]], [[Post-traumatic stress disorder|post-traumatic stress]], and other anxiety disorders.<ref name="INSERM" />

A [[systematic review]] of CBT in depression and anxiety disorders concluded that "CBT delivered in primary care, especially including computer- or Internet-based self-help programs, is potentially more effective than usual care and could be delivered effectively by primary care therapists."<ref name="HoifodtRS">{{cite journal | vauthors = Høifødt RS, Strøm C, Kolstrup N, Eisemann M, Waterloo K | title = Effectiveness of cognitive behavioural therapy in primary health care: a review | journal = Family Practice | volume = 28 | issue = 5 | pages = 489–504 | date = October 2011 | pmid = 21555339 | doi = 10.1093/fampra/cmr017 | doi-access = free }}</ref>

A 2024 systematic review found that [[Exposure and response prevention (ERP) therapy|exposure and response prevention (ERP)]], a specific form of cognitive behavioral therapy, is considered a first-line treatment for pediatric obsessive–compulsive disorder (OCD). Research indicates that ERP is effective in both in-person and remote settings, providing flexibility in treatment delivery without compromising efficacy.<ref>{{Cite report |url=https://effectivehealthcare.ahrq.gov/products/obsessive-compulsive-disorder/research |title=Diagnosis and Management of Obsessive Compulsive Disorders in Children: A Systematic Review |last1=Steele |first1=Dale W. |last2=Caputo |first2=Eduardo L. |last3=Kanaan |first3=Ghid |last4=Zahradnik |first4=Michael L. |last5=Brannon |first5=Elizabeth |last6=Freeman |first6=Jennifer B. |last7=Balk |first7=Ethan M. |last8=Trikalinos |first8=Thomas A. |last9=Adam |first9=Gaelen P. |date=2024-12-06 |publisher=Agency for Healthcare Research and Quality (AHRQ) |doi=10.23970/ahrqepccer276|url-access=subscription }}</ref>

According to ''The Anxiety and Worry Workbook:'' ''The Cognitive Behavioral Solution'' by Clark and Beck:<ref>{{Cite book |last1=Clark |first1=David A.  |title=The anxiety and worry workbook: the cognitive behavioral solution |last2=Beck |first2=Aaron T. |date=2023 |publisher=The Guilford Press |isbn=978-1-4625-4616-9 |edition=Second |series=Psychology |location=New York London |page=37 |language=en}}</ref>

{{Quote2|In CBT, you work on reducing fear by changing how you think and act. Instead of thinking of the fear object (for example, a spider) as an imminent threat or danger, you're taught to reevaluate the fear object as less threatening to your safety and well-being. Instead of avoiding or running from the fear, you're encouraged to face the fear.}}

====Theoretical approaches====
One [[Etiology|etiological]] theory of depression is [[Aaron T. Beck]]'s cognitive theory of depression. His theory states that depressed people think the way they do because their thinking is biased towards negative interpretations. Beck's theory rests on the aspect of cognitive behavioral therapy known as [[Schema (psychology)|schemata]].<ref name=":0">{{Cite journal |last1=Turk |first1=Dennis C. |last2=Salovey |first2=Peter |date=1985-02-01 |title=Cognitive structures, cognitive processes, and cognitive-behavior modification: I. client issues |journal=Cognitive Therapy and Research |language=en |volume=9 |issue=1 |pages=1–17 |doi=10.1007/BF01178747 |issn=1573-2819}}</ref> Schemata are the mental maps used to integrate new information into memories and to organize existing information in the mind. An example of a [[Schema (psychology)|schema]] would be a person hearing the word "dog" and picturing different versions of the animal that they have grouped together in their mind.<ref name=":0" /> According to this theory, depressed people acquire a negative schema of the world in childhood and adolescence as an effect of stressful life events, and the negative schema is activated later in life when the person encounters similar situations.<ref name="Neale247">{{Cite book|vauthors = Neale JM, Davison GC|title = Abnormal psychology|edition = 8th|publisher = John Wiley & Sons|location = New York|year = 2001|page = [https://archive.org/details/abnormalpsycholo00gera/page/247 247]|isbn = 978-0-471-31811-8|url-access = registration|url = https://archive.org/details/abnormalpsycholo00gera/page/247}}</ref>

Beck also described a negative [[Beck's cognitive triad|cognitive triad]]. The cognitive triad is made up of the depressed individual's negative evaluations of themselves, the world, and the future. Beck suggested that these negative evaluations derive from the negative schemata and cognitive biases of the person. According to this theory, depressed people have views such as "I never do a good job", "It is impossible to have a good day", and "things will never get better". A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema. Beck further proposed that depressed people often have the following cognitive biases: [[arbitrary inference]], [[selective abstraction]], overgeneralization, magnification, and [[Minimisation (psychology)|minimization]]. These cognitive biases are quick to make negative, generalized, and personal inferences of the self, thus fueling the negative schema.<ref name="Neale247" />

On the other hand, a positive cognitive triad relates to a person's positive evaluations of themself, the world, and the future.<ref name=":1">{{Cite journal |last1=Mehta |first1=Mansi H. |last2=Grover |first2=Rachel L. |last3=DiDonato |first3=Theresa E. |last4=Kirkhart |first4=Matthew W. |date=June 2019 |title=Examining the Positive Cognitive Triad: A Link Between Resilience and Well-Being |url=http://journals.sagepub.com/doi/10.1177/0033294118773722 |journal=Psychological Reports |language=en |volume=122 |issue=3 |pages=776–788 |doi=10.1177/0033294118773722 |pmid=29708049 |issn=0033-2941|url-access=subscription }}</ref> More specifically, a positive cognitive triad requires [[self-esteem]] when viewing oneself and hope for the future. A person with a positive cognitive triad has a positive schema used for viewing themself in addition to a positive schema for the world and for the future. Cognitive behavioral research suggests a positive cognitive triad bolsters [[Psychological resilience|resilience]], or the ability to cope with stressful events. Increased levels of resilience is associated with greater resistance to [[Depression (mood)|depression]].<ref name=":1" />

Another major theoretical approach to cognitive behavioral therapy treatment is the concept of [[Locus of control|Locus of Control]] outlined in [[Social learning theory|Julian Rotter's Social Learning Theory]]. Locus of control refers to the degree to which an individual's sense of control is either internal or external.<ref name=":2">{{Cite journal |last1=Nowicki |first1=Stephen |last2=Iles-Caven |first2=Yasmin |last3=Kalechstein |first3=Ari |last4=Golding |first4=Jean |date=June 29, 2021 |title=Editorial: Locus of Control: Antecedents, Consequences and Interventions Using Rotter's Definition |journal=Frontiers in Psychology |volume=12 |article-number=698917 |doi=10.3389/fpsyg.2021.698917 |doi-access=free |pmid=34267714|pmc=8275955 }}</ref> An internal locus of control exists when an individual views an outcome of a particular action as being reliant on themselves and their personal attributes whereas an external locus of control exists when an individual views other's or some outside, intangible force such as luck or fate as being responsible for the outcome of a particular action.<ref name=":2" />

A basic concept in some CBT treatments used in anxiety disorders is ''in vivo'' [[Exposure therapy|exposure]]. CBT-exposure therapy refers to the direct confrontation of feared objects, activities, or situations by a patient. For example, a woman with PTSD who fears the location where she was assaulted may be assisted by her therapist in going to that location and directly confronting those fears.<ref>{{Cite web|url=https://www.div12.org/sites/default/files/WhatIsExposureTherapy.pdf |archive-url=https://ghostarchive.org/archive/20221010/https://www.div12.org/sites/default/files/WhatIsExposureTherapy.pdf |archive-date=2022-10-10 |url-status=live|title=What is Exposure Therapy?|author=((American Psychological Association {{!}} Division 12)) |website=div12.org/}}</ref> Likewise, a person with a social anxiety disorder who fears public speaking may be instructed to directly confront those fears by giving a speech.<ref>{{cite web|url = http://ptsd.about.com/od/glossary/g/invivo.htm|title = Definition of In Vivo Exposure|publisher = Ptsd.about.com|date = 9 June 2014|access-date = 14 August 2014|archive-date = 19 March 2016|archive-url = https://web.archive.org/web/20160319155913/http://ptsd.about.com/od/glossary/g/invivo.htm}}</ref> This "two-factor" model is often credited to [[Orval Hobart Mowrer|O. Hobart Mowrer]].<ref>{{Cite book |publisher = Wiley|location = New York|author = Mowrer OH|title = Learning theory and behavior|year = 1960|oclc=179388}}{{Page needed|date = April 2012}}</ref> Through exposure to the stimulus, this harmful conditioning can be "unlearned" (referred to as [[Extinction (psychology)|extinction]] and [[habituation]]).

CBT for children with phobias is normally delivered over multiple sessions, but one-session treatment has been shown to be equally effective and is cheaper.<ref>{{Cite journal |date=April 2023 |title=One-session treatment is as effective as multi-session therapy for young people with phobias |url=https://evidence.nihr.ac.uk/alert/one-session-cbt-treatment-effective-for-young-people-with-phobias/ |journal=NIHR Evidence|doi=10.3310/nihrevidence_57627 |s2cid=258149486 |url-access=subscription }}</ref><ref>{{cite journal | vauthors = Wright B, Tindall L, Scott AJ, Lee E, Biggs K, Cooper C, Bee P, Wang HI, Gega L, Hayward E, Solaiman K, Teare MD, Davis T, Lovell K, Wilson J, McMillan D, Barr A, Edwards H, Lomas J, Turtle C, Parrott S, Teige C, Chater T, Hargate R, Ali S, Parkinson S, Gilbody S, Marshall D | display-authors = 6 | title = One-session treatment compared with multisession CBT in children aged 7-16 years with specific phobias: the ASPECT non-inferiority RCT | language = EN | journal = Health Technology Assessment | volume = 26 | issue = 42 | pages = 1–174 | date = October 2022 | pmid = 36318050 | pmc = 9638885 | doi = 10.3310/IBCT0609 }}</ref>

====Specialized forms of CBT====
CBT-SP, an adaptation of CBT for suicide prevention (SP), was specifically designed for treating youths who are severely depressed and who have recently attempted suicide within the past 90 days, and was found to be effective, feasible, and acceptable.<ref>{{cite journal | vauthors = Stanley B, Brown G, Brent DA, Wells K, Poling K, Curry J, Kennard BD, Wagner A, Cwik MF, Klomek AB, Goldstein T, Vitiello B, Barnett S, Daniel S, Hughes J | display-authors = 6 | title = Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 48 | issue = 10 | pages = 1005–1013 | date = October 2009 | pmid = 19730273 | pmc = 2888910 | doi = 10.1097/chi.0b013e3181b5dbfe }}</ref>

[[Acceptance and commitment therapy]] (ACT) is a specialist branch of CBT (sometimes referred to as contextual CBT).<ref>{{cite journal | vauthors = McCracken LM, Vowles KE | title = Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress | journal = The American Psychologist | volume = 69 | issue = 2 | pages = 178–187 | year = 2014 | pmid = 24547803 | doi = 10.1037/a0035623 | s2cid = 16276904 | url = https://pure.qub.ac.uk/en/publications/acceptance-and-commitment-therapy-and-mindfulness-for-chronic-pain-model-process-and-progress(e4edf891-b582-4202-a4d6-ab8948539356).html }}</ref><ref>{{Cite web |title=Acceptance and Commitment Therapy {{!}} Psychology Today |url=https://www.psychologytoday.com/us/therapy-types/acceptance-and-commitment-therapy |access-date=2025-03-15 |website=www.psychologytoday.com |language=en-US}}</ref> ACT uses mindfulness and acceptance interventions and has been found to have a greater longevity in therapeutic outcomes. In a study with anxiety, CBT and ACT improved similarly across all outcomes from pre- to post-treatment. However, during a 12-month follow-up, ACT proved to be more effective, showing that it is a highly viable lasting treatment model for anxiety disorders.<ref>{{Cite web|title=Randomized Clinical Trial of Cognitive Behavioral Therapy (CBT) Versus Acceptance and Commitment Therapy (ACT) for Mixed Anxiety Disorders|url=http://thehappinesstrap.com/wp-content/uploads/2017/06/ACt-vs-CBT-for-Anxiety.pdf |archive-url=https://ghostarchive.org/archive/20221010/http://thehappinesstrap.com/wp-content/uploads/2017/06/ACt-vs-CBT-for-Anxiety.pdf |archive-date=2022-10-10 |url-status=live|website=The Happiness Trap}}</ref>

Computerized CBT (CCBT) has been proven to be effective by randomized controlled and other trials in treating depression and anxiety disorders,<ref name="plosone.org" /><ref name="biomedcentral.com" /><ref name="HoifodtRS" /><ref>{{cite web|title=MoodGYM|url=http://www.ehub.anu.edu.au/assist/about/research.php|archive-url=https://web.archive.org/web/20130221021730/http://www.ehub.anu.edu.au/assist/about/research.php|archive-date=21 February 2013|access-date=22 November 2012}}</ref><ref name="pmid20948835" /><ref>{{cite journal | vauthors = Williams AD, Andrews G | title = The effectiveness of Internet cognitive behavioural therapy (iCBT) for depression in primary care: a quality assurance study | journal = PLOS ONE | volume = 8 | issue = 2 | article-number = e57447 | year = 2013 | pmid = 23451231 | pmc = 3579844 | doi = 10.1371/journal.pone.0057447 | bibcode = 2013PLoSO...857447W | veditors = Andersson G | doi-access = free }}</ref> including children.<ref>{{cite journal | vauthors = Khanna MS, Kendall PC | title = Computer-assisted cognitive behavioral therapy for child anxiety: results of a randomized clinical trial | journal = Journal of Consulting and Clinical Psychology | volume = 78 | issue = 5 | pages = 737–745 | date = October 2010 | pmid = 20873909 | doi = 10.1037/a0019739 | url = http://www.seattleimplementation.org/wp-content/uploads/2011/12/ccp-78-5-737.pdf | publisher = [[American Psychological Association]] | access-date = 1 December 2013 | archive-url = https://web.archive.org/web/20131203035310/http://www.seattleimplementation.org/wp-content/uploads/2011/12/ccp-78-5-737.pdf | archive-date = 3 December 2013 }}</ref> Some research has found similar effectiveness to an intervention of informational websites and weekly telephone calls.<ref name="Schneider">{{cite web| vauthors = Schneider J |title=Computerised CBT for Common Mental Disorders: RCT of a Workplace Intervention|url=http://www.bohrf.org.uk/downloads/Computerised_CBT-Sep2012.pdf|archive-url=https://web.archive.org/web/20131203020947/http://www.bohrf.org.uk/downloads/Computerised_CBT-Sep2012.pdf|archive-date=3 December 2013|access-date=29 January 2013}}</ref><ref name="MoodGym no better than informational websites_2012">{{cite web|date=20 September 2012|title=MoodGym no better than informational websites, according to new workplace RCT|url=http://www.thementalelf.net/mental-health-conditions/anxiety-disorders/moodgym-no-better-than-informational-websites-according-to-new-workplace-rct/|archive-url=https://web.archive.org/web/20121116020909/http://www.thementalelf.net/mental-health-conditions/anxiety-disorders/moodgym-no-better-than-informational-websites-according-to-new-workplace-rct|archive-date=16 November 2012|access-date=29 January 2013}}</ref> CCBT was found to be equally effective as face-to-face CBT in adolescent anxiety.<ref>{{cite journal | vauthors = Spence SH, Donovan CL, March S, Gamble A, Anderson RE, Prosser S, Kenardy J | title = A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety | journal = Journal of Consulting and Clinical Psychology | volume = 79 | issue = 5 | pages = 629–642 | date = October 2011 | pmid = 21744945 | doi = 10.1037/a0024512 | hdl-access = free | s2cid = 19631532 | hdl = 10072/43516 }}</ref>

====Combined with other treatments====
Studies have provided evidence that when examining animals and humans, that [[glucocorticoid]]s may lead to a more successful extinction learning during exposure therapy for anxiety disorders.<ref>{{Cite journal |last1=Bentz |first1=Dorothée |last2=Michael |first2=Tanja |last3=de Quervain |first3=Dominique J.-F. |last4=Wilhelm |first4=Frank H. |date=2010-03-24 |title=Enhancing exposure therapy for anxiety disorders with glucocorticoids: from basic mechanisms of emotional learning to clinical applications |journal=Journal of Anxiety Disorders |volume=24 |issue=2 |pages=223–230 |doi=10.1016/j.janxdis.2009.10.011 |issn=1873-7897 |pmid=19962269}}</ref> For instance, glucocorticoids can prevent aversive learning episodes from being retrieved and heighten reinforcement of memory traces creating a non-fearful reaction in feared situations. A combination of glucocorticoids and exposure therapy may be a better-improved treatment for treating people with anxiety disorders.<ref>{{cite journal | vauthors = Bentz D, Michael T, de Quervain DJ, Wilhelm FH | title = Enhancing exposure therapy for anxiety disorders with glucocorticoids: from basic mechanisms of emotional learning to clinical applications | journal = Journal of Anxiety Disorders | volume = 24 | issue = 2 | pages = 223–230 | date = March 2010 | pmid = 19962269 | doi = 10.1016/j.janxdis.2009.10.011 }}</ref>

====Prevention====
For anxiety disorders, use of CBT with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes.<ref name="pmid20948835" /><ref>{{cite journal| vauthors = Seligman M, Schulman P, DeRubeis R, Hollon S |year=1999|title=The prevention of depression and anxiety|journal=Prevention & Treatment|volume=2|issue=1|pages=1111–1126|citeseerx=10.1.1.421.9996|doi=10.1037/1522-3736.2.1.28a|s2cid=211577 }}</ref><ref>{{cite journal | vauthors = Schmidt NB, Eggleston AM, Woolaway-Bickel K, Fitzpatrick KK, Vasey MW, Richey JA | title = Anxiety Sensitivity Amelioration Training (ASAT): a longitudinal primary prevention program targeting cognitive vulnerability | journal = Journal of Anxiety Disorders | volume = 21 | issue = 3 | pages = 302–319 | year = 2007 | pmid = 16889931 | doi = 10.1016/j.janxdis.2006.06.002 }}</ref> In another study, 3% of the group receiving the CBT intervention developed generalized anxiety disorder by 12 months postintervention compared with 14% in the control group.<ref>{{cite journal | vauthors = Higgins DM, Hecker JE | title = A randomized trial of brief cognitive-behavioral therapy for prevention of generalized anxiety disorder | journal = The Journal of Clinical Psychiatry | volume = 69 | issue = 8 | page = 1336 | date = August 2008 | pmid = 18816156 | doi = 10.4088/JCP.v69n0819a | doi-access = free }}</ref> Individuals with subthreshold levels of panic disorder significantly benefitted from use of CBT.<ref>{{cite journal | vauthors = Meulenbeek P, Willemse G, Smit F, van Balkom A, Spinhoven P, Cuijpers P | title = Early intervention in panic: pragmatic randomised controlled trial | journal = The British Journal of Psychiatry | volume = 196 | issue = 4 | pages = 326–331 | date = April 2010 | pmid = 20357312 | doi = 10.1192/bjp.bp.109.072504 | doi-access = free }}</ref><ref>{{cite journal| vauthors = Gardenswartz CA, Craske MG |year=2001|title=Prevention of panic disorder|journal=Behavior Therapy|volume=32|issue=4|pages=725–737|doi=10.1016/S0005-7894(01)80017-4}}</ref> Use of CBT was found to significantly reduce social anxiety prevalence.<ref>{{cite journal | vauthors = Aune T, Stiles TC | title = Universal-based prevention of syndromal and subsyndromal social anxiety: A randomized controlled study | journal = Journal of Consulting and Clinical Psychology | volume = 77 | issue = 5 | pages = 867–879 | date = October 2009 | pmid = 19803567 | doi = 10.1037/a0015813 }}</ref>

For depressive disorders, a stepped-care intervention (watchful waiting, CBT and medication if appropriate) achieved a 50% lower incidence rate in a patient group aged 75 or older.<ref>{{cite journal | vauthors = van't Veer-Tazelaar PJ, van Marwijk HW, van Oppen P, van Hout HP, van der Horst HE, Cuijpers P, Smit F, Beekman AT | display-authors = 6 | title = Stepped-care prevention of anxiety and depression in late life: a randomized controlled trial | journal = Archives of General Psychiatry | volume = 66 | issue = 3 | pages = 297–304 | date = March 2009 | pmid = 19255379 | doi = 10.1001/archgenpsychiatry.2008.555 | doi-access = free | hdl = 1871/16425 }}</ref> Another depression study found a neutral effect compared to personal, social, and health education, and usual school provision, and included a comment on potential for increased depression scores from people who have received CBT due to greater self recognition and acknowledgement of existing symptoms of depression and negative thinking styles.<ref>{{cite journal | vauthors = Stallard P, Sayal K, Phillips R, Taylor JA, Spears M, Anderson R, Araya R, Lewis G, Millings A, Montgomery AA | display-authors = 6 | title = Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial | journal = BMJ | volume = 345 | article-number = e6058 | date = October 2012 | pmid = 23043090 | pmc = 3465253 | doi = 10.1136/bmj.e6058 }}</ref> A further study also saw a neutral result.<ref>{{cite journal|vauthors=Clarke GN, Hawkins W, Murphy M, Sheeber L|year=1993|title=School-Based Primary Prevention of Depressive Symptomatology in Adolescents: Findings from Two Studies|journal=Journal of Adolescent Research|volume=8|issue=2|pages=183–204|doi=10.1177/074355489382004|s2cid=143775884}}</ref> A meta-study of the Coping with Depression course, a cognitive behavioral intervention delivered by a psychoeducational method, saw a 38% reduction in risk of major depression.<ref>{{cite journal | vauthors = Cuijpers P, Muñoz RF, Clarke GN, Lewinsohn PM | title = Psychoeducational treatment and prevention of depression: the "Coping with Depression" course thirty years later | journal = Clinical Psychology Review | volume = 29 | issue = 5 | pages = 449–458 | date = July 2009 | pmid = 19450912 | doi = 10.1016/j.cpr.2009.04.005 }}</ref>

===Bipolar disorder===
Many studies show CBT, combined with pharmacotherapy, is effective in improving depressive symptoms, [[mania]] severity and psychosocial functioning with mild to moderate effects, and that it is better than medication alone.<ref name="daCostaRT">{{cite journal | vauthors = da Costa RT, Rangé BP, Malagris LE, Sardinha A, de Carvalho MR, Nardi AE | title = Cognitive-behavioral therapy for bipolar disorder | journal = Expert Review of Neurotherapeutics | volume = 10 | issue = 7 | pages = 1089–1099 | date = July 2010 | pmid = 20586690 | doi = 10.1586/ern.10.75 | s2cid = 20590868 }}</ref><ref>{{cite journal | vauthors = Chiang KJ, Tsai JC, Liu D, Lin CH, Chiu HL, Chou KR | title = Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials | journal = PLOS ONE | volume = 12 | issue = 5 | article-number = e0176849 | date = 4 May 2017 | pmid = 28472082 | pmc = 5417606 | doi = 10.1371/journal.pone.0176849 | bibcode = 2017PLoSO..1276849C | doi-access = free }}</ref><ref name="Kingdon">{{cite journal | vauthors = Kingdon D, Price J |title = Cognitive-behavioral Therapy in Severe Mental Illness|journal = Psychiatric Times|volume = 26|issue = 5|date = 17 April 2009|url = https://www.psychiatrictimes.com/view/cognitive-behavioral-therapy-severe-mental-illness}}</ref>

[[INSERM]]'s 2004 review found that CBT is an effective therapy for several mental disorders, including bipolar disorder.<ref name="INSERM" /> This included schizophrenia, [[Depression (mood)|depression]], [[bipolar disorder]], [[panic disorder]], [[Post-traumatic stress disorder|post-traumatic stress]], anxiety disorders, [[bulimia]], [[Anorexia nervosa|anorexia]], personality disorders and [[Alcoholism|alcohol dependency]].<ref name="INSERM" />

===Psychosis===
In long-term [[Psychosis|psychoses]], CBT is used to complement medication and is adapted to meet individual needs. Interventions particularly related to these conditions include exploring reality testing, changing delusions and hallucinations, examining factors which precipitate relapse, and managing relapses.<ref name="GutierrezM" /> Meta-analyses confirm the effectiveness of [[metacognitive training]] (MCT) for the improvement of positive symptoms (e.g., delusions).<ref>{{cite journal | vauthors = Liu YC, Tang CC, Hung TT, Tsai PC, Lin MF | title = The Efficacy of Metacognitive Training for Delusions in Patients With Schizophrenia: A Meta-Analysis of Randomized Controlled Trials Informs Evidence-Based Practice | journal = Worldviews on Evidence-Based Nursing | volume = 15 | issue = 2 | pages = 130–139 | date = April 2018 | pmid = 29489070 | doi = 10.1111/wvn.12282 | s2cid = 4328727 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Sauvé G, Lavigne KM, Pochiet G, Brodeur MB, Lepage M | title = Efficacy of psychological interventions targeting cognitive biases in schizophrenia: A systematic review and meta-analysis | journal = Clinical Psychology Review | volume = 78 | article-number = 101854 | date = June 2020 | pmid = 32361339 | doi = 10.1016/j.cpr.2020.101854 | s2cid = 218490087 | url = https://escholarship.mcgill.ca/concern/articles/05741x60t }}</ref> <!-- cites previous two sentences -->

For people at risk of [[psychosis]], in 2014 the UK [[National Institute for Health and Care Excellence|National Institute for Health and Care Excellence (NICE)]] recommended preventive CBT.<ref name="thementalelf.net">{{cite web|date=19 February 2014|title=Psychosis and schizophrenia in adults: updated NICE guidance for 2014|url=http://www.thementalelf.net/treatment-and-prevention/medicines/antipsychotics/psychosis-and-schizophrenia-in-adults-updated-nice-guidance-for-2014/|work=National Elf Service}}</ref><ref>{{cite web|title=Psychosis and schizophrenia|url=http://pathways.nice.org.uk/pathways/psychosis-and-schizophrenia#path=view%3A/pathways/psychosis-and-schizophrenia/prevention-in-adults-at-risk-of-developing-psychosis.xml&content=view-node%3Anodes-interventions-to-prevent-psychosis|work=nice.org.uk|access-date=25 July 2016|archive-date=20 April 2019|archive-url=https://web.archive.org/web/20190420143334/https://pathways.nice.org.uk/pathways/psychosis-and-schizophrenia#path=view%3A/pathways/psychosis-and-schizophrenia/prevention-in-adults-at-risk-of-developing-psychosis.xml&content=view-node%3Anodes-interventions-to-prevent-psychosis}}</ref>

===Schizophrenia===
[[INSERM]]'s 2004 review found that CBT is an effective therapy for several mental disorders, including schizophrenia.<ref>{{Cite journal |date=2010-01-03 |title=Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials |journal=Psychological Medicine |volume=40 |issue=1 |pages=9–24 |doi=10.1017/S003329170900590X |issn=1469-8978 |pmid=19476688 |hdl=2299/5741 |hdl-access=free | vauthors = Lynch D, Laws KR, McKenna PJ }}</ref><ref name="INSERM" />

A Cochrane review reported CBT had "no effect on long‐term risk of relapse" and no additional effect above standard care.<ref>{{cite journal | vauthors = Jones C, Hacker D, Xia J, Meaden A, Irving CB, Zhao S, Chen J, Shi C | display-authors = 6 | title = Cognitive behavioural therapy plus standard care versus standard care for people with schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 12 | article-number = CD007964 | date = December 2018 | pmid = 30572373 | pmc = 6517137 | doi = 10.1002/14651858.CD007964.pub2 | collaboration = Cochrane Schizophrenia Group }}</ref> A 2015 [[systematic review]] investigated the effects of CBT compared with other psychosocial therapies for people with schizophrenia and determined that there is no clear advantage over other, often less expensive, interventions but acknowledged that better quality evidence is needed before firm conclusions can be drawn.<ref>{{cite journal | vauthors = Jones C, Hacker D, Meaden A, Cormac I, Irving CB, Xia J, Zhao S, Shi C, Chen J | display-authors = 6 | title = Cognitive behavioural therapy plus standard care versus standard care plus other psychosocial treatments for people with schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 11 | issue = 6 | article-number = CD008712 | date = November 2018 | pmid = 30480760 | pmc = 6516879 | doi = 10.1002/14651858.CD008712.pub3 }}</ref>

===Addiction and substance use disorders===
====Pathological and problem gambling====
CBT is also used for [[problem gambling|pathological and problem gambling]]. The percentage of people who problem gamble is 1–3% around the world.<ref>{{cite journal | vauthors = Okuda M, Balán I, Petry NM, Oquendo M, Blanco C | title = Cognitive-behavioral therapy for pathological gambling: cultural considerations | journal = The American Journal of Psychiatry | volume = 166 | issue = 12 | pages = 1325–1330 | date = December 2009 | pmid = 19952084 | pmc = 2789341 | doi = 10.1176/appi.ajp.2009.08081235 }}</ref> Cognitive behavioral therapy develops skills for relapse prevention and someone can learn to control their mind and manage high-risk cases.<ref>{{Cite web|url=http://www.antonpsych.org/~antonpsy/ieadmin/files/Stop_Addictions_Now.pdf|title=Cognitive–Behavioral Therapy for Pathological Gamblers|archive-url=https://web.archive.org/web/20160919030318/http://www.antonpsych.org/~antonpsy/ieadmin/files/Stop_Addictions_Now.pdf|archive-date=19 September 2016}}</ref> There is evidence of efficacy of CBT for treating pathological and problem gambling at immediate follow up, however the longer term efficacy of CBT for it is currently unknown.<ref>{{cite journal | vauthors = Cowlishaw S, Merkouris S, Dowling N, Anderson C, Jackson A, Thomas S | title = Psychological therapies for pathological and problem gambling | journal = The Cochrane Database of Systematic Reviews | volume = 2012 | article-number = CD008937 | date = November 2012 | issue = 11 | pmid = 23152266 | doi = 10.1002/14651858.CD008937.pub2 | collaboration = Cochrane Common Mental Disorders Group | pmc = 11955261 }}</ref>

====Smoking cessation====
CBT looks at the habit of smoking cigarettes as a learned behavior, which later evolves into a coping strategy to handle daily stressors. Since smoking is often easily accessible and quickly allows the user to feel good, it can take precedence over other coping strategies, and eventually work its way into everyday life during non-stressful events as well. CBT aims to target the function of the behavior, as it can vary between individuals, and works to inject other coping mechanisms in place of smoking. CBT also aims to support individuals with strong cravings, which are a major reported reason for relapse during treatment.<ref>{{Cite web|url=http://www.abct.org/Information/?m=mInformation&fa=fs_TOBACCO|title=Association for Behavioral and Cognitive Therapies; Tobacco Dependence |website=Association for Behavioral and Cognitive Therapies|date=11 March 2021 }}</ref>

A 2008 controlled study out of Stanford University School of Medicine suggested CBT may be an effective tool to help maintain abstinence. The results of 304 random adult participants were tracked over the course of one year. During this program, some participants were provided medication, CBT, 24-hour phone support, or some combination of the three methods. At 20 weeks, the participants who received CBT had a 45% abstinence rate, versus non-CBT participants, who had a 29% abstinence rate. Overall, the study concluded that emphasizing cognitive and behavioral strategies to support smoking cessation can help individuals build tools for long term smoking abstinence.<ref>{{cite journal | vauthors = Killen JD, Fortmann SP, Schatzberg AF, Arredondo C, Murphy G, Hayward C, Celio M, Cromp D, Fong D, Pandurangi M | display-authors = 6 | title = Extended cognitive behavior therapy for cigarette smoking cessation | journal = Addiction | volume = 103 | issue = 8 | pages = 1381–1390 | date = August 2008 | pmid = 18855829 | pmc = 4119230 | doi = 10.1111/j.1360-0443.2008.02273.x }}</ref>

Mental health history can affect the outcomes of treatment. Individuals with a history of depressive disorders had a lower rate of success when using CBT alone to combat smoking addiction.<ref name="pmid12924670">{{cite journal | vauthors = Hitsman B, Borrelli B, McChargue DE, Spring B, Niaura R | title = History of depression and smoking cessation outcome: a meta-analysis | journal = Journal of Consulting and Clinical Psychology | volume = 71 | issue = 4 | pages = 657–663 | date = August 2003 | pmid = 12924670 | doi = 10.1037/0022-006X.71.4.657 | s2cid = 524006 | url = http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1261&context=psychfacpub | url-access = subscription }}</ref>

A 2019 Cochrane review was unable to find sufficient evidence to differentiate effects between CBT and hypnosis for smoking cessation and highlighted that a review of the current research showed variable results for both modalities.<ref name="pmid31198991">{{cite journal | vauthors = Barnes J, McRobbie H, Dong CY, Walker N, Hartmann-Boyce J | title = Hypnotherapy for smoking cessation | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | issue = 6 | article-number = CD001008 | date = June 2019 | pmid = 31198991 | pmc = 6568235 | doi = 10.1002/14651858.CD001008.pub3 }}</ref>

====Substance use disorders====
{{Disputed section|date=May 2024}}
Studies have shown CBT to be an effective treatment for substance use disorders.<ref name="McHughRK" /><ref>{{cite journal | vauthors = Magill M, Ray LA | title = Cognitive-behavioral treatment with adult alcohol and illicit drug users: a meta-analysis of randomized controlled trials | journal = Journal of Studies on Alcohol and Drugs | volume = 70 | issue = 4 | pages = 516–527 | date = July 2009 | pmid = 19515291 | pmc = 2696292 | doi = 10.15288/jsad.2009.70.516 }}</ref><ref>{{cite journal | vauthors = Perry AE, Martyn-St James M, Burns L, Hewitt C, Glanville JM, Aboaja A, Thakkar P, Santosh Kumar KM, Pearson C, Wright K | display-authors = 6 | title = Interventions for female drug-using offenders | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | issue = 12 | article-number = CD010910 | date = December 2019 | pmid = 31834635 | pmc = 6910124 | doi = 10.1002/14651858.CD010910.pub3 }}</ref><ref>{{Cite journal |last1=Boness |first1=Cassandra L. |last2=Votaw |first2=Victoria R. |last3=Schwebel |first3=Frank J. |last4=Moniz-Lewis |first4=David I. K. |last5=McHugh |first5=R. Kathryn |last6=Witkiewitz |first6=Katie |date=27 February 2023 |title=An evaluation of cognitive behavioral therapy for substance use disorders: A systematic review and application of the society of clinical psychology criteria for empirically supported treatments. |journal=Clinical Psychology: Science and Practice |language=en |volume=30 |issue=2 |pages=129–142 |doi=10.1037/cps0000131 |issn=1468-2850 |pmc=10572095 |pmid=37840853}}</ref> For individuals with substance use disorders, CBT aims to reframe maladaptive thoughts, such as denial, minimizing and catastrophizing thought patterns, with healthier narratives.<ref>{{Cite web|url=https://www.sprouthealthgroup.com/treatments/what-is-cognitive-behavioral-therapy/|title=What Is Cognitive Behavioral Therapy? Expert Dr. Mendonsa Explains|date=21 October 2019|website=Sprout Health Group|language=en-US|access-date=15 November 2019}}</ref> Specific techniques include identifying potential triggers and developing coping mechanisms to manage high-risk situations. Research has shown CBT to be particularly effective when combined with other therapy-based treatments or medication.<ref>{{Cite web|url=https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral|title=Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine)|author=National Institute on Drug Abuse|website=drugabuse.gov|language=en|access-date=15 November 2019|archive-date=4 June 2020|archive-url=https://web.archive.org/web/20200604151236/https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral}}</ref>

[[INSERM]]'s 2004 review found that CBT is an effective therapy for several mental disorders, including [[Alcoholism|alcohol dependency]].<ref name=":4" /><ref name="INSERM" />

====Internet addiction====
Research has identified [[Internet addiction disorder|Internet addiction]] as a new clinical disorder that causes relational, occupational, and social problems. CBT has been suggested as the treatment of choice for Internet addiction, and addiction recovery in general has used CBT as part of treatment planning.<ref>{{Cite journal| vauthors = Young K |year=2011|title=CBT-IA: The First Treatment Model for Internet Addiction|url=http://netaddiction.com/wp-content/uploads/2012/10/JCP.CBT-IA.pdf |archive-url=https://ghostarchive.org/archive/20221010/http://netaddiction.com/wp-content/uploads/2012/10/JCP.CBT-IA.pdf |archive-date=2022-10-10 |url-status=live|journal=Journal of Cognitive Psychotherapy|volume=25|issue=4|pages=304–310|doi=10.1891/0889-8391.25.4.304|s2cid=144190312}}</ref>

===Eating disorders===
{{main|Cognitive behavioral treatment of eating disorders}}

Though many forms of [[Eating disorder#Treatment|treatment]] can support individuals with eating disorders, CBT is proven to be a more effective treatment than medications and interpersonal psychotherapy alone.<ref name="MurphyR" /><ref name="Agras" /> CBT aims to combat major causes of distress such as negative cognitions surrounding body weight, shape and size. CBT therapists also work with individuals to regulate strong emotions and thoughts that lead to dangerous compensatory behaviors. CBT is the first line of treatment for [[Bulimia nervosa#Psychotherapy|bulimia nervosa]], and non-specific eating disorders.<ref>{{cite journal | vauthors = Linardon J, Wade TD, de la Piedad Garcia X, Brennan L | title = The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis | journal = Journal of Consulting and Clinical Psychology | volume = 85 | issue = 11 | pages = 1080–1094 | date = November 2017 | pmid = 29083223 | doi = 10.1037/ccp0000245 | s2cid = 8002347 }}</ref> While there is evidence to support the efficacy of CBT for bulimia nervosa and binging, the evidence is somewhat variable and limited by small study sizes.<ref>{{cite journal | vauthors = Hay PP, Bacaltchuk J, Stefano S, Kashyap P | title = Psychological treatments for bulimia nervosa and binging | journal = The Cochrane Database of Systematic Reviews | issue = 4 | article-number = CD000562 | date = October 2009 | volume = 2009 | pmid = 19821271 | pmc = 7034415 | doi = 10.1002/14651858.CD000562.pub3 | collaboration = Cochrane Common Mental Disorders Group }}</ref> [[INSERM]]'s 2004 review found that CBT is an effective therapy for several mental disorders, including [[bulimia]] and [[anorexia nervosa]].<ref name="INSERM" />

===With autistic adults===
Emerging evidence for cognitive behavioral interventions aimed at reducing symptoms of depression, anxiety, and obsessive-compulsive disorder in [[Autism spectrum|autistic]] adults without intellectual disability has been identified through a systematic review.<ref>{{cite journal | vauthors = Benevides TW, Shore SM, Andresen ML, Caplan R, Cook B, Gassner DL, Erves JM, Hazlewood TM, King MC, Morgan L, Murphy LE, Purkis Y, Rankowski B, Rutledge SM, Welch SP, Wittig K | display-authors = 6 | title = Interventions to address health outcomes among autistic adults: A systematic review | journal = Autism | volume = 24 | issue = 6 | pages = 1345–1359 | date = August 2020 | pmid = 32390461 | pmc = 7787674 | doi = 10.1177/1362361320913664 | doi-access = free }}</ref> While the research was focused on adults, cognitive behavioral interventions have also been beneficial to autistic children.<ref>{{cite journal | vauthors = Wood JJ, Drahota A, Sze K, Har K, Chiu A, Langer DA | title = Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 50 | issue = 3 | pages = 224–234 | date = March 2009 | pmid = 19309326 | pmc = 4231198 | doi = 10.1111/j.1469-7610.2008.01948.x }}</ref>  A 2021 Cochrane review found limited evidence regarding the efficacy of CBT for obsessive-compulsive disorder in adults with Autism Spectrum Disorder stating a need for further study.<ref>{{cite journal | vauthors = Elliott SJ, Marshall D, Morley K, Uphoff E, Kumar M, Meader N | title = Behavioural and cognitive behavioural therapy for obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD) | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | issue = 9 | article-number = CD013173 | date = September 2021 | pmid = 34693989 | pmc = 8543671 | doi = 10.1002/14651858.CD013173.pub2 | collaboration = Cochrane Developmental, Psychosocial and Learning Problems Group }}</ref>

===Dementia and mild cognitive impairment===
{{Disputed inline|Talk page section https://en.m.wikipedia.org/w/index.php?title=Talk:Cognitive_behavioral_therapy&diff=prev&oldid=1295461051|date=June 2025}}
A Cochrane review in 2022 found that adults with [[dementia]] and [[Mild cognitive impairment|mild cognitive impairment (MCI)]] who experience symptoms of depression may benefit from CBT, whereas other counselling or supportive interventions might not improve symptoms significantly.<ref name="Orgeta_2022">{{cite journal | vauthors = Orgeta V, Leung P, Del-Pino-Casado R, Qazi A, Orrell M, Spector AE, Methley AM | title = Psychological treatments for depression and anxiety in dementia and mild cognitive impairment | journal = The Cochrane Database of Systematic Reviews | volume = 2022 | issue = 4 | article-number = CD009125 | date = April 2022 | pmid = 35466396 | pmc = 9035877 | doi = 10.1002/14651858.CD009125.pub3 }}</ref> Across 5 different psychometric scales, where higher scores indicate severity of depression, adults receiving CBT reported somewhat lower mood scores than those receiving usual care for dementia and MCI overall.<ref name="Orgeta_2022" />  In this review, a sub-group analysis found [[clinically significant]] benefits only among those diagnosed with dementia, rather than MCI.<ref name="Orgeta_2022" /><ref>{{cite journal | vauthors = Andrade C | title = Mean Difference, Standardized Mean Difference (SMD), and Their Use in Meta-Analysis: As Simple as It Gets | journal = The Journal of Clinical Psychiatry | volume = 81 | issue = 5 | article-number = 20f13681 | date = September 2020 | pmid = 32965803 | doi = 10.4088/JCP.20f13681 | s2cid = 221865130 | doi-access = free }}</ref>

The likelihood of remission from depression also appeared to be 84% higher following CBT, though the evidence for this was less certain. Anxiety, cognition and other neuropsychiatric symptoms were not significantly improved following CBT, however this review did find moderate evidence of improved quality of life and daily living activity scores in those with dementia and MCI.<ref name="Orgeta_2022" />

=== Post-traumatic stress ===
Cognitive behavioral therapy interventions may have some benefits for people who have post-traumatic stress related to surviving rape, sexual abuse, or sexual assault.<ref>{{cite journal | vauthors = O'Doherty L, Whelan M, Carter GJ, Brown K, Tarzia L, Hegarty K, Feder G, Brown SJ | display-authors = 6 | title = Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood | journal = The Cochrane Database of Systematic Reviews | volume = 2023 | issue = 10 | article-number = CD013456 | date = October 2023 | pmid = 37795783 | pmc = 10552071 | doi = 10.1002/14651858.CD013456.pub2 | collaboration = Cochrane Developmental, Psychosocial and Learning Problems Group }}</ref> There is strong evidence that CBT-exposure therapy can reduce PTSD symptoms and lead to the loss of a PTSD diagnosis.<ref>{{cite report |title=Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update |date=17 May 2018 |publisher=Agency for Healthcare Research and Quality |doi=10.23970/ahrqepccer207 |pmid=30204376 |doi-access=free |vauthors=Forman-Hoffman V, Middleton JC, Feltner C, Gaynes BN, Weber RP, Bann C, Viswanathan M, Lohr KN, Baker C, Green J |display-authors=6 |publication-place=Rockville, MD}}</ref> In addition, CBT has also been shown to be effective for post-traumatic stress disorder in very young children (3 to 6 years of age).<ref>{{cite journal |vauthors=Scheeringa MS, Weems CF, Cohen JA, Amaya-Jackson L, Guthrie D |date=August 2011 |title=Trauma-focused cognitive-behavioral therapy for posttraumatic stress disorder in three-through six year-old children: a randomized clinical trial |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |volume=52 |issue=8 |pages=853–860 |doi=10.1111/j.1469-7610.2010.02354.x |pmc=3116969 |pmid=21155776}}</ref> There is lower quality evidence that CBT may be more effective than other psychotherapies in reducing symptoms of posttraumatic stress disorder in children and adolescents.<ref>{{cite journal |vauthors=Gillies D, Maiocchi L, Bhandari AP, Taylor F, Gray C, O'Brien L |date=October 2016 |title=Psychological therapies for children and adolescents exposed to trauma |journal=The Cochrane Database of Systematic Reviews |volume=2016 |issue=10 |article-number=CD012371 |doi=10.1002/14651858.CD012371 |pmc=6457979 |pmid=27726123 |collaboration=Cochrane Common Mental Disorders Group}}</ref>

===Other uses===
Evidence suggests a possible role for CBT in the treatment of [[attention deficit hyperactivity disorder]] (ADHD),<ref name="KnouseLE">{{cite journal | vauthors = Knouse LE, Safren SA | title = Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder | journal = The Psychiatric Clinics of North America | volume = 33 | issue = 3 | pages = 497–509 | date = September 2010 | pmid = 20599129 | pmc = 2909688 | doi = 10.1016/j.psc.2010.04.001 }}</ref> [[hypochondriasis]],<ref>{{cite journal | vauthors = Thomson AB, Page LA | title = Psychotherapies for hypochondriasis | journal = The Cochrane Database of Systematic Reviews | issue = 4 | article-number = CD006520 | date = October 2007 | volume = 2007 | pmid = 17943915 | pmc = 6956615 | doi = 10.1002/14651858.CD006520.pub2 | veditors = Thomson A }}</ref> and bipolar disorder,<ref name="daCostaRT" /> but more study is needed and results should be interpreted with caution. Moderate evidence from a 2024 systematic review supports the effectiveness of CBT and neurofeedback as part of [[psychosocial]] interventions for improving ADHD symptoms in children and adolescents.<ref>{{Cite journal |last1=Peterson |first1=Bradley S. |last2=Trampush |first2=Joey |last3=Maglione |first3=Margaret |last4=Bolshakova |first4=Maria |last5=Rozelle |first5=Mary |last6=Miles |first6=Jeremy |last7=Pakdaman |first7=Sheila |last8=Brown |first8=Morah |last9=Yagyu |first9=Sachi |last10=Motala |first10=Aneesa |last11=Hempel |first11=Susanne |date=2024-04-01 |title=Treatments for ADHD in Children and Adolescents: A Systematic Review |url=https://publications.aap.org/pediatrics/article/153/4/e2024065787/196922/Treatments-for-ADHD-in-Children-and-Adolescents-A |journal=Pediatrics |language=en |volume=153 |issue=4 |article-number=e2024065787 |doi=10.1542/peds.2024-065787 |pmid=38523592 |issn=0031-4005|url-access=subscription }}</ref>

CBT has been studied as an aid in the treatment of anxiety associated with [[stuttering]]. Initial studies have shown CBT to be effective in reducing social anxiety in adults who stutter,<ref name="pmid21705407">{{cite journal | vauthors = O'Brian S, Onslow M | title = Clinical management of stuttering in children and adults | journal = BMJ | volume = 342 | article-number = d3742 | date = June 2011 | pmid = 21705407 | doi = 10.1136/bmj.d3742 | s2cid = 26821286 }}</ref> but not in reducing stuttering frequency.<ref name="pmid21478283">{{cite journal | vauthors = Iverach L, Menzies RG, O'Brian S, Packman A, Onslow M | title = Anxiety and stuttering: continuing to explore a complex relationship | journal = American Journal of Speech-Language Pathology | volume = 20 | issue = 3 | pages = 221–232 | date = August 2011 | pmid = 21478283 | doi = 10.1044/1058-0360(2011/10-0091) }}</ref><ref name="pmid19948272">{{cite journal | vauthors = Menzies RG, Onslow M, Packman A, O'Brian S | title = Cognitive behavior therapy for adults who stutter: a tutorial for speech-language pathologists | journal = Journal of Fluency Disorders | volume = 34 | issue = 3 | pages = 187–200 | date = September 2009 | pmid = 19948272 | doi = 10.1016/j.jfludis.2009.09.002 | s2cid = 38492355 }}</ref>

There is some evidence that CBT is superior in the long-term to [[benzodiazepine]]s and the [[nonbenzodiazepine]]s in the treatment and management of [[insomnia]].<ref name="Mitchell-2012">{{cite journal | vauthors = Mitchell MD, Gehrman P, Perlis M, Umscheid CA | title = Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review | journal = BMC Family Practice | volume = 13 | issue = 1 | article-number = 40 | date = May 2012 | pmid = 22631616 | pmc = 3481424 | doi = 10.1186/1471-2296-13-40 | doi-access = free }}</ref> Computerized CBT (CCBT) has been proven to be effective by randomized controlled and other trials in treating insomnia.<ref name="DoisleepMissing">{{cite journal | vauthors = Espie CA, Kyle SD, Williams C, Ong JC, Douglas NJ, Hames P, Brown JS | title = A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application | journal = Sleep | volume = 35 | issue = 6 | pages = 769–781 | date = June 2012 | pmid = 22654196 | pmc = 3353040 | doi = 10.5665/sleep.1872 }}</ref> Some research has found similar effectiveness to an intervention of informational websites and weekly telephone calls.<ref name="Schneider" /><ref name="MoodGym no better than informational websites_2012" /> CCBT was found to be equally effective as face-to-face CBT in [[insomnia]].<ref name="DoisleepMissing" />

A Cochrane review of interventions aimed at preventing psychological stress in healthcare workers found that CBT was more effective than no intervention but no more effective than alternative stress-reduction interventions.<ref>{{cite journal | vauthors = Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF | display-authors = 6 | title = Individual-level interventions for reducing occupational stress in healthcare workers | journal = The Cochrane Database of Systematic Reviews | volume = 2023 | issue = 5 | article-number = CD002892 | date = May 2023 | pmid = 37169364 | pmc = 10175042 | doi = 10.1002/14651858.CD002892.pub6 }}</ref>

Cochrane Reviews have found no convincing evidence that CBT training helps [[foster care]] providers manage difficult behaviors in the youths under their care,<ref name="Turner W, Macdonald GM, Dennis JA 2007 CD003760">{{cite journal | vauthors = Turner W, Macdonald GM, Dennis JA | title = Cognitive-behavioural training interventions for assisting foster carers in the management of difficult behaviour | journal = The Cochrane Database of Systematic Reviews | issue = 1 | article-number = CD003760 | date = January 2007 | volume = 2007 | pmid = 17253496 | pmc = 8728638 | doi = 10.1002/14651858.CD003760.pub3 | veditors = Turner W | s2cid = 43214648}}</ref> nor was it helpful in treating people who [[Domestic violence|abuse]] their intimate partners.<ref name="Smedslund G, Dalsbø TK, Steiro AK, Winsvold A, Clench-Aas J 2007 CD006048">{{cite journal | vauthors = Smedslund G, Dalsbø TK, Steiro AK, Winsvold A, Clench-Aas J | title = Cognitive behavioural therapy for men who physically abuse their female partner | journal = The Cochrane Database of Systematic Reviews | issue = 3 | article-number = CD006048 | date = July 2007 | volume = 2012 | pmid = 17636823 | doi = 10.1002/14651858.CD006048.pub2 | veditors = Smedslund G | s2cid = 41205102 | pmc = 12047670 }}</ref>

CBT has been applied in both clinical and non-clinical environments to treat disorders such as personality disorders and behavioral problems.<ref>{{cite journal | vauthors = Butler AC, Chapman JE, Forman EM, Beck AT | title = The empirical status of cognitive-behavioral therapy: a review of meta-analyses | journal = Clinical Psychology Review | volume = 26 | issue = 1 | pages = 17–31 | date = January 2006 | pmid = 16199119 | doi = 10.1016/j.cpr.2005.07.003 | citeseerx = 10.1.1.413.7178 | s2cid = 8511716 }}</ref> [[INSERM]]'s 2004 review found that CBT is an effective therapy for personality disorders.<ref name="INSERM" />

CBT has been used with other researchers as well to minimize [[chronic pain]] and help relieve symptoms from those suffering from [[irritable bowel syndrome]] (IBS).<ref>{{cite journal | vauthors = Lackner JM, Keefer L, Jaccard J, Firth R, Brenner D, Bratten J, Dunlap LJ, Ma C, Byroads M | display-authors = 6 | title = The Irritable Bowel Syndrome Outcome Study (IBSOS): rationale and design of a randomized, placebo-controlled trial with 12 month follow up of self- versus clinician-administered CBT for moderate to severe irritable bowel syndrome | journal = Contemporary Clinical Trials | volume = 33 | issue = 6 | pages = 1293–1310 | date = November 2012 | pmid = 22846389 | pmc = 3468694 | doi = 10.1016/j.cct.2012.07.013 }}</ref>

====Individuals with medical conditions====
In the case of people with [[metastatic breast cancer]], data is limited but CBT and other psychosocial interventions might help with psychological outcomes and pain management.<ref name="Mustafa2013">{{cite journal | vauthors = Mustafa M, Carson-Stevens A, Gillespie D, Edwards AG | title = Psychological interventions for women with metastatic breast cancer | journal = The Cochrane Database of Systematic Reviews | issue = 6 | article-number = CD004253 | date = June 2013 | volume = 2015 | pmid = 23737397 | doi = 10.1002/14651858.CD004253.pub4 | pmc = 11032751 }}</ref> There is also some evidence that CBT may help reduce insomnia in cancer patients.<ref>{{Cite journal |last1=Johnson |first1=Jillian A. |last2=Rash |first2=Joshua A. |last3=Campbell |first3=Tavis S. |last4=Savard |first4=Josée |last5=Gehrman |first5=Philip R. |last6=Perlis |first6=Michael |last7=Carlson |first7=Linda E. |last8=Garland |first8=Sheila N. |date=2016-06-01 |title=A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors |url=https://www.sciencedirect.com/science/article/abs/pii/S1087079215000921 |journal=Sleep Medicine Reviews |volume=27 |pages=20–28 |doi=10.1016/j.smrv.2015.07.001 |pmid=26434673 |issn=1087-0792|url-access=subscription }}</ref> 

There is some evidence that using CBT for symptomatic management of non-specific chest pain is probably effective in the short term. However, the findings were limited by small trials and the evidence was considered of questionable quality.<ref>{{cite journal | vauthors = Kisely SR, Campbell LA, Yelland MJ, Paydar A | title = Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | issue = 6 | article-number = CD004101 | date = June 2015 | pmid = 26123045 | pmc = 6599861 | doi = 10.1002/14651858.cd004101.pub5 }}</ref> [[Cochrane Collaboration|Cochrane reviews]] have found no evidence that CBT is effective for [[tinnitus]], although there appears to be an effect on management of associated depression and quality of life in this condition.<ref name="Martinez-Devesa P, Perera R, Theodoulou M, Waddell A 2010 CD005233">{{cite journal | vauthors = Martinez-Devesa P, Perera R, Theodoulou M, Waddell A | title = Cognitive behavioural therapy for tinnitus | journal = The Cochrane Database of Systematic Reviews | issue = 9 | article-number = CD005233 | date = September 2010 | pmid = 20824844 | doi = 10.1002/14651858.CD005233.pub3 | veditors = Martinez-Devesa P | type = Submitted manuscript | pmc = 6956618 }}</ref> CBT combined with hypnosis and distraction reduces self-reported pain in children.<ref>{{cite journal | vauthors = Robertson J | title = Review: distraction, hypnosis, and combined cognitive-behavioural interventions reduce needle related pain and distress in children and adolescents | journal = Evidence-Based Nursing | volume = 10 | issue = 3 | page = 75 | date = July 2007 | pmid = 17596380 | doi = 10.1136/ebn.10.3.75 | s2cid = 34364928 }}</ref>

There is limited evidence to support CBT's use in managing the impact of [[multiple sclerosis]],<ref>{{cite journal | vauthors = Thomas PW, Thomas S, Hillier C, Galvin K, Baker R | title = Psychological interventions for multiple sclerosis | journal = The Cochrane Database of Systematic Reviews | volume = 2010 | issue = 1 | article-number = CD004431 | date = January 2006 | pmid = 16437487 | pmc = 8406851 | doi = 10.1002/14651858.CD004431.pub2 | veditors = Thomas PW }}</ref><ref>{{Cite web |date=2023-09-01 |title=Comparing Treatments for Multiple Sclerosis-Related Fatigue - Evidence Update for Clinicians {{!}} PCORI |url=https://www.pcori.org/evidence-updates/comparing-treatments-multiple-sclerosis-related-fatigue |access-date=2023-12-21 |website=www.pcori.org |language=en}}</ref> sleep disturbances related to aging,<ref>{{cite journal | vauthors = Montgomery P, Dennis J | title = Cognitive behavioural interventions for sleep problems in adults aged 60+ | journal = The Cochrane Database of Systematic Reviews | issue = 1 | article-number = CD003161 | date = 2003 | pmid = 12535460 | pmc = 6991159 | doi = 10.1002/14651858.CD003161 }}</ref> and [[dysmenorrhea]],<ref>{{cite journal | vauthors = Proctor ML, Murphy PA, Pattison HM, Suckling J, Farquhar CM | title = Behavioural interventions for primary and secondary dysmenorrhoea | journal = The Cochrane Database of Systematic Reviews | issue = 3 | article-number = CD002248 | date = July 2007 | volume = 2007 | pmid = 17636702 | pmc = 7137212 | doi = 10.1002/14651858.CD002248.pub3 | veditors = Proctor M }}</ref> but more study is needed and results should be interpreted with caution.

Previously CBT has been considered as moderately effective for treating [[myalgic encephalomyelitis/chronic fatigue syndrome]] (ME/CFS),<ref name="cbt_systematic_review">{{cite journal | vauthors = Chambers D, Bagnall AM, Hempel S, Forbes C | title = Interventions for the treatment, management and rehabilitation of patients with chronic fatigue syndrome/myalgic encephalomyelitis: an updated systematic review | journal = Journal of the Royal Society of Medicine | volume = 99 | issue = 10 | pages = 506–520 | date = October 2006 | pmid = 17021301 | pmc = 1592057 | doi = 10.1177/014107680609901012 }}</ref> however a [[National Institutes of Health]] Pathways to Prevention Workshop stated that in respect of improving treatment options for ME/CFS that the modest benefit from cognitive behavioral therapy should be studied as an adjunct to other methods.<ref name="Position Papers">{{cite journal | vauthors = Green CR, Cowan P, Elk R, O'Neil KM, Rasmussen AL | title = National Institutes of Health Pathways to Prevention Workshop: Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | journal = Annals of Internal Medicine | volume = 162 | issue = 12 | pages = 860–865 | date = June 2015 | pmid = 26075757 | doi = 10.7326/M15-0338 | s2cid = 24156332 }}</ref> The [[Centres for Disease Control]] advice on the treatment of ME/CFS<ref>{{Cite web|url=https://www.cdc.gov/me-cfs/treatment/index.html|title=Treatment of ME/CFS &#124; Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) &#124; CDC|date=11 February 2021|website=www.cdc.gov}}</ref> makes no reference to CBT while the [[National Institute for Health and Care Excellence]]<ref>{{Cite web|url=https://www.nice.org.uk/guidance/ng206/chapter/Recommendations#managing-mecfs|title=Recommendations &#124; Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management &#124; Guidance &#124; NICE|website=www.nice.org.uk|date=29 October 2021 }}</ref> states that cognitive behavioral therapy (CBT) has sometimes been assumed to be a cure for ME/CFS, however, it should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness. 

===Age===
CBT is used to help people of all ages, but the therapy should be adjusted based on the age of the patient with whom the therapist is dealing. Older individuals in particular have certain characteristics that need to be acknowledged and the therapy altered to account for these differences thanks to age.<ref name="Bienenfeld">{{cite journal |vauthors=Bienenfeld D |year=2009 |title=Cognitive therapy with older adults |journal=Psychiatric Annals |volume=39 |issue=9 |pages=828–832 |doi=10.3928/00485713-20090821-02}}</ref> Of the small number of studies examining CBT for the management of depression in older people, there is currently no strong support.<ref>{{cite journal |vauthors=Wilson KC, Mottram PG, Vassilas CA |date=January 2008 |title=Psychotherapeutic treatments for older depressed people |journal=The Cochrane Database of Systematic Reviews |issue=1 |article-number=CD004853 |doi=10.1002/14651858.CD004853.pub2 |pmid=18254062 |collaboration=Cochrane Common Mental Disorders Group}}</ref>

==Description==
Mainstream cognitive behavioral therapy assumes that changing [[maladaptive]] thinking leads to change in [[behavior]] and [[Affect (psychology)|affect]],<ref name="HassettAL" /> but recent variants emphasize changes in one's relationship to maladaptive thinking rather than changes in thinking itself.<ref name="HayesSC">{{cite journal |vauthors=Hayes SC, Villatte M, Levin M, Hildebrandt M |year=2011 |title=Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies |journal=Annual Review of Clinical Psychology |volume=7 |issue=1 |pages=141–168 |doi=10.1146/annurev-clinpsy-032210-104449 |pmid=21219193 |s2cid=6529775}}</ref>

===Cognitive distortions===
Therapists use CBT techniques to help people challenge their patterns and beliefs and replace errors in thinking, known as [[cognitive distortion]]s with "more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior".<ref name="HassettAL" /> Cognitive distortions can be either a pseudo-discrimination belief{{Clarify|date=October 2023}} or an overgeneralization of something.<ref>{{cite journal |vauthors=Dawes RM |date=April 1964 |title=Cognitive Distortion: Monograph Supplement 4-V14 |journal=Psychological Reports |volume=14 |issue=2 |pages=443–459 |doi=10.2466/pr0.1964.14.2.443 |s2cid=144381210}}</ref> CBT techniques may also be used to help individuals take a more open, mindful, and aware posture toward cognitive distortions so as to diminish their impact.<ref name="HayesSC" />

Mainstream CBT helps individuals replace "maladaptive... coping skills, cognitions, emotions and behaviors with more adaptive ones",<ref name="GatchelRJ" /> by challenging an individual's way of thinking and the way that they react to certain habits or behaviors,<ref>{{cite book |url=https://books.google.com/books?id=_0_pRyy9McQC |title=Fundamentals of nursing: concepts, process and practice |vauthors=Kozier B |publisher=Pearson Education |year=2008 |isbn=978-0-13-197653-5 |page=187}}</ref> but there is still controversy about the degree to which these traditional cognitive elements account for the effects seen with CBT over and above the earlier behavioral elements such as exposure and skills training.<ref name="LongmoreRJ">{{cite journal |vauthors=Longmore RJ, Worrell M |date=March 2007 |title=Do we need to challenge thoughts in cognitive behavior therapy? |journal=Clinical Psychology Review |volume=27 |issue=2 |pages=173–187 |doi=10.1016/j.cpr.2006.08.001 |pmid=17157970}}</ref>

===Assumptions===
Chaloult, Ngo, Cousineau and Goulet<ref>{{Cite book |last1=Chaloult |first1=Louis |title=La thérapie cognitivo-comportementale: théorie et pratique |last2=Ngo |first2=Thanh-Lan |last3=Cousineau |first3=Pierre |last4=Goulet |first4=Jean |publisher=Gaëtan Morin |year=2008 |isbn=978-2-89632-021-9 |pages=68–80}}</ref> have attempted to identify the main assumptions of cognitive therapy used in CBT based on the research literature (Beck;<ref>{{cite book | vauthors = Beck AT | date = 1979 | title = Cognitive Therapy and the Emotional Disorders | publisher = Plume | isbn = 978-0-452-00928-8 }}</ref> Walen and Wessler;<ref>{{Cite book |last1=Walen |first1=Susan R. |title=A practitioner's guide to rational-emotive therapy |last2=DiGiuseppe |first2=Raymond |last3=Wessler |first3=Richard L. |date=1980 |publisher=Oxford University Press |isbn=978-0-19-502667-2 |location=New York}}</ref> Beck, Emery and Greenberg,<ref>{{Cite book |last1=Beck |first1=Aaron |title=Anxiety Disorders And Phobias: A Cognitive Perspective |last2=Emery |first2=Gary |last3=Greenberg |first3=Ruth L |publisher=[[Basic Books]] |year=1985 |isbn=978-0-465-00385-3}}</ref> and Auger<ref>{{Cite book |last=Auger |first=Lucien |title=La démarche émotivo-rationnelle |publisher=Éditions Ville-Marie |year=1986 |isbn=978-2-89194-153-2}}</ref>). They describe fourteen assumptions:
# Human emotions are primarily caused by people's thoughts and perceptions rather than events.
# Events, thoughts, emotions, behaviors, and physiological reactions influence each other.
# Dysfunctional emotions are typically caused by unrealistic thoughts. Reducing dysfunctional emotions requires becoming aware of irrational thoughts and changing them.
# Human beings have an innate tendency to develop irrational thoughts. This tendency is reinforced by their environment.
# People are largely responsible for their own dysfunctional emotions, as they maintain and reinforce their own beliefs.
# Sustained effort is necessary to modify dysfunctional thoughts, emotions, and behaviors.
# Rational thinking usually causes a decrease in the frequency, intensity, and duration of dysfunctional emotions, rather than an absence of affect or feelings.
# A positive therapeutic relationship is essential to successful cognitive therapy.
# Cognitive therapy is based on a teacher-student relationship, where the therapist educates the client.
# Cognitive therapy uses [[Socratic questioning]] to challenge cognitive distortions.
# Homework is an essential aspect of cognitive therapy. It consolidates the skills learned in therapy.
# The cognitive approach is active, directed, and structured.
# Cognitive therapy is generally short.
# Cognitive therapy is based on predictable steps.

These steps largely involve learning about the CBT model; making links between thoughts, emotions, behaviors, and physiological reactions; noticing when dysfunctional emotions occur; learning to question the thoughts associated with these emotions; replacing irrational thoughts with others more grounded in reality; modifying behaviors based on new interpretations of events; and, in some cases, learning to recognize and change the major beliefs and attitudes underlying cognitive distortions.

Chaloult, Ngo, Cousineau and Goulet have also described the assumptions of behavioral therapy as used in CBT.<ref>{{Cite book |last1=Chaloult |first1=Louis |title=La thérapie cognitivo-comportementale: théorie et pratique |last2=Ngo |first2=Thanh-Lan |last3=Cousineau |first3=Pierre |last4=Goulet |first4=Jean |publisher=Gaëtan Morin |year=2008 |isbn=978-2-89632-021-9 |pages=18–21}}</ref> They refer to the work of Agras,<ref>{{Cite book |last=Agras |first=WS |title=Kaplan & Sadock's Comprehensive Textbook of Psychiatry |publisher=Williams and Wilkins |year=1995 |isbn=978-1-4511-0047-1 |editor-last=Kaplan |editor-first=HI |edition=6th |location=Philadelphia |chapter=Behavior Therapy |editor-last2=Sadock |editor-first2=BJ }}</ref> Prochaska and Norcross,<ref>{{Cite book |last1=Prochaska |first1=James O. |title=Systems of psychotherapy: a transtheoretical analysis |last2=Norcross |first2=John C. |date=1994 |publisher=Oxford University Press |isbn=978-0-19-088041-5 |location=New York, NY}}</ref> and Kirk.<ref>{{Citation |last=Kirk |first=Joan |title=Cognitive–behavioural assessment |date=1989 |work=Cognitive Behaviour Therapy for Psychiatric Problems |pages=13–51 |publisher=Oxford University Press|doi=10.1093/med:psych/9780192615879.003.0002 |isbn=978-0-19-261587-9 }}</ref> The assumptions are:
# Behaviors play an essential role in the onset, perpetuation and exacerbation of psychopathology.
# [[behaviorism|Learning theory]] is key in understanding the treatment of mental illness, as behaviors can be learned and unlearned.
# A rigorous evaluation ([[applied behavior analysis]]) is essential at the start of treatment. It includes identifying behaviors; precipitating, moderating, and perpetuating factors; the consequences of the behaviors; avoidance, and personal resources.
# The effectiveness of the treatment is monitored throughout its duration.
# Behavior therapy is scientific and the different forms of treatment are evaluated with rigorous evidence.
# Behavior therapy is active, directed, and structured.

Together, these sets of assumptions cover the cognitive and behavioral aspects of CBT.

===Phases in therapy===
CBT can be seen as having six phases:<ref name="GatchelRJ" />
# Assessment or [[psychological assessment]];
# Reconceptualization;
# Skills acquisition;
# Skills consolidation and application training;
# [[Generalization]] and maintenance;
# Post-treatment assessment follow-up.

These steps are based on a system created by Kanfer and Saslow.<ref name="Psychological Testing">{{cite book |title=Psychological Testing |vauthors=Kaplan R, Saccuzzo D |publisher=Wadsworth |page=415}}</ref> After identifying the behaviors that need changing, whether they be in excess or deficit, and treatment has occurred, the psychologist must identify whether or not the intervention succeeded. For example, "If the goal was to decrease the behavior, then there should be a decrease relative to the baseline. If the critical behavior remains at or above the baseline, then the intervention has failed."<ref name="Psychological Testing" />

The steps in the assessment phase include:
# Identify critical behaviors;
# Determine whether critical behaviors are excesses or deficits;
# Evaluate critical behaviors for frequency, duration, or intensity (obtain a baseline);
# If excess, attempt to decrease frequency, duration, or intensity of behaviors; if deficits, attempt to increase behaviors.<ref>{{cite book |title=Psychological Testing |vauthors=Kaplan R, Saccuzzo D |publisher=Wadsworth |pages=415, Table 15.3}}</ref>

The re-conceptualization phase makes up much of the "cognitive" portion of CBT.<ref name="GatchelRJ" />

===Delivery protocols===
There are different protocols for delivering cognitive behavioral therapy, with important similarities among them.<ref name="HofmannSG">{{cite journal |vauthors=Hofmann SG, Sawyer AT, Fang A |date=September 2010 |title=The empirical status of the "new wave" of cognitive behavioral therapy |journal=The Psychiatric Clinics of North America |volume=33 |issue=3 |pages=701–710 |doi=10.1016/j.psc.2010.04.006 |pmc=2898899 |pmid=20599141}}</ref> Use of the term CBT may refer to different interventions, including "self-instructions (e.g. distraction, imagery, motivational self-talk), relaxation and/or [[biofeedback]], development of adaptive coping strategies (e.g. minimizing negative or self-defeating thoughts), changing maladaptive beliefs about pain, and [[goal setting]]".<ref name="GatchelRJ" /> Treatment is sometimes manualized, with brief, direct, and time-limited treatments for individual psychological disorders that are specific technique-driven.<ref>{{cite journal |vauthors=Pagano J, Kyle BN, Johnson TL |date=February 2017 |title=A Manual by Any Other Name: Identifying Psychotherapy Manuals for Resident Training |journal=Academic Psychiatry |volume=41 |issue=1 |pages=44–50 |doi=10.1007/s40596-016-0492-4 |pmid=27048607 |s2cid=26071140}}</ref> CBT is used in both individual and group settings, and the techniques are often adapted for [[self-help]] applications. Some clinicians and researchers are cognitively oriented (e.g. [[cognitive restructuring]]), while others are more behaviorally oriented (e.g. ''[[in vivo]]'' [[exposure therapy]]). Interventions such as imaginal exposure therapy combine both approaches.<ref>{{cite journal |vauthors=Foa EB, Rothbaum BO, Furr JM |date=Jan 2003 |title=Augmenting exposure therapy with other CBT procedures |journal=Psychiatric Annals |volume=33 |issue=1 |pages=47–53 |doi=10.3928/0048-5713-20030101-08}}</ref><ref>{{cite book |title=This book will make you happy |vauthors=Jessamy H, Jo U |publisher=Quercus |year=2014 |isbn=978-1-84866-281-0}}</ref>

===Related techniques===
CBT may be delivered in conjunction with a variety of diverse but related techniques such as [[exposure therapy]], [[stress inoculation]], [[cognitive processing therapy]], [[cognitive therapy]], [[metacognitive therapy]], [[metacognitive training]], [[relaxation training]], [[dialectical behavior therapy]], and [[acceptance and commitment therapy]].<ref>{{cite book |title=Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies |vauthors=Foa EB |publisher=Guilford |year=2009 |edition=2nd |place=New York}}{{page needed|date=April 2013}}</ref><ref name="KaczkurkinFoa2015">{{cite journal |vauthors=Kaczkurkin AN, Foa EB |date=September 2015 |title=Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence |journal=Dialogues in Clinical Neuroscience |type=Review |volume=17 |issue=3 |pages=337–346 |doi=10.31887/DCNS.2015.17.3/akaczkurkin |pmc=4610618 |pmid=26487814}}</ref> Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.<ref>{{cite book |title=Facts of Life: ten issues of contentment |vauthors=Graham MC |date=2014 |publisher=Outskirts Press |isbn=978-1-4787-2259-5}}</ref>

==Methods of access==
===Therapist===
A typical CBT program would consist of face-to-face sessions between patient and therapist, made up of 6–18 sessions of around an hour each with a gap of 1–3 weeks between sessions. This initial program might be followed by some booster sessions, for instance after one month and three months.<ref>{{cite book|title=Cognitive behavioural therapy for the management of common mental health problems|url=http://www.nice.org.uk/media/878/F7/CBTCommissioningGuide.pdf|publisher=[[National Institute for Health and Care Excellence]]|year=2008|access-date=4 November 2013|archive-url=https://web.archive.org/web/20131105200545/http://www.nice.org.uk/media/878/f7/cbtcommissioningguide.pdf|archive-date=5 November 2013}}{{page needed|date=April 2013}}</ref> CBT has also been found to be effective if patient and therapist type in real time to each other over computer links.<ref>{{cite journal | vauthors = Kessler D, Lewis G, Kaur S, Wiles N, King M, Weich S, Sharp DJ, Araya R, Hollinghurst S, Peters TJ | display-authors = 6 | title = Therapist-delivered Internet psychotherapy for depression in primary care: a randomised controlled trial | journal = Lancet | volume = 374 | issue = 9690 | pages = 628–634 | date = August 2009 | pmid = 19700005 | doi = 10.1016/S0140-6736(09)61257-5 | s2cid = 13715933 }}</ref><ref>{{cite journal | vauthors = Hollinghurst S, Peters TJ, Kaur S, Wiles N, Lewis G, Kessler D | title = Cost-effectiveness of therapist-delivered online cognitive-behavioural therapy for depression: randomised controlled trial | journal = The British Journal of Psychiatry | volume = 197 | issue = 4 | pages = 297–304 | date = October 2010 | pmid = 20884953 | doi = 10.1192/bjp.bp.109.073080 | doi-access = free }}</ref>

Cognitive-behavioral therapy is most closely allied with the [[scientist–practitioner model]] in which clinical practice and research are informed by a scientific perspective, clear [[operationalization]] of the problem, and an emphasis on [[measurement]], including measuring changes in cognition and behavior and the attainment of [[goal]]s.<ref>{{Cite web |title=Cognitive Behaviour Therapy (CBT) and Relaxation Therapy Change Psychological and Biological Variables |url=https://www.ijirset.com/upload/may/49_Cognitive.pdf |website=IJIRSET}}</ref> These are often met through "[[Homework in psychotherapy|homework]]" assignments in which the patient and the therapist work together to craft an assignment to complete before the next session.<ref name="Martin">{{Unreliable medical source|date=April 2012}} {{cite web|author=Martin, Ben|title=In-Depth: Cognitive Behavioral Therapy|work=Psych Central.com |url=http://psychcentral.com/lib/2007/in-depth-cognitive-behavioral-therapy/all/1/|publisher=PsychCentral|access-date=15 March 2012|archive-date=3 July 2013|archive-url=https://web.archive.org/web/20130703112428/http://psychcentral.com/lib/2007/in-depth-cognitive-behavioral-therapy/all/1/}}</ref> The completion of these assignments&nbsp;– which can be as simple as a person with depression attending some kind of social event&nbsp;– indicates a dedication to treatment compliance and a desire to change.<ref name="Martin" /> The therapists can then logically gauge the next step of treatment based on how thoroughly the patient completes the assignment.<ref name="Martin" /> Effective cognitive behavioral therapy is dependent on a [[Therapeutic relationship|therapeutic alliance]] between the healthcare practitioner and the person seeking assistance.<ref name="CBT" /><ref name="BAT">{{cite book |vauthors=Bender S, Messner E |year=2003 |title=Becoming a therapist: What do I say, and why? |pages=24, 34–35 |location=New York|publisher=The Guilford Press}}</ref> Unlike many other forms of psychotherapy, the patient is very involved in CBT.<ref name="Martin" /> For example, an anxious patient may be asked to talk to a stranger as a homework assignment, but if that is too difficult, he or she can work out an easier assignment first.<ref name="Martin" /> The therapist needs to be flexible and willing to listen to the patient rather than acting as an authority figure.<ref name="Martin" />

==={{anchor|Computerized}} Computerized or Internet-delivered (CCBT)===

Computerized cognitive behavioral therapy (CCBT) has been described by [[National Institute for Health and Clinical Excellence|NICE]] as a "generic term for delivering CBT via an interactive computer interface delivered by a personal computer, internet, or interactive voice response system",<ref name="NiceTA97">{{cite web|url = http://www.nice.org.uk/guidance/TA97|title = Depression and anxiety&nbsp;– computerised cognitive behavioural therapy (CCBT)|publisher = National Institute for Health and Care Excellence|date = 12 January 2012|access-date = 4 February 2012}}</ref> instead of face-to-face with a human therapist. It is also known as internet-delivered cognitive behavioral therapy or ICBT.<ref>{{cite journal | vauthors = Nordgren LB, Hedman E, Etienne J, Bodin J, Kadowaki A, Eriksson S, Lindkvist E, Andersson G, Carlbring P | display-authors = 6 | title = Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial | journal = Behaviour Research and Therapy | volume = 59 | pages = 1–11 | date = August 2014 | pmid = 24933451 | doi = 10.1016/j.brat.2014.05.007 | doi-access = free }}</ref> CCBT has potential to improve access to evidence-based therapies, and to overcome the prohibitive costs and lack of availability sometimes associated with retaining a human therapist.<ref>{{cite journal | vauthors = Marks IM, Mataix-Cols D, Kenwright M, Cameron R, Hirsch S, Gega L | title = Pragmatic evaluation of computer-aided self-help for anxiety and depression | journal = The British Journal of Psychiatry | volume = 183 | pages = 57–65 | date = July 2003 | pmid = 12835245 | doi = 10.1192/bjp.183.1.57 | doi-access = free }}</ref><ref>{{Cite journal |title=What is digital health technology and what can it do for me? |url=https://evidence.nihr.ac.uk/collection/what-is-digital-health-technology/ |website=NIHR Evidence|year=2022 |doi=10.3310/nihrevidence_53447 |s2cid=252584020 |url-access=subscription }}</ref> In this context, it is important not to confuse CBT with 'computer-based training', which nowadays is more commonly referred to as [[e-Learning]].

Although improvements in both  research quality and treatment adherence is required before advocating for the global dissemination of CCBT,<ref>{{cite journal | vauthors = Heeren A | title = Commentary: The Impact of Digital Technology on Psychological Treatments and Their Dissemination | journal = Frontiers in Psychology | volume = 9 | article-number = 1571 | date = August 2018 | pmid = 30210401 | doi = 10.3389/fpsyg.2018.01571 | pmc = 6122262 | doi-access = free }}</ref> it has been found in meta-studies to be cost-effective and often cheaper than usual care,<ref name="journals.cambridge.org">{{cite journal | vauthors = Musiat P, Tarrier N | title = Collateral outcomes in e-mental health: a systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health | journal = Psychological Medicine | volume = 44 | issue = 15 | pages = 3137–3150 | date = November 2014 | pmid = 25065947 | doi = 10.1017/S0033291714000245 | s2cid = 25303848 }}</ref><ref>MoodGYM was superior to informational websites in terms of psychological outcomes or service use</ref> including for anxiety<ref>{{cite journal | vauthors = Adelman CB, Panza KE, Bartley CA, Bontempo A, Bloch MH | title = A meta-analysis of computerized cognitive-behavioral therapy for the treatment of DSM-5 anxiety disorders | journal = The Journal of Clinical Psychiatry | volume = 75 | issue = 7 | pages = e695–e704 | date = July 2014 | pmid = 25093485 | doi = 10.4088/JCP.13r08894 | s2cid = 40954269 }}</ref> and PTSD.<ref name="NIHR Evidence_2023">{{Cite journal |date=27 January 2023 |title=Online CBT for post-traumatic stress disorder is as effective as face-to-face therapy |url=https://evidence.nihr.ac.uk/alert/online-cbt-for-ptsd-is-as-effective-as-face-to-face-therapy/ |journal=NIHR Evidence|doi=10.3310/nihrevidence_56507 |s2cid=257844874 |url-access=subscription }}</ref><ref name="Bisson_2022">{{cite journal | vauthors = Bisson JI, Ariti C, Cullen K, Kitchiner N, Lewis C, Roberts NP, Simon N, Smallman K, Addison K, Bell V, Brookes-Howell L, Cosgrove S, Ehlers A, Fitzsimmons D, Foscarini-Craggs P, Harris SR, Kelson M, Lovell K, McKenna M, McNamara R, Nollett C, Pickles T, Williams-Thomas R | display-authors = 6 | title = Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID) | journal = BMJ | volume = 377 | article-number = e069405 | date = June 2022 | pmid = 35710124 | doi = 10.1136/bmj-2021-069405 | pmc = 9202033 | s2cid = 249679685 }}</ref> Studies have shown that individuals with social anxiety and depression experienced improvement with online CBT-based methods.<ref>{{cite journal | vauthors = Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N | title = Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis | journal = PLOS ONE | volume = 5 | issue = 10 | article-number = e13196 | date = October 2010 | pmid = 20967242 | pmc = 2954140 | doi = 10.1371/journal.pone.0013196 | bibcode = 2010PLoSO...513196A | doi-access = free }}</ref> A study assessing an online version of CBT for people with mild-to-moderate PTSD found that the online approach was as effective as, and cheaper than, the same therapy given face-to-face.<ref name="NIHR Evidence_2023" /><ref name="Bisson_2022" /> A review of current CCBT research in the treatment of OCD in children found this interface to hold great potential for future treatment of OCD in youths and adolescent populations.<ref name="Freeman2014" /> Additionally, most [[Internet Interventions for Posttraumatic Stress|internet interventions for post-traumatic stress disorder]] use CCBT. CCBT is also predisposed to treating mood disorders amongst non-heterosexual populations, who may avoid face-to-face therapy from fear of stigma. However presently CCBT programs seldom cater to these populations.<ref>{{cite journal | vauthors = Rozbroj T, Lyons A, Pitts M, Mitchell A, Christensen H | title = Assessing the applicability of e-therapies for depression, anxiety, and other mood disorders among lesbians and gay men: analysis of 24 web- and mobile phone-based self-help interventions | journal = Journal of Medical Internet Research | volume = 16 | issue = 7 | pages = e166 | date = July 2014 | pmid = 24996000 | pmc = 4115263 | doi = 10.2196/jmir.3529 | doi-access = free }}</ref>

In February 2006 NICE recommended that CCBT be made available for use within the [[National Health Service|NHS]] across England and Wales for patients presenting with mild-to-moderate depression, rather than immediately opting for antidepressant medication,<ref name="NiceTA97" /> and CCBT is made available by some health systems.<ref>{{cite web|url=http://www.devonpartnership.nhs.uk/uploads/tx_mocarticles/CCBT_Leaflet.pdf |archive-url=https://web.archive.org/web/20090504084624/http://www.devonpartnership.nhs.uk/uploads/tx_mocarticles/CCBT_Leaflet.pdf |archive-date=2009-05-04 |url-status=live|title=Devon Partnership NHS Trust: Home|publisher=NHS UK}}</ref> The 2009 NICE guideline recognized that there are likely to be a number of computerized CBT products that are useful to patients, but removed endorsement of any specific product.<ref>{{cite web |url = http://guidance.nice.org.uk/CG91/NICEGuidance/pdf/English|title = CG91 Depression with a chronic physical health problem|date = 28 October 2009|publisher = National Institute for Health and Care Excellence}}{{page needed|date = April 2013}}</ref>

===Smartphone app-delivered===
Another new method of access is the use of [[mobile app]] or smartphone applications to deliver self-help or guided CBT. Technology companies are developing mobile-based artificial intelligence [[chatbot]] applications in delivering CBT as an early intervention to support [[mental health]], to build [[psychological resilience]], and to promote [[emotional well-being]]. [[Artificial intelligence]] (AI) text-based conversational application delivered securely and privately over smartphone devices have the ability to scale globally and offer contextual and always-available support. Active research is underway including real-world data studies<ref>{{cite journal | vauthors = Inkster B, Sarda S, Subramanian V | title = An Empathy-Driven, Conversational Artificial Intelligence Agent (Wysa) for Digital Mental Well-Being: Real-World Data Evaluation Mixed-Methods Study | journal = JMIR mHealth and uHealth | volume = 6 | issue = 11 | article-number = e12106 | date = November 2018 | pmid = 30470676 | pmc = 6286427 | doi = 10.2196/12106 | doi-access = free }}</ref> that measure effectiveness and engagement of text-based smartphone chatbot apps for delivery of CBT using a text-based conversational interface. Recent market research and analysis of over 500 online mental healthcare solutions identified 3 key challenges in this market: quality of the content, guidance of the user and personalisation.<ref>{{cite web|url=https://www.intelliprove.com/news/the-3-key-challenges-of-digital-mental-healthcare-2023/|title=The 3 key challenges of digital mental healthcare (2023)|work=IntelliProve – IntelliProve measures health through face analysis, using the camera of your smartphone or tablet. |date=21 February 2023 |access-date=1 March 2023}}</ref>

A study compared CBT alone with a mindfulness-based therapy combined with CBT, both delivered via an app. It found that mindfulness-based self-help reduced the severity of depression more than CBT self-help in the short-term. Overall, NHS costs for the mindfulness approach were £500 less per person than for CBT.<ref>{{cite journal | vauthors = Strauss C, Bibby-Jones AM, Jones F, Byford S, Heslin M, Parry G, Barkham M, Lea L, Crane R, de Visser R, Arbon A, Rosten C, Cavanagh K | display-authors = 6 | title = Clinical Effectiveness and Cost-Effectiveness of Supported Mindfulness-Based Cognitive Therapy Self-help Compared With Supported Cognitive Behavioral Therapy Self-help for Adults Experiencing Depression: The Low-Intensity Guided Help Through Mindfulness (LIGHTMind) Randomized Clinical Trial | journal = JAMA Psychiatry | volume = 80 | issue = 5 | pages = 415–424 | date = May 2023 | pmid = 36947058 | pmc = 10034662 | doi = 10.1001/jamapsychiatry.2023.0222 }}</ref><ref>{{Cite journal |date=2023-10-11 |title=Mindfulness-based cognitive therapy, delivered as supported self-help, can help people with depression |url= https://evidence.nihr.ac.uk/alert/mindfulness-based-cognitive-therapy-delivered-as-supported-self-help-can-help-people-with-depression/ |journal=NIHR Evidence|doi=10.3310/nihrevidence_59926 |s2cid=264068810 |url-access=subscription }}</ref>

===Reading self-help materials===
Enabling patients to read self-help CBT guides has been shown to be effective by some studies.<ref>{{cite web|url=http://www.mindinbexley.org.uk/docs/E-self_help_guide.pdf|title=A Step By Step Guide to Delivering Guided Self Help CBT |access-date=9 April 2013|archive-url=https://web.archive.org/web/20121024054235/http://www.mindinbexley.org.uk/docs/E-self_help_guide.pdf|archive-date=24 October 2012}}</ref><ref>{{cite journal | vauthors = Williams C, Wilson P, Morrison J, McMahon A, Walker A, Andrew W, Allan L, McConnachie A, McNeill Y, Tansey L | display-authors = 6 | title = Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial | journal = PLOS ONE | volume = 8 | issue = 1 | article-number = e52735 | year = 2013 | pmid = 23326352 | pmc = 3543408 | doi = 10.1371/journal.pone.0052735 | veditors = Andersson G | doi-access = free | bibcode = 2013PLoSO...852735W }}</ref><ref>{{cite journal |doi = 10.1192/apt.7.3.233|title = Use of written cognitive-behavioural therapy self-help materials to treat depression|year = 2001| vauthors = Williams C |journal = Advances in Psychiatric Treatment|volume = 7|issue = 3|pages = 233–240|doi-access = free}}</ref> However one study found a negative effect in patients who tended to ruminate,<ref>{{cite journal | vauthors = Haeffel GJ | title = When self-help is no help: traditional cognitive skills training does not prevent depressive symptoms in people who ruminate | journal = Behaviour Research and Therapy | volume = 48 | issue = 2 | pages = 152–157 | date = February 2010 | pmid = 19875102 | doi = 10.1016/j.brat.2009.09.016 }}</ref> and another meta-analysis found that the benefit was only significant when the self-help was guided (e.g. by a medical professional).<ref>{{cite journal | vauthors = Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S, Lovell K | title = What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression | journal = Psychological Medicine | volume = 37 | issue = 9 | pages = 1217–1228 | date = September 2007 | pmid = 17306044 | doi = 10.1017/S0033291707000062 | hdl-access = free | s2cid = 12980225 | hdl = 10036/46773 }}</ref>

===Group educational course===
Patient participation in group courses has been shown to be effective.<ref>{{cite journal | vauthors = Houghton S, Saxon D | title = An evaluation of large group CBT psycho-education for anxiety disorders delivered in routine practice | journal = Patient Education and Counseling | volume = 68 | issue = 1 | pages = 107–110 | date = September 2007 | pmid = 17582724 | doi = 10.1016/j.pec.2007.05.010 }}</ref> In a meta-analysis reviewing evidence-based treatment of OCD in children, individual CBT was found to be more efficacious than group CBT.<ref name="Freeman2014">{{cite journal | vauthors = Freeman J, Garcia A, Frank H, Benito K, Conelea C, Walther M, Edmunds J | title = Evidence base update for psychosocial treatments for pediatric obsessive-compulsive disorder | journal = Journal of Clinical Child and Adolescent Psychology | volume = 43 | issue = 1 | pages = 7–26 | date = 2014 | pmid = 23746138 | pmc = 3815743 | doi = 10.1080/15374416.2013.804386 }}</ref>

==Types==
===Brief cognitive behavioral therapy===
Brief cognitive behavioral therapy (BCBT) is a form of CBT which has been developed for situations in which there are time constraints on the therapy sessions and specifically for those struggling with suicidal ideation and/or making suicide attempts.<ref name="RuddDM">{{cite journal |doi = 10.1080/08995605.2012.736325|title = Brief cognitive behavioral therapy (BCBT) for suicidality in military populations|year = 2012| vauthors = Rudd MD |s2cid = 3619107 |journal = Military Psychology|volume = 24|issue = 6|pages = 592–603}}</ref> BCBT was based on Rudd's proposed "suicidal mode", an elaboration of Beck's modal theory.<ref>{{cite journal | vauthors = Rudd MD |title=The Suicidal Mode: A Cognitive-Behavioral Model of Suicidality |journal=Suicide and Life-Threatening Behavior |date=March 2000 |volume=30 |issue=1 |pages=18–33 |doi=10.1111/j.1943-278X.2000.tb01062.x|pmid=10782716 |s2cid=40359959 }}</ref><ref name="pmid10782716">{{cite journal | vauthors = Rudd MD | title = The suicidal mode: a cognitive-behavioral model of suicidality | journal = Suicide & Life-Threatening Behavior | volume = 30 | issue = 1 | pages = 18–33 | date = 2000 | pmid = 10782716 | doi = 10.1111/j.1943-278X.2000.tb01062.x| s2cid = 40359959 | url = }}</ref> BCBT takes place over a couple of sessions that can last up to 12 accumulated hours by design. This technique was first implemented and developed with soldiers on active duty by Dr. [[M. David Rudd]] to prevent suicide.<ref name="RuddDM" />

Breakdown of treatment<ref name="RuddDM" />
# Orientation
## Commitment to treatment
## Crisis response and safety planning
## Means restriction
## Survival kit
## Reasons for living card
## Model of suicidality
## Treatment journal
## Lessons learned
# Skill focus
## Skill development worksheets
## Coping cards
## Demonstration
## Practice
## Skill refinement
# [[Relapse]] prevention
## Skill generalization
## Skill refinement

===Cognitive emotional behavioral therapy===
{{Main|Cognitive emotional behavioral therapy}}

[[Cognitive emotional behavioral therapy]] (CEBT) is a form of CBT developed initially for individuals with eating disorders but now used with a range of problems including [[anxiety]], [[Depression (mood)|depression]], [[obsessive compulsive disorder]] (OCD), [[post-traumatic stress disorder]] (PTSD) and anger problems. It combines aspects of CBT and [[dialectical behavioral therapy]] and aims to improve understanding and tolerance of emotions in order to facilitate the therapeutic process. It is frequently used as a "pretreatment" to prepare and better equip individuals for longer-term therapy.<ref>{{Cite book|title=Managing workplace stress: the cognitive behavioural way| vauthors = Choudhury K |publisher=Springer India|year=2013|isbn=978-81-322-0683-5|location=New York}}{{Page needed|date=July 2022}}</ref>

===Structured cognitive behavioral training===
{{Main|Structured cognitive behavioral training}}

Structured cognitive-behavioral training (SCBT) is a cognitive-based process with core philosophies that draw heavily from CBT. Like CBT, SCBT asserts that behavior is inextricably related to beliefs, thoughts, and emotions. SCBT also builds on core CBT philosophy by incorporating other well-known modalities in the fields of [[behavioral health]] and [[psychology]]: most notably, [[Albert Ellis]]'s [[rational emotive behavior therapy]]. SCBT differs from CBT in two distinct ways. First, SCBT is delivered in a highly regimented format. Second, SCBT is a predetermined and finite training process that becomes personalized by the input of the participant. SCBT is designed to bring a participant to a specific result in a specific period of time. SCBT has been used to challenge addictive behavior, particularly with substances such as tobacco,<ref>{{Cite web|title=Effectiveness of Manual-Based Cognitive Behavioral Therapy in Routine Outpatient Alcohol Treatment|url=https://www.researchgate.net/publication/241873508| vauthors = de Wildt WA, Oudejans SC, Merkx MJ, Schippers GM, Koeter MW, van den Brink W |website=ResearchGate|access-date=13 May 2020}}</ref> [[alcohol (drug)|alcohol]] and food, and to manage [[diabetes]] and subdue stress and anxiety. SCBT has also been used in the field of [[criminal psychology]] in the effort to reduce recidivism.

==={{anchor|MRT}}Moral reconation therapy===
[[Moral reconation therapy]], a type of CBT used to help felons overcome [[antisocial personality disorder]] (ASPD), slightly decreases the risk of further offending.<ref>{{cite journal | vauthors = Ferguson LM, Wormith JS | title = A meta-analysis of moral reconation therapy | journal = International Journal of Offender Therapy and Comparative Criminology | volume = 57 | issue = 9 | pages = 1076–1106 | date = September 2013 | pmid = 22744908 | doi = 10.1177/0306624x12447771 | s2cid = 206514862 }}</ref> It is generally implemented in a group format because of the risk of offenders with ASPD being given one-on-one therapy reinforces narcissistic behavioral characteristics, and can be used in correctional or outpatient settings. Groups usually meet weekly for two to six months.<ref name="SAMHSA">{{cite web|last1=SAMHSA|title=Moral Reconation Therapy|url=http://legacy.nreppadmin.net/ViewIntervention.aspx?id=34|access-date=22 February 2015|archive-url=https://web.archive.org/web/20170629064635/http://legacy.nreppadmin.net/ViewIntervention.aspx?id=34|archive-date=29 June 2017}}</ref>

===Stress inoculation training===
{{Main|Stress inoculation training}}

This type of therapy uses a blend of cognitive, behavioral, and certain humanistic training techniques to target the stressors of the client. This is usually used to help clients better cope with their stress or anxiety after stressful events.<ref name="Meichenbaum 1996 4–7">{{cite journal| vauthors = Meichenbaum D|author1-link=Donald Meichenbaum|title = Stress Inoculation Training for Coping with Stressors| journal = The Clinical Psychologist | year = 1996|volume = 69|pages = 4–7}}</ref> This is a three-phase process that trains the client to use skills that they already have to better adapt to their current stressors. The first phase is an interview phase that includes psychological testing, client self-monitoring, and a variety of reading materials. This allows the therapist to individually tailor the training process to the client.<ref name="Meichenbaum 1996 4–7" /> Clients learn how to categorize problems into emotion-focused or problem-focused so that they can better treat their negative situations. This phase ultimately prepares the client to eventually confront and reflect upon their current reactions to stressors, before looking at ways to change their reactions and emotions to their stressors. The focus is conceptualization.<ref name="Meichenbaum 1996 4–7" />

The second phase emphasizes the aspect of skills acquisition and rehearsal that continues from the earlier phase of conceptualization. The client is taught skills that help them cope with their stressors. These skills are then practiced in the space of therapy. These skills involve self-regulation, problem-solving, interpersonal communication skills, etc.<ref name="Meichenbaum 1996 4–7" />

The third and final phase is the application and following through of the skills learned in the training process. This gives the client opportunities to apply their learned skills to a wide range of stressors. Activities include role-playing, imagery, modeling, etc. In the end, the client will have been trained on a preventive basis to inoculate personal, chronic, and future stressors by breaking down their stressors into problems they will address in long-term, short-term, and intermediate coping goals.<ref name="Meichenbaum 1996 4–7" />

===Activity-guided CBT: Group-knitting===
{{Multiple issues|{{importance section|date=September 2023}}
{{tone|section|date=September 2023}}|section=y}}
A recently developed group therapy model, based on CBT, integrates knitting into the therapeutic process and has been proven to yield reliable and promising results. The foundation for this novel approach to CBT is the frequently emphasized notion that therapy success depends on how embedded  the therapy method is in the patients' natural routine. Similar to standard group-based CBT, patients meet once a week in a group of 10 to 15 patients and knit together under the instruction of a trained psychologist or mental health professional. Central for the therapy is the patient's imaginative ability to assign each part of the wool to a certain thought. During the therapy, the wool is carefully knitted, creating a knitted piece of any form. This therapeutic process teaches the patient to meaningfully align thought, by (physically) creating a coherent knitted piece. Moreover, since CBT emphasizes the behavior as a result of cognition, the knitting illustrates how thoughts (which are tried to be imaginary tight to the wool) materialize into the reality surrounding us.<ref>Corkhill, B., Hemmings, J., Maddock, A., & Riley, J. (2014). "Knitting and Well-being". ''Textile'', 12(1), 34–57.</ref><ref>"Dugas, M. J., Ladouceur, R., Léger, E., Freeston, M. H., Langolis, F., Provencher, M. D., & Boisvert, J. M. (2003). "Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up". ''Journal of consulting and clinical psychology'', 71(4), 821.</ref>

===Mindfulness-based cognitive behavioral hypnotherapy===
Mindfulness-based cognitive behavioral hypnotherapy (MCBH) is a form of CBT that focuses on awareness in a reflective approach, addressing subconscious tendencies. It is more the process that contains three phases for achieving wanted goals and integrates the principles of mindfulness and cognitive-behavioral techniques with the transformative potential of hypnotherapy.<ref>{{cite book |vauthors=Tencl J |year=2017 |title=Perception from a multicultural perspective |url=http://explore.bl.uk/BLVU1:LSCOP-ALL:BLL01018446240 |location=London |publisher=Create Space |page=83 |isbn=978-1-5376-3900-0 |access-date=6 December 2017 |archive-date=19 December 2020 |archive-url=https://web.archive.org/web/20201219055220/http://explore.bl.uk/primo_library/libweb/action/dlDisplay.do?vid=BLVU1&search_scope=LSCOP-ALL&docId=BLL01018446240&fn=permalink }}</ref>

===Unified Protocol===
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is a form of CBT, developed by [[David H. Barlow]] and researchers at [[Boston University]], that can be applied to a range of anxiety disorders. The rationale is that anxiety and depression disorders often occur together due to [[Transdiagnostic process|common underlying causes]] and can efficiently be treated together.<ref>{{cite web | url = http://www.unifiedprotocol.com/About/Rationale/67/ | title = Rationale for the Development of the UP | website = unifiedprotocol.com | publisher = Unified Protocol Institute | access-date = 22 April 2018 | archive-date = 3 June 2020 | archive-url = https://web.archive.org/web/20200603120915/http://www.unifiedprotocol.com/About/Rationale/67/ }}</ref>

The UP includes a common set of components:<ref>{{cite magazine | url = https://www.psychologytoday.com/us/blog/insight-therapy/201101/the-future-therapy-unified-treatment-approach | title = The Future of Therapy: A Unified Treatment Approach | magazine = Psychology Today | date = 9 January 2011 | access-date = 22 April 2018 | vauthors = Shpancer N }}</ref>

# Psycho-education
# Cognitive reappraisal
# Emotion regulation
# Changing behaviour

The UP has been shown to produce equivalent results to single-diagnosis protocols for specific disorders, such as [[OCD]] and [[social anxiety disorder]].<ref>{{cite journal | vauthors = Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A, Carl JR, Boettcher HT, Cassiello-Robbins C | display-authors = 6 | title = The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial | journal = JAMA Psychiatry | volume = 74 | issue = 9 | pages = 875–884 | date = September 2017 | pmid = 28768327 | pmc = 5710228 | doi = 10.1001/jamapsychiatry.2017.2164 | author1-link = David H. Barlow }}</ref>
Several studies have shown that the UP is easier to disseminate as compared to single-diagnosis protocols.

'''Culturally adapted CBT'''
The study of psychotherapy across races, religions, and cultures, or "ethno-psycho-therapy", is a relatively new discipline

==Criticisms<!--[[Criticism of cognitive behavioral therapy]] redirects here. This section is also linked from other articles: do not rename without including an anchor to the previous name ([[MOS:HEAD]])-->==
{{See also|Behavior modification#Criticism|Psychotherapy#General critiques}}

===Relative effectiveness===
The research conducted for CBT has been a topic of sustained controversy. While some researchers write that CBT is more effective than other treatments,<ref name="Tolin_2010" /> many other researchers<ref name="Barth_2013" /><ref>{{cite journal | vauthors = Wampold BE, Flückiger C, Del Re AC, Yulish NE, Frost ND, Pace BT, Goldberg SB, Miller SD, Baardseth TP, Laska KM, Hilsenroth MJ | display-authors = 6 | title = In pursuit of truth: A critical examination of meta-analyses of cognitive behavior therapy | journal = Psychotherapy Research | volume = 27 | issue = 1 | pages = 14–32 | date = January 2017 | pmid = 27884095 | doi = 10.1080/10503307.2016.1249433 | s2cid = 37490848 }}</ref><ref name="Baardseth_2013" /><ref name="Cuijpers_2008" /><ref name="Glenn">{{cite journal | vauthors = Glenn CR, Franklin JC, Nock MK | title = Evidence-based psychosocial treatments for self-injurious thoughts and behaviors in youth | journal = Journal of Clinical Child and Adolescent Psychology | volume = 44 | issue = 1 | pages = 1–29 | year = 2014 | pmid = 25256034 | pmc = 4557625 | doi = 10.1080/15374416.2014.945211 }}</ref> and practitioners<ref name="Slife">{{cite book | vauthors = Slife BD, William RN | date = 1995 | title = What's behind the research? Discovering hidden assumptions in the behavioral sciences | location = Thousand Oaks, CA | publisher = Sage }}</ref><ref name="Fancher">{{cite book | vauthors = Fancher RT | date = 1995 | title = Cultures of healing: Correcting the image of American mental health care | location = New York | publisher = W. H. Freeman and Company }}</ref> have questioned the validity of such claims. For example, one study<ref name="Tolin_2010" /> determined CBT to be superior to other treatments in treating anxiety and depression. However, researchers<ref name="Baardseth_2013" /> responding directly to that study conducted a re-analysis and found no evidence of CBT being superior to other, non-CBT treatments, and conducted an analysis of thirteen other CBT clinical trials and determined that they failed to provide evidence of CBT superiority. Another example is the £5 million [[PACE trial]], of which the results were claimed to show that CBT, and [[graded exercise therapy]] (GET) cured [[Myalgic encephalomyelitis/chronic fatigue syndrome]]. But, when the PACE results were later comprehensively reanalyzed and subjects followed-up, it was found that the CBT and GET treatments were ''not'' effective and possibly not safe. The PACE study's design was riddled with design flaws such as lacking both single and double blinding and engaging in the retrospective manipulation of [[Outcome measure|primary outcome measures]] while systematically ignoring ME/CFS sufferers' negative health outcomes as a consequences of engaging in CBT and GET <ref>{{Cite news |last=Monbiot |first=George |date=2024-03-12 |title='You don't want to get better': the outdated treatment of ME/CFS patients is a national scandal |url=https://www.theguardian.com/commentisfree/2024/mar/12/chronic-fatigue-syndrome-me-treatments-social-services |access-date=2024-04-30 |work=The Guardian |language=en-GB |issn=0261-3077}}</ref><ref>{{cite journal | vauthors = Vink M | s2cid = 206713549 | title = PACE trial authors continue to ignore their own null effect | journal = Journal of Health Psychology | volume = 22 | issue = 9 | pages = 1134–1140 | date = August 2017 | pmid = 28805519 | doi = 10.1177/1359105317703785 | doi-access = free }}</ref><ref name="Vink_2018">{{cite journal | vauthors = Vink M, Vink-Niese A | title = Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review | journal = Health Psychology Open | volume = 5 | issue = 2 | article-number = 2055102918805187 | date = 2018-10-08 | pmid = 30305916 | pmc = 6176540 | doi = 10.1177/2055102918805187 }}</ref><ref name="Twisk_2009">{{cite journal |vauthors=Twisk FN, Maes M |date=2009 |title=A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS |journal=Neuro Endocrinology Letters |volume=30 |issue=3 |pages=284–99 |pmid=19855350}}</ref><ref name="Wilshire_2018">{{cite journal | vauthors = Wilshire CE, Kindlon T, Courtney R, Matthees A, Tuller D, Geraghty K, Levin B | title = Rethinking the treatment of chronic fatigue syndrome-a reanalysis and evaluation of findings from a recent major trial of graded exercise and CBT | journal = BMC Psychology | volume = 6 | issue = 1 | page = 6 | date = March 2018 | pmid = 29562932 | pmc = 5863477 | doi = 10.1186/s40359-018-0218-3 | doi-access = free }}</ref>. In cases where CBT has been reported to be statistically better than other psychological interventions in terms of primary outcome measures, effect sizes were small and suggested that those differences were clinically meaningless and insignificant. Nonetheless, CBT remains widely recognized for its structured approach to identifying and modifying maladaptive cognitive appraisals, which has been associated with improved emotional regulation in individuals with mood and anxiety disorders.<ref name="Hofmann2012">Hofmann, S.G., Asnaani, A., Vonk, I.J., Sawyer, A.T., Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. doi:10.1007/s10608-012-9476-1.</ref> Moreover, on secondary outcomes (i.e., measures of general functioning) no significant differences have been typically found between CBT and other treatments.<ref name="Baardseth_2013" /><ref>{{cite journal | vauthors = Marcus DK, O'Connell D, Norris AL, Sawaqdeh A | title = Is the Dodo bird endangered in the 21st century? A meta-analysis of treatment comparison studies | journal = Clinical Psychology Review | volume = 34 | issue = 7 | pages = 519–530 | date = November 2014 | pmid = 25238455 | doi = 10.1016/j.cpr.2014.08.001 }}</ref>

A major criticism has been that clinical studies of CBT efficacy (or any psychotherapy) are not double-blind (i.e., either the subjects or the therapists in psychotherapy studies are not blind to the type of treatment). They may be single-blinded, i.e. the rater may not know the treatment the patient received, but neither the patients nor the therapists are blinded to the type of therapy given (two out of three of the persons involved in the trial, i.e., all of the persons involved in the treatment, are unblinded). The patient is an active participant in correcting negative distorted thoughts, thus quite aware of the treatment group they are in.<ref name="psychiatrictimes.com" />

The importance of double-blinding was shown in a meta-analysis that examined the effectiveness of CBT when placebo control and blindness were factored in.<ref>{{cite journal | vauthors = Lynch D, Laws KR, McKenna PJ | title = Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials | journal = Psychological Medicine | volume = 40 | issue = 1 | pages = 9–24 | date = January 2010 | pmid = 19476688 | doi = 10.1017/S003329170900590X | doi-access = free | hdl = 2299/5741 | hdl-access = free }}</ref> Pooled data from published trials of CBT in [[schizophrenia]], [[major depressive disorder]] (MDD), and [[bipolar disorder]] that used controls for non-specific effects of intervention were analyzed. This study concluded that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates; treatment effects are small in treatment studies of MDD, and it is not an effective treatment strategy for prevention of relapse in bipolar disorder. For MDD, the authors note that the pooled effect size was very low.<ref>{{cite journal | vauthors = Lincoln TM | title = Letter to the editor: a comment on Lynch et al. (2009) | journal = Psychological Medicine | volume = 40 | issue = 5 | pages = 877–880 | date = May 2010 | pmid = 19917145 | doi = 10.1017/S0033291709991838 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Kingdon D | title = Over-simplification and exclusion of non-conforming studies can demonstrate absence of effect: a lynching party? | journal = Psychological Medicine | volume = 40 | issue = 1 | pages = 25–27 | date = January 2010 | pmid = 19570315 | doi = 10.1017/S0033291709990201 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Wood AM, Joseph S | title = Letter to the Editor: An agenda for the next decade of psychotherapy research and practice | journal = Psychological Medicine | volume = 40 | issue = 6 | pages = 1055–1056 | date = June 2010 | pmid = 20158935 | doi = 10.1017/S0033291710000243 | doi-access = free }}</ref>

===Declining effectiveness===
Additionally, a 2015 meta-analysis revealed that the positive effects of CBT on depression have been declining since 1977.<!-- <ref name = Johnsen2015/> --> The overall results showed two different declines in [[effect size]]s: 1) an overall decline between 1977 and 2014, and 2) a steeper decline between 1995 and 2014. Additional sub-analysis revealed that CBT studies where therapists in the test group were instructed to adhere to the Beck CBT manual had a steeper decline in effect sizes since 1977 than studies where therapists in the test group were instructed to use CBT without a manual. The authors reported that they were unsure why the effects were declining but did list inadequate therapist training, failure to adhere to a manual, lack of therapist experience, and patients' hope and faith in its efficacy waning as potential reasons.<!-- <ref name = Johnsen2015/> --> The authors did mention that the current study was limited to depressive disorders only.<ref name="Johnsen2015">{{cite journal | vauthors = Johnsen TJ, Friborg O | title = The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis | journal = Psychological Bulletin | volume = 141 | issue = 4 | pages = 747–768 | date = July 2015 | pmid = 25961373 | doi = 10.1037/bul0000015 | s2cid = 27777178 }}</ref>

===High drop-out rates===
Furthermore, other researchers write that CBT studies have high drop-out rates compared to other treatments.  One meta-analysis found that CBT drop-out rates were 17% higher than those of other therapies.<ref name="Cuijpers_2008" /> This high drop-out rate is also evident in the treatment of several disorders, particularly the [[eating disorder]] [[anorexia nervosa]], which is commonly treated with CBT. Those treated with CBT have a high chance of dropping out of therapy before completion and reverting to their anorexia behaviors.<ref>{{cite book | vauthors = Nolen-Hoeksema S | date = 2014 | title = Abnormal Psychology | edition = 6th | publisher = McGraw-Hill Education | page = 357 | isbn = 978-1-259-06072-4 }}</ref>

Other researchers analyzing treatments for youths who self-injure found similar drop-out rates in CBT and [[Dialectical behavioral therapy|DBT]] groups. In this study, the researchers analyzed several clinical trials that measured the efficacy of CBT administered to youths who self-injure. The researchers concluded that none of them were found to be efficacious.<ref name="Glenn" />

===Philosophical concerns with CBT methods===
The methods employed in CBT research have not been the only criticisms; some individuals have called its theory and therapy into question.<ref>{{cite book | vauthors = Fancher RT | date = 1995 | title = Cultures of healing: Correcting the image of American mental health care | page = 231 | location = New York | publisher = W. H. Freeman and Company }}</ref>

Slife and Williams write that one of the hidden assumptions in CBT is that of [[determinism]], or the absence of [[free will]]. They argue that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states: nowhere in CBT theory is agency, or free will, accounted for.<ref name="Slife" />

Another criticism of CBT theory, especially as applied to major depressive disorder (MDD), is that it confounds the symptoms of the disorder with its causes.<ref name="psychiatrictimes.com">{{cite web |date=30 July 2013 |title=Cognitive Behavioral Therapy: Escape From the Binds of Tight Methodology |url=https://www.psychiatrictimes.com/view/cognitive-behavioral-therapy-escape-binds-tight-methodology |publisher=Psychiatric Times |vauthors=Berger D}}</ref> Other criticisms include that CBT may view people as stupid or can address only simple or superficial problems.<ref>{{Cite web |title=The Limits of Cognitive Psychotherapy {{!}} Psychology Today |url=https://www.psychologytoday.com/us/blog/matter-personality/201111/the-limits-cognitive-psychotherapy |access-date=2025-06-15 |website=www.psychologytoday.com |language=en-US}}</ref>

===Side effects===
CBT is generally regarded as having very few if any side effects.<ref>{{Cite web|url=https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610|title=Cognitive behavioral therapy – Mayo Clinic|website=www.mayoclinic.org}}</ref><ref>{{Cite web|title=Ten Things You Need To Know To Overcome OCD|url=https://beyondocd.org/expert-perspectives/articles/ten-things-you-need-to-know-to-overcome-ocd|access-date=2 August 2020|website=Beyond OCD|language=en-US}}</ref> Calls have been made by some for more appraisal of possible side effects of CBT.<ref>{{cite web|url=http://www.nationalelfservice.net/treatment/psychotherapy/psychotherapy-trials-should-report-the-side-effects-of-treatment/|title=Psychotherapy trials should report on the side effects of treatment|date=30 April 2014}}</ref> Many randomized trials of psychological interventions like CBT do not monitor potential harms to the patient.<ref>{{cite journal | vauthors = Jonsson U, Alaie I, Parling T, Arnberg FK | title = Reporting of harms in randomized controlled trials of psychological interventions for mental and behavioral disorders: a review of current practice | journal = Contemporary Clinical Trials | volume = 38 | issue = 1 | pages = 1–8 | date = May 2014 | pmid = 24607768 | doi = 10.1016/j.cct.2014.02.005 | url = http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-219714 }}</ref> In contrast, randomized trials of pharmacological interventions are much more likely to take adverse effects into consideration.<ref>{{cite journal | vauthors = Vaughan B, Goldstein MH, Alikakos M, Cohen LJ, Serby MJ | title = Frequency of reporting of adverse events in randomized controlled trials of psychotherapy vs. psychopharmacotherapy | journal = Comprehensive Psychiatry | volume = 55 | issue = 4 | pages = 849–855 | date = May 2014 | pmid = 24630200 | pmc = 4346151 | doi = 10.1016/j.comppsych.2014.01.001 }}</ref>

A 2017 meta-analysis revealed that adverse events are not common in children receiving CBT and, furthermore, that CBT is associated with fewer dropouts than either placebo or medications.<ref>{{cite journal | vauthors = Wang Z, Whiteside SP, Sim L, Farah W, Morrow AS, Alsawas M, Barrionuevo P, Tello M, Asi N, Beuschel B, Daraz L, Almasri J, Zaiem F, Larrea-Mantilla L, Ponce OJ, LeBlanc A, Prokop LJ, Murad MH | display-authors = 6 | title = Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders: A Systematic Review and Meta-analysis | journal = JAMA Pediatrics | volume = 171 | issue = 11 | pages = 1049–1056 | date = November 2017 | pmid = 28859190 | pmc = 5710373 | doi = 10.1001/jamapediatrics.2017.3036 }}</ref> Nevertheless, CBT therapists do sometimes report 'unwanted events' and side effects in their outpatients with "negative wellbeing/distress" being the most frequent.<ref>{{Cite journal|date=1 June 2018|title=Unwanted Events and Side Effects in Cognitive Behavior Therapy|journal=Cognitive Therapy |volume=42 |issue=3 |pages=219–229 |doi=10.1007/s10608-018-9904-y |s2cid=44034271 |issn=1573-2819| vauthors = Schermuly-Haupt ML, Linden M, Rush AJ }}</ref>

==Society and culture==
The UK's [[National Health Service (England)|National Health Service]] announced in 2008 that more therapists would be trained to provide CBT at government expense<ref name="Laurence" /> as part of an initiative called [[Improving Access to Psychological Therapies]] (IAPT).<ref name="Leader">{{cite news |url = https://www.theguardian.com/science/2008/sep/09/psychology.humanbehaviour|author = Leader D|title = A quick fix for the soul|date = 8 September 2008|work = The Guardian|access-date = 22 April 2012}}</ref> The [[National Institute for Health and Clinical Excellence|NICE]] said that CBT would become the mainstay of treatment for non-severe depression, with medication used only in cases where CBT had failed.<ref name="Laurence" /> Therapists complained that the data does not fully support the attention and funding CBT receives. Psychotherapist and professor [[Andrew Samuels]] stated that this constitutes "a coup, a power play by a community that has suddenly found itself on the brink of corralling an enormous amount of money&nbsp;... Everyone has been seduced by CBT's apparent cheapness."<ref name="Laurence">{{Cite news |url = https://www.independent.co.uk/life-style/health-and-wellbeing/health-news/the-big-question-can-cognitive-behavioral-therapy-help-people-with-eating-disorders-1128229.html|date = 16 December 2008|access-date = 22 April 2012|title = The big question: can cognitive behavioral therapy help people with eating disorders?|work = [[The Independent]]|author = Laurance J}}</ref><ref name="conf1">{{cite web|url = http://www.uea.ac.uk/mac/comm/media/press/2008/july/CBT+superiority+questioned+at+conference|title = CBT superiority questioned at conference|publisher = University of East Anglia|date = 7 July 2008|access-date = 22 April 2012|archive-date = 27 October 2014|archive-url = https://web.archive.org/web/20141027052529/http://www.uea.ac.uk/mac/comm/media/press/2008/july/CBT+superiority+questioned+at+conference}}</ref>

The [[UK Council for Psychotherapy]] issued a press release in 2012 saying that the IAPT's policies were undermining traditional psychotherapy and criticized proposals that would limit some approved therapies to CBT,<ref name="UKCP" /> claiming that they restricted patients to "a watered-down version of cognitive behavioural therapy (CBT), often delivered by very lightly trained staff".<ref name="UKCP">{{cite press release|url = http://www.psychotherapy.org.uk/article1488.html|title = UKCP response to Andy Burnham's speech on mental health|date = 1 February 2012|publisher = UK Council for Psychotherapy|access-date = 22 April 2012|archive-url = https://web.archive.org/web/20130221020422/http://www.psychotherapy.org.uk/article1488.html|archive-date = 21 February 2013}}</ref>

==References==
{{Reflist|30em}}

==Further reading==
{{refbegin}}
* {{cite book |vauthors=Butler G, Fennell M, Hackmann A |date=2008 |title=Cognitive-Behavioral Therapy for Anxiety Disorders |location=New York |publisher=The Guilford Press |isbn=978-1-60623-869-1}}
* {{cite book |veditors=Dattilio FM, Freeman A |date=2007 |title=Cognitive-Behavioral Strategies in Crisis Intervention |edition=3rd |location=New York |publisher=The Guilford Press |isbn=978-1-60623-648-2}}
* {{cite book |vauthors=Fancher RT |date=1995 |chapter=The Middlebrowland of Cognitive Therapy |title=Cultures of Healing: Correcting the image of American mental healthcare |pages=195–250}}
* {{cite book |vauthors=Dobson KS |title=Handbook of Cognitive-Behavioral Therapies |edition=Third |date=2009 |publisher=Guilford Press |isbn=978-1-60623-438-9 |pages=74–88}}
* {{cite book |vauthors=Hofmann SG |date=2011 |chapter=An Introduction to Modern CBT |title=Psychological Solutions to Mental Health Problems |location=Chichester, UK |publisher=Wiley-Blackwell |isbn=978-0-470-97175-8}}
* {{cite book |vauthors=Willson R, Branch R |date=2006 |title=Cognitive Behavioural Therapy for Dummies |publisher=Wiley |isbn=978-0-470-01838-5}}
{{refend}}

==External links==
{{Library resources box|by=no|onlinebooks=no|about=yes|wikititle=cognitive behavioral therapy}}
{{subject bar|auto=y|d=y|psychology}}
* [http://www.abct.org/ Association for Behavioral and Cognitive Therapies (ABCT)]
* [http://www.babcp.com/ British Association for Behavioural and Cognitive Psychotherapies]
* [http://www.nacbt.org/ National Association of Cognitive-Behavioral Therapists]
* [https://i-acbt.com/ International Association of Cognitive Psychotherapy]
* [https://www.nimh.nih.gov/health/topics/psychotherapies Information on Research-based CBT Treatments]

{{Cognitive behavioral therapy}}
{{Addiction}}
{{Psychology}}
{{Psychotherapy}}

{{Authority control}}

{{DEFAULTSORT:Cognitive Behavioral Therapy}}
[[Category:Cognitive behavioral therapy| ]]
[[Category:Addiction]]
[[Category:Addiction medicine]]
[[Category:Treatment of obsessive–compulsive disorder]]