Cognitive behavioral therapy (CBT)

CBT (cognitive behavioral therapy) is a practical, structured form of talk therapy. It's built on the idea that thoughts, feelings and actions affect each other, so changing unhelpful thinking patterns and habits can change how you feel. CBT is one of the most studied treatments in mental health, it often takes a few months of weekly sessions, and the skills you learn keep working after therapy ends.

How does CBT work?

In CBT, you and your therapist work on what's happening now rather than mostly exploring the past. Together you:

• Notice patterns: the thoughts, feelings and actions that keep a problem going, such as assuming the worst or avoiding things that make you anxious.
• Test and reframe thoughts: look at the evidence for a worried or critical thought and find a more balanced way to see things.
• Change behaviors: gradually face situations you've been avoiding, plan activities that improve mood, or build new routines.
• Practice between sessions: short exercises, like tracking thoughts or trying a new behavior, which is where much of the change happens.

What does CBT help with?

CBT has strong evidence for many conditions, often with versions adapted to each one:

• Depression, including behavioral activation, which focuses on rebuilding activities
• Anxiety and panic disorder, including gradual exposure to feared situations and body sensations
• PTSD, through trauma-focused forms like cognitive processing therapy
• OCD, through exposure and response prevention (ERP)
• Insomnia, through CBT for insomnia (CBT-I), a first-choice treatment for long-term sleep problems
• Eating disorders, ADHD in adults, and chronic pain

If you're wondering whether anxiety or depression is the issue, the free anxiety self-check and depression self-check take a few minutes.

What is a CBT session like?

Sessions usually last about 50 minutes, once a week, in person or by video. A session often starts with a quick check-in and an agenda, then works on one or two specific problems, and ends with something to practice before next time. CBT is collaborative: your therapist teaches and guides, and you bring your own experience and set the goals.

How long does CBT take?

Many people do 12 to 20 weekly sessions, though it can be shorter for a focused problem and longer for more complex ones. Some people notice changes within a few weeks. Because CBT teaches skills, people often keep improving after therapy ends.

How well does CBT work?

For mild to moderate depression and for most anxiety disorders, CBT works about as well as medication, and its benefits tend to last longer after treatment stops. For more severe depression, combining CBT with medication often works best. Not everyone responds, and the fit with your therapist matters, so it's fine to switch if it isn't working after several sessions.

How do I find a CBT therapist?

Many therapists say they use CBT. To find one who uses it well, ask:

• How do you use CBT, and have you had specific training in it?
• Do you have experience treating my concern (for example panic attacks, OCD or insomnia)?
• What would treatment look like, and how will we know it's working?

Psychologists, licensed counselors, clinical social workers and marriage and family therapists can all provide CBT. Our guide on how to find a therapist who fits walks through the search, and psychiatrist vs therapist explains who does what.

How much does CBT cost?

CBT is covered like other therapy: most insurance plans cover it, and you pay a copay or coinsurance. Without insurance, a session often costs $100 to $200. Self-guided CBT programs and apps are cheaper and can help with milder symptoms. See how much does therapy cost for details.