What is cognitive behaviour therapy (CBT)?

Cognitive behaviour therapy (CBT) is a type of psychotherapy (talking therapy) based on the idea that how you think and act affects how you feel. It can help in many different situations — with both mental and physical health problems.

How does CBT work?

If you are thinking negatively about yourself or a situation and that is causing you problems, CBT might be able to help.

In CBT, you work with a therapist to recognise the patterns of thinking (cognition) and behaviour that cause you problems. Then CBT teaches you practical ways to learn or re-learn more helpful and healthy habits. Basically, the aim is to challenge and break the habit of negative thinking. Negative and unhelpful thinking can show itself in different ways. Some examples are catastrophising, where you always assume the worst possible outcome, and personalisation, where you take everything personally.

CBT is a practical therapy — it focusses on goals and is specific to an individual. It doesn’t look back over your past, it centres on solving current problems.

CBT has been around for many years. It’s the basis of other therapies such as acceptance and commitment therapy, mindfulness-based cognitive therapy, schema therapy and dialectical behaviour therapy (DBT).

What can CBT help with?

CBT can help children, teenagers and adults with emotional, psychological and psychiatric issues such as anxiety and depression.

CBT has also been shown to help people with:

• anxiety issues like generalised anxiety disorder, panic disorder, social anxiety disorder, health anxiety and phobias
• obsessive compulsive disorder
• post-traumatic stress disorder
• depression and bipolar disorder
• eating disorders
• relationship issues
• anger and stress
• problem gambling
• substance abuse
• schizophrenia

CBT can also help people with physical problems, such as:

• chronic pain
• fibromyalgia
• migraines
• chronic fatigue syndrome
• insomnia

Who can provide CBT?

Psychologists, psychiatrists, some GPs with training in mental health, mental health nurses, some counsellors and other therapists may provide CBT. You may be eligible for a mental health plan by your doctor to access Medicare rebates for CBT.

CBT can be conducted in private or group sessions — it may be in person or via telehealth or be an online course/ online (e-therapy). Your doctor can refer you to a CBT therapist, or help you find a counsellor or psychologist experienced in it.

There are several online CBT programs (some free) that you can access or that your GP can refer you to, including moodgym.

What can I expect from CBT?

CBT helps you to understand how your thinking affects your mood and behaviour.

You’ll learn skills that will help with your current problems and that you can apply to future problems.

It relies on a close professional relationship with your therapist. They will help you to recognise the difference between helpful and unhelpful thoughts, and teach you how to challenge and let go of the unhelpful thoughts.

CBT is structured and usually has a set end point.

CBT usually involves a session lasting an hour once a week. In addition, there is usually some homework to do between sessions. You’ll work with your therapist to set some tasks to practise what you talk about. CBT can be used at the same time as relaxation techniques, breathing techniques, medication or supportive counselling.

What are the stages of CBT?

1. First you will work with your therapist to understand what are the most troubling problems for you.
2. Then you work out what your thoughts, emotions and beliefs are about these situations.
3. You will identify which of these thoughts, emotions and beliefs are negative or inaccurate.
4. Working with your therapist, you find ways to challenge them. You might ask yourself: is that true? Or you might ask yourself: so what?
5. You then also identify what behaviours are you doing based on these negative beliefs that you could change.
6. Then you can find ways to think and act that are less harmful to you.

When doesn’t CBT work?

CBT may be difficult for people with learning difficulties and for those with complex mental health problems.

Also, CBT does not explore the underlying reasons for a person’s negative thoughts and unhelpful thought patterns — it focusses on improving the present problem.

How long does CBT take to work?

Your CBT program could be anywhere between 5 and 20 weeks, depending on your problem and the treatment program you and your therapist agree on.

Resources and support

Your GP should be able to guide you and may offer CBT themselves. They will be able to advise if you qualify for a mental health treatment plan to access Medicare rebates for CBT.

If you are finding it difficult to broach the topic with your GP — here are some tips for talking to your doctor about mental health.

If you are looking for a therapist, search for health services in your area. The Australian Psychological Society lists registered psychologists in Australia.

If you want general mental health support and information:

• MindSpot (anyone suffering from anxiety or depression) — call 1800 61 44 34
• Beyond Blue (anyone feeling depressed or anxious) — call 1300 22 4636 or chat online
• Black Dog Institute (people affected by depression and extreme mood swings) — online help
• Lifeline (anyone experiencing a crisis or thinking about suicide) — call 13 11 14 or chat online
• Suicide Call Back Service (anyone thinking about suicide) — call 1300 659 467
• ReachOut (online mental health services for young people and their parents)
• Headspace (mental health information, group chat, and online communities
• SANE Australia (mental health information, peer support and counselling support)
• MensLine Australia (telephone and online counselling service)
• This Way Up clinic (anyone with stress, anxiety and depression) — online courses