How Does Cognitive Behavioral Therapy for Depression Work?

CBT for depression focuses on disrupting negative thought patterns and replacing them with more helpful ones.

CBT session — Stefa Nikolic/Getty Images

Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on identifying specific negative thought patterns and behavioral responses to challenging or stressful situations.

It’s a blend of cognitive therapyTrusted Source and behavioral therapy. Cognitive therapy focuses on moods and thoughts, while behavioral therapy specifically targets actions and behaviors.

The underlying idea behind CBT is that negative actions or feelings, such as depression, are the results of current distorted beliefs or thoughts, not unconscious forces from the past. Here’s how it works.

How can CBT help with depression?

If you’re someone who lives with depression, your therapist may use CBT techniques to help you uncover unhealthy patterns of thought and identify how they may be affecting:

your mood
beliefs about yourself
your overall outlook on life

CBT has been proven to be effectiveTrusted Source in treating mild to moderate levels of depression. In some cases, it can be combined with other treatments, like antidepressants or other medications, to treat depression.

Cognitive distortions and depression

You may be asked to keep a journal as part of CBT. The journal provides a place for you to record life events and your reactions.

Your therapist can help you break down reactions and thought patterns into several categories of self-defeating thought (also known as cognitive distortions) that tend to perpetuate your depressive mood.

These may include:

all-or-nothing thinking: viewing the world in absolute, black-and-white terms
disqualifying the positive: rejecting positive experiences by insisting they “don’t count” for some reason
automatic negative reactions: having habitual, scolding thoughts
magnifying or minimizing the importance of an event: making a bigger deal about a specific event or moment
overgeneralization: drawing overly broad conclusions from a single event
personalization: taking things too personally or feeling actions are specifically directed at you
mental filter: picking out a single negative detail and dwelling on it exclusively so that the vision of reality becomes darkened

You and your therapist can also use the journal to help replace negative thought patterns or perceptions with more constructive ones. This can be done through a series of well-practiced techniques, such as:

learning to manage and modify distorted thoughts and reactions
learning to accurately and comprehensively assess external situations and reactions or emotional behavior
practicing self-talk that is accurate and balanced
using self-evaluation to reflect and respond appropriately

You can practice these coping methods on your own or with your therapist. Alternately, you can practice them in controlled settings in which you’re confronted with challenges. You can use these settings to build on your ability to respond successfully.

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What experts say

“There is a massive tidal wave of evidence for cognitive behavioral therapy that suggests it is very effective at treating certain problems,” Simon Rego, PsyD of Montefiore Medical Center in New York, told Healthline. “The breadth of evidence isn’t as extensive for other forms of psychotherapy.”

That’s not to say other therapies aren’t equally effective and beneficial. “They just don’t fit as neatly into anything that can be studied,” Rego says. “More evidence-based studies have been conducted on the results of cognitive behavioral therapy than any other kind.”

Online therapy for CBT

If you feel that you or a loved one could benefit from CBT, there are several telehealth platforms that can virtually connect you with a trained therapist. Here are some to consider:

TalkSpace. After taking an initial assessment and choosing your subscription plan, you’ll be connected with someone from their network of over 3,000 licensed therapists.
BetterHelp. This telehealth company has one of the largest networks of licensed therapists and offers individual, couples, and family counseling.
Amwell. Along with talk therapy, Amwell can also connect you with online psychiatrists who can prescribe medications.
7 Cups. This telehealth network is significantly less expensive than other online therapy platforms. Plus, 7 Cups offers emotional support and access to speak to a trained volunteer (not a licensed counselor) at no charge.

CBT vs. other therapies

CBT is a more short-term approach than psychoanalysis and psychodynamic therapies. Other types of therapies may require several years for discovery and treatment.

CBT often requires only up to 20 sessions, according to the National Health Services, but you can continue seeing your therapist for as long as you need. Every situation is unique, so how long you pursue treatment is up to you and your therapist.

CBT sessions provide opportunities to identify current life situations that may be causing or contributing to your mental health conditions, like anxiety or depression. CBT allows you and your therapist to identify patterns of thinking or distorted perceptions that are no longer serving you.

This is different from psychoanalysis. This type of therapy involves working backward through your life history to discover an unconscious source of the problems you’re facing and having these unresolved emotions play out in sessions with your therapist.

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Are there any risks?

There is little long-term emotional risk associated with CBT. However, exploring painful feelings and experiences can be stressful. Treatment may involve facing situations you’d otherwise avoid.

For instance, you may be asked to spend time in public places if you have a fear of crowds. Alternatively, you may need to confront difficult sources of trauma, like the death of a loved one.

These scenarios can provide opportunities to practice altered responses to stressful or adverse situations. The eventual goal of therapy is to teach you how to manage your anxiety and stress in a safe and constructive manner.

Frequently asked questions

How can I find a CBT therapist?

If you think CBT may be a fit for you, there are several ways to find a therapist.

You can:

talk with your doctor
search the directory of certified therapists
reach out to an online therapy program
contact your health insurance company to see if your plan covers therapy visits

What can I expect from CBT?

Your CBT experience will be unique based on your situation, and know that there is not just one right way to experience therapy.

Your therapist will take time to get to know you, so be prepared to discuss:

what brought you to therapy
your mental health history
current circumstances

Will CBT help my depression?

CBT has been found to be effective in treating those with mild to moderate depression. It has also been proven effective when combined with other treatment options, like antidepressants or other medications.

Remember that change is often gradual, requiring a time commitment and the willingness to be open to the experience.

Takeaway

Cognitive behavioral therapy (CBT) is a type of psychotherapy that helps you recognize and replace negative or unhelpful thought and behavior patterns.

It can be a highly rewarding and effective form of mental health support, especially for those affected by depression.

CBT requires a willingness to be open to change, along with a time commitment to do the work with your trusted therapist.

The goal of CBT is to help you develop the skills to deal with difficulties on your own, at the moment when they arise, ideally giving you tools that last a lifetime.

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Last medically reviewed on November 20, 2024

How we reviewed this article:

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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Nov 20, 2024

Written By

Kimberly Holland, Katie Nave

Edited By

Ari Howard

Medically Reviewed By

Lori Lawrenz, PsyD

Copy Edited By

Copy Editors

Apr 27, 2022