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If you've recently started exploring mental health support, you may have come across the term CBT. But what is CBT, and why is it one of the most widely recommended forms of psychological therapy worldwide? In this beginner's guide, we'll explain what cognitive behavioural therapy is, how it works, what a typical session looks like, and who may benefit from this therapeutic approach.
So, what is CBT exactly? Cognitive Behavioural Therapy (CBT) is a structured, goal-oriented form of psychotherapy that focuses on the connection between our thoughts, emotions, physical sensations, and behaviours.
The central idea behind CBT is that the way we think about situations influences how we feel and act. Sometimes, people develop patterns of negative or unhelpful thinking that can contribute to emotional distress.
CBT helps individuals:
Recognise unhelpful thought patterns.
Challenge inaccurate or negative beliefs.
Develop healthier ways of thinking.
Learn practical coping strategies.
Change behaviours that may be maintaining emotional difficulties.
CBT grew from the cognitive model developed by psychiatrist Aaron Beck in the 1960s. This model suggests that thoughts, feelings, behaviours, and physical sensations are closely linked. A shift in one part of that system can affect the others.
For example, two people may experience the same event but interpret it differently. One interpretation may lead to calm or confidence; another may trigger anxiety, shame, or withdrawal. CBT pays close attention to those interpretations, especially the automatic thoughts that arise quickly and often go unquestioned.
Situation | Thought | Feeling | Behaviour |
A friend does not reply to a message. | “They must be upset with me.” | Anxiety | Avoid contacting them again. |
In therapy, that chain would be explored rather than accepted at face value. Is there evidence the friend is upset? Could there be another explanation? What happens when the anxious thought is treated as fact? The goal is not forced positivity, but a fairer and more realistic perspective.
The main aim of CBT is to help people build healthier patterns of thinking and behaviour so that emotional distress becomes easier to understand and manage. In practice, that can mean reducing the intensity of anxiety, softening self-critical thoughts, improving coping skills, or gradually returning to activities that have been avoided.
CBT is also designed to be lasting. Rather than creating dependence on therapy, it aims to teach tools people can continue using long after treatment ends. These may include recognising triggers, questioning assumptions, setting realistic goals, and responding to setbacks without spiralling into old habits. In that sense, CBT often supports resilience as much as symptom relief.
CBT is one of the most extensively studied psychological therapies and is used across a wide range of difficulties. It is commonly offered for anxiety disorders, depression, panic disorder, social anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, health anxiety, stress and burnout, phobias, eating disorders, insomnia, and chronic pain. In the UK, it is widely recommended for several common mental health conditions, including anxiety and depression.
CBT is especially well known for treating anxiety. It helps people identify fearful predictions, challenge catastrophic thinking, reduce avoidance, and gradually face situations that have become loaded with fear. Relaxation, coping strategies, and behavioural experiments may also be used to test what happens in practice rather than relying on worst-case assumptions.
When someone is depressed, thinking often becomes narrowed by hopelessness, guilt, self-criticism, or a sense that nothing will change. CBT helps people notice these patterns and examine them more carefully. It also encourages behavioural changes, such as reintroducing meaningful, pleasurable, or necessary activities that depression has pushed aside.
CBT for insomnia, often called CBT-I, is a specialised form of treatment for persistent sleep difficulties. It may include sleep education, sleep scheduling, stimulus control, relaxation strategies, and work on the beliefs and worries that often surround poor sleep. CBT-I is frequently recommended as a first-line treatment for chronic insomnia.
CBT can also be adapted to support people with attention-deficit/hyperactivity disorder. In this context, the focus is often on organisation, time management, problem-solving, emotional regulation, and reducing procrastination. It is commonly used alongside medication and other support strategies rather than as a stand-alone answer to every difficulty.
Trauma-Focused CBT is a specialist adaptation developed primarily for children and adolescents who have experienced traumatic events. It combines core cognitive and behavioural techniques with trauma-sensitive support to help young people process difficult experiences safely.
Enhanced Cognitive Behavioural Therapy, often called CBT-E, is tailored for eating disorders. It addresses unhelpful beliefs about weight and shape, eating behaviours, emotional regulation, perfectionism, and self-esteem. It is widely used in the treatment of conditions such as bulimia nervosa and binge eating disorder.
One important CBT approach, especially in depression, is behavioural activation. Depression often causes people to withdraw from the very activities that could help them feel more connected, capable, or energised. The result can be a cycle of low mood, less activity, and even lower mood.
Behavioural activation works by gently reversing that pattern. A therapist may help someone plan manageable actions that bring a sense of pleasure, achievement, or contact with other people. These steps are usually small and realistic, but over time they can interrupt the cycle of withdrawal and help rebuild momentum.
Unlike some forms of therapy, CBT is usually structured and collaborative. A typical CBT session may include:
Reviewing progress since the previous session.
Discussing current difficulties.
Identifying unhelpful thoughts or behaviours.
Practising specific techniques or exercises.
Agreeing on goals or homework for the following week.
Sessions typically last between 45 and 60 minutes. Many people describe CBT as practical, active, and solution-focused.
A central CBT technique is Socratic questioning. This means the therapist asks guided questions that help a person examine their thoughts more carefully instead of automatically believing them. The purpose is not to argue or dismiss feelings, but to create enough distance for a more balanced view to emerge.
Typical questions might include:
What evidence supports this thought?
What evidence does not support it?
Is there another explanation for what happened?
What would you say to a friend in the same situation?
Are you treating the worst-case scenario as if it were certain?
Understanding a real-life example can make CBT easier to understand.
Situation: You make a mistake during a work presentation.
Automatic thought: "I'm terrible at my job."
Emotion: Anxiety and shame.
Behaviour: Avoid speaking during future meetings.
In CBT, a therapist would help you examine this thought by exploring evidence for and against it. A more balanced thought might become:
"I made a mistake, but everyone makes mistakes occasionally. One presentation doesn't define my abilities."
Over time, this can reduce anxiety and encourage healthier behaviours.
CBT does not usually follow a rigid, one-time sequence. These stages are a simplified way to understand the process, but in real therapy they are often revisited and adjusted over several sessions as new situations, thoughts, and behaviours come up.
The first step in CBT involves identifying the specific problem or challenge you would like to address. This could be anxiety, depression, stress, sleep difficulties, relationship issues, or any other concern affecting your wellbeing. Your therapist will work with you to clearly define the issue and understand how it impacts different areas of your life.
Once the problem has been identified, you'll begin exploring how your thoughts, emotions, physical sensations, and behaviours interact with one another. For example, someone who feels anxious about public speaking may think, "I'm going to embarrass myself," which leads to feelings of anxiety and avoidance behaviours, such as declining speaking opportunities.
The next step is recognising negative or unhelpful thinking patterns that may be contributing to emotional distress.
Common cognitive distortions include:
Catastrophising
Black-and-white thinking
Mind reading
Overgeneralisation
After identifying unhelpful thoughts, CBT encourages individuals to examine whether these beliefs are realistic, accurate, or helpful. Therapists often use techniques such as Socratic questioning to help clients look at situations from a different perspective. For instance, instead of thinking "I'm terrible at my job," a person might learn to reframe this thought as "I made a mistake, but everyone makes mistakes from time to time." Over time, this process can lead to healthier and more balanced thinking patterns.
The final step focuses on applying new skills in everyday life. CBT is a practical therapy, so clients are encouraged to put what they learn into action outside of sessions. Depending on the person's goals, this may involve gradually facing feared situations, establishing healthier routines, practising relaxation techniques, or increasing participation in enjoyable activities.
CBT can be adapted for children, adolescents, adults, and older adults. For younger children, therapists may use:
Games
Stories
Drawings
Play-based activities
The suitability of CBT depends more on developmental stage, communication abilities, and individual needs than age alone.
Many studies have shown CBT to be highly effective for a range of mental health conditions. The exact success rate varies depending on the condition being treated, symptom severity, and individual circumstances. However, research consistently demonstrates significant improvements for many people receiving CBT for anxiety and depression.
The strongest outcomes typically occur when individuals actively engage in sessions and practise techniques between appointments.
For moderate to severe depression or severe anxiety disorders, CBT may also be used alongside medication, depending on the person’s symptoms, preferences, and clinical needs. This does not mean CBT is less useful, but rather that combined treatment can sometimes offer more appropriate support.
Research consistently shows that CBT can be highly effective for many people and across many conditions, particularly anxiety and depression. That said, there is no single success rate that applies to everyone. Outcomes vary depending on the problem being treated, how severe it is, whether there are other complicating factors, and how actively the person is able to engage with the process.
In general, CBT tends to work best when people attend regularly, practise strategies between sessions, and give themselves enough time to build new habits rather than expecting an immediate transformation.
If you're considering Cognitive Behavioural Therapy, it's natural to wonder what the process involves. While every therapist works slightly differently, CBT is generally structured, collaborative, and focused on helping you develop practical skills to manage your difficulties.
During the first few sessions, your therapist will usually spend time getting to know you, understanding your concerns, and discussing your goals for therapy. Together, you'll identify the thoughts, emotions, and behaviours that may be contributing to your current challenges.
Throughout treatment, you can expect CBT to involve:
Setting clear and achievable goals.
Exploring how your thoughts influence your feelings and behaviours.
Learning practical coping strategies and techniques.
Identifying and challenging unhelpful thinking patterns.
Practising new skills both during and between sessions.
Regularly reviewing your progress and adjusting goals when needed.
CBT is often an active form of therapy, meaning you may be encouraged to complete exercises or "homework" between sessions. These activities are designed to help you apply what you've learned in real-life situations and reinforce new coping skills.
The number of sessions required varies depending on the individual and the difficulties being addressed. Some people may benefit from short-term therapy lasting 6 to 12 sessions, while others may require longer-term support. Above all, CBT is designed to help you become your own therapist over time, equipping you with tools and strategies that you can continue using long after treatment has ended.
Evidence and Citations
National Health Service (NHS). Cognitive Behavioural Therapy (CBT). https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy -cbt/
National Institute for Health and Care Excellence (NICE). Generalised anxiety disorder and panic disorder in adults: management (CG113). https://www.nice.org.uk/guidance/cg113
National Institute for Health and Care Excellence (NICE). Depression in adults: treatment and management (NG222). https://www.nice.org.uk/guidance/ng222
Cuijpers P, Karyotaki E, Reijnders M, Huibers MJH. Who benefits from cognitive behavioral therapy? A meta-analytic update of the evidence. Cognitive Behaviour Therapy. 2020;49(3):197-205. https://pubmed.ncbi.nlm.nih.gov/31944836/
Trauma-Focused Cognitive Behavioral Therapy National Therapist Certification Program. What is TF-CBT? https://tfcbt.org/
Fairburn CG. . New York: Guilford Press; 2008.
Reviewed by: Rami Hanania - Psychotherapist (View Professional Profile)
Your email address will not be published. Required fields are marked *
National Institute for Health and Care Excellence (NICE). Attention deficit hyperactivity disorder: diagnosis and management (NG87). https://www.nice.org.uk/guidance/ng87
Experiencing reduced productivity and effectiveness.
Although burnout is most often linked to the workplace, similar experiences can occur in other areas of life, including parenting, caregiving, studying, and demanding personal circumstances.
Many people confuse stress with burnout, but they are not the same. Stress often involves feeling overwhelmed while still believing you can cope. Burnout, on the other hand, is marked by feeling emotionally depleted, unmotivated, and unable to continue functioning as you normally would.
Recognising the early signs of burnout is important because early intervention may help prevent more serious physical and mental health difficulties.
Burnout can affect every aspect of your wellbeing. Some symptoms are physical, while others are emotional signs, behavioural, or cognitive. Not everyone experiences burnout in the same way, but recognising several of these warning signs may indicate that it's time to slow down and seek support.
One of the most common burnout symptoms is persistent exhaustion. This isn't the normal tiredness that disappears after a good night's sleep. Instead, you may wake up already feeling drained, struggle to get through the day, or feel completely depleted even after resting.
These physical signs of burnout often include:
Ongoing fatigue
Low energy levels
Difficulty getting out of bed
Feeling physically weak
Reduced motivation to complete everyday tasks
If exhaustion continues for several weeks despite adequate rest, it may be worth exploring whether burnout is contributing to your symptoms.
Many people describe losing the emotional energy they once had for work, family, or activities they previously enjoyed. You may find yourself feeling detached, overwhelmed, or unable to cope with situations that once seemed manageable.
Common signs of emotional burnout include:
Feeling emotionally numb
Losing empathy
Feeling overwhelmed by small problems
Increased frustration
Reduced motivation
These emotional changes often develop gradually, making them easy to overlook until they begin affecting daily life.
Tasks that once felt straightforward may suddenly seem difficult. You may struggle to concentrate, take longer to complete projects, or begin making more mistakes than usual.
Difficulty concentrating
Reduced productivity
Lack of creativity
Missing deadlines
Feeling disconnected from your work
You may become increasingly negative, cynical, or indifferent towards colleagues, clients, or even people you care about. This emotional distancing is considered one of the hallmark characteristics of burnout syndrome.
Some people also lose their sense of purpose or begin questioning whether their work has any meaning at all.
5. You're Forgetting Things More Often
If you've been wondering, is forgetfulness a sign of burnout? the answer is that it certainly can be. Chronic stress affects attention and working memory, making it harder to process and retain information. As a result, you may:
Forget appointments
Lose track of conversations
Misplace everyday items
Struggle to remember simple tasks
Find it difficult to stay focused
You may find yourself putting off tasks you would normally complete without difficulty, even when you know they are important.
If you're asking yourself, is procrastination a sign of burnout?, the answer may be yes. Procrastination is often less about laziness and more about emotional exhaustion. When your mental resources are depleted, even small tasks can feel overwhelming.
Over time, this can create a cycle where unfinished work increases stress, making burnout even worse.
Research suggests that chronic stress can reduce emotional resilience, making it harder to regulate emotions.
You may notice yourself:
Becoming impatient with colleagues or family members.
Feeling frustrated over minor inconveniences.
Reacting more strongly than usual.
Feeling constantly "on edge."
Some people experiencing burnout find themselves becoming unusually emotional. You might find yourself crying over situations that previously wouldn't have affected you, or feeling unable to control your emotions after a stressful day.While occasional tears are a normal emotional response, persistent emotional overwhelm may indicate that your mind and body need time to recover.
One of the more subtle signs and symptoms of burnout is losing interest in activities that once brought you happiness.You may stop enjoying hobbies, spending time with friends, exercising, or pursuing personal goals. Instead, everything can begin to feel like another obligation.
This loss of motivation often develops gradually and can affect both your professional and personal life.
Perhaps the biggest warning sign of all is when rest no longer restores your energy. A relaxing weekend, a day off, or even a holiday may provide temporary relief, but the exhaustion quickly returns once you resume your normal routine.
This is one of the strongest signs of extreme burnout and suggests that recovery may require more than simply taking a few days off. Addressing the underlying causes of chronic stress is often necessary to regain your physical and emotional wellbeing.
Chronic stress places continuous strain on the body, and over time this can contribute to a wide range of physical symptoms. Some of the most common physical signs of burnout include:
Persistent fatigue, even after sleeping.
Frequent headaches or migraines.
Muscle tension, particularly in the neck and shoulders.
Difficulty sleeping or insomnia.
Digestive problems.
Changes in appetite.
Increased susceptibility to colds and infections.
Feeling physically drained throughout the day.
These symptoms can have many possible causes, so it's important not to assume they are always the result of burnout. If you experience persistent or worsening physical symptoms, consult a healthcare professional for a proper assessment.
Although the core symptoms of burnout are similar, the way burnout develops can vary depending on a person's responsibilities, lifestyle, and environment.
Research suggests that women may experience burnout differently due to factors such as workplace demands, caregiving responsibilities, and the mental load associated with managing multiple roles.
Common signs of burnout in women may include:
Constant exhaustion despite getting enough sleep.
Feeling emotionally overwhelmed.
Difficulty balancing work and family responsibilities.
Increased anxiety or irritability.
Feelings of guilt about not "doing enough."
Women who are balancing careers with caregiving responsibilities may also find it difficult to prioritise their own wellbeing, increasing the risk of chronic stress.
Although burnout affects people of all genders, men may sometimes be less likely to recognise or openly discuss emotional symptoms.
Some common signs of burnout in men include:
Increased irritability or anger.
Emotional withdrawal.
Reduced motivation at work.
Physical exhaustion.
Difficulty concentrating.
The workplace is one of the most common settings in which burnout develops, particularly when high workloads, unrealistic expectations, or limited support persist over time. Common signs of burnout in the workplace include:
Feeling exhausted before the workday begins.
Reduced productivity.
Difficulty concentrating.
Increased absenteeism.
Feeling detached from colleagues or clients.
Loss of motivation.
Making more mistakes than usual.
Managers should also be aware of signs of employee burnout, as early recognition can help prevent long-term health problems and improve workplace wellbeing.
Profession | Common Signs of Burnout |
Healthcare Professionals (doctors, nurses, therapists, paramedics) | Emotional exhaustion, compassion fatigue, feeling detached from patients, difficulty concentrating, increased irritability, sleep problems. |
Caregivers (family caregivers, support workers) | Feeling constantly overwhelmed, emotional exhaustion, guilt about taking breaks, physical fatigue, social withdrawal, neglecting personal needs. |
Teachers & Educators | Reduced motivation, emotional exhaustion, frustration, decreased job satisfaction, difficulty managing classroom demands, feeling ineffective. |
Corporate & Office Professionals | Chronic stress, declining productivity, procrastination, forgetfulness, difficulty concentrating, feeling disconnected from work. |
Students & Academics | Mental fatigue, loss of motivation, procrastination, poor concentration, sleep disturbances, anxiety around deadlines and exams. |
Parents | Constant exhaustion, emotional overwhelm, impatience, loss of personal identity, feeling guilty, lack of time for self-care. |
First Responders (police officers, firefighters, emergency responders) | Hypervigilance, emotional numbness, chronic stress, sleep disturbances, irritability, compassion fatigue. |
Hospitality & Customer Service Workers | Emotional exhaustion from constant customer interaction, irritability, physical fatigue, reduced job satisfaction, feeling undervalued. |
Managers & Business Leaders | Decision fatigue, difficulty switching off from work, chronic stress, reduced concentration, feeling responsible for everyone else, emotional exhaustion. |
Remote Workers & Freelancers | Difficulty separating work from personal life, overworking, social isolation, lack of motivation, blurred boundaries, feeling "always on. |
Therapists | Emotional exhaustion, compassion fatigue, difficulty disconnecting from clients' concerns, reduced empathy, feeling overwhelmed, and increased risk of emotional depletion. |
Burnout isn't limited to professional life. Parenting, caregiving, household responsibilities, and ongoing personal stress can all contribute to emotional exhaustion.
Some signs of burnout at home include:
Feeling overwhelmed by everyday responsibilities.
Losing patience with loved ones.
Having little energy for hobbies or social activities.
Feeling emotionally detached from family life.
Constantly feeling like there is never enough time to rest.
Recognising these symptoms early can help prevent burnout from affecting relationships and overall quality of life.
Caring for children while managing everyday responsibilities can be emotionally and physically demanding. Common signs of burnout as a mum include constant exhaustion, irritability, emotional overwhelm, guilt about taking time for yourself, and feeling like you're always running on empty. If these feelings persist, seeking support and prioritising self-care can make a significant difference.
Relationship burnout can develop when ongoing conflict, emotional strain, or unmet needs leave one or both partners feeling exhausted. Common signs of relationship burnout include emotional distance, frequent arguments, lack of communication, reduced intimacy, and feeling disconnected from your partner. Addressing concerns early through open communication or couples therapy can help strengthen the relationship.
Students can also experience burnout, particularly during periods of prolonged academic pressure.
Common signs of burnout from studying include:
Difficulty concentrating while studying.
Feeling mentally exhausted.
Loss of motivation.
Increased procrastination.
Anxiety around exams or coursework.
Maintaining a healthy balance between study, rest, and social activities is important for preventing burnout during education.
Experiencing one or two signs of burnout from time to time doesn't necessarily mean you're burnt out. However, if several of these symptoms have persisted for weeks or months and are affecting your work, relationships, or overall wellbeing, it's important to take them seriously.
Burnout is not something that can simply be "pushed through." Recovery usually involves addressing both the symptoms and the underlying causes of chronic stress.
Here are some practical steps that may help.
Many people experiencing burnout try to compensate by working harder, but this often makes the situation worse.
Instead, make time for genuine rest. This means allowing yourself opportunities to recover physically and mentally, rather than simply switching from one responsibility to another. Recovery takes time, so it's important to be patient with yourself.
Burnout often develops when demands consistently exceed the time or energy available to meet them. Learning to set boundaries can help reduce ongoing stress. Depending on your situation, this might include:
Saying no to additional responsibilities.
Delegating tasks where possible.
Limiting overtime.
Taking proper lunch breaks.
Disconnecting from work outside working hours.
Healthy boundaries aren't about doing less, they're about protecting your long-term wellbeing.
When people are burnt out, they often stop doing the very things that help them recover. Try to gradually reintroduce activities that make you feel relaxed, connected, or energised, such as going for a walk, reading a book, spending time with friends or family, mindfulness, etc.
Small, consistent changes are often more sustainable than trying to make dramatic lifestyle changes all at once.
Burnout can feel isolating, but you don't have to deal with it alone. Talking openly with a trusted friend, family member, colleague, or manager can help reduce feelings of isolation and may lead to practical solutions.
If work is contributing to your burnout, discussing your workload or responsibilities with your employer may also be beneficial where appropriate.
If your symptoms are persistent or significantly affecting your daily life, speaking with a qualified mental health professional can be an important step. Evidence-based approaches such as Cognitive Behavioural Therapy (CBT), Mindfulness-Based Stress Reduction (MBSR), and Acceptance and Commitment Therapy (ACT) may support people experiencing stress, anxiety, and burnout-related difficulties. However, burnout is not only an individual problem. Recovery often works best when personal support is combined with changes to the underlying environment, such as workload, boundaries, autonomy, fairness, and access to practical support.
When Should You Seek Professional Help?
Although mild burnout may improve with rest and lifestyle changes, professional support is recommended if symptoms continue or become more severe.
Consider seeking help if:
Your symptoms have lasted for several weeks.
You're struggling to perform everyday tasks.
Burnout is affecting your work or relationships.
You feel persistently anxious or low.
Rest no longer helps you recover.
You feel emotionally overwhelmed most days.
A healthcare professional or therapist can assess your symptoms, rule out other possible causes, and recommend the most appropriate support. Seeking help early can make recovery easier and may prevent burnout from progressing further.
Reviewed by: Alexandra K (View Professional Profile)
