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  • Writer's pictureAmy Smith

Cognitive Behavioural Therapy (CBT) in a Nutshell

Updated: Feb 11, 2023

Cognitive Behavioural Therapy (CBT) is a model commonly used in therapy for a range of difficulties, including, depression, anxiety, OCD, chronic pain and eating difficulties, to name but a few. There is lots of evidence to support its effectiveness. CBT hypotheses that in all situations four components come into play:


· Thoughts (what runs through our minds, images, memories)

· Behaviours (our actions/what we have the urge to do)

· Feelings (or emotions)

· Physical Sensations (or bodily sensations)


CBT suggests that the above four components are interlinked, that is, if one area is troublesome/challenging it will then have a knock-on negative effect on the other areas and thus a vicious cycle is formed. The following diagram shows this in action in a social situation where someone is feeling anxious:








In the early stages of CBT you will be helped to try to be mindful of such cycles when you are struggling. Identifying this cycle can be helpful in itself as it can help us to gain a deeper understanding into why we feel how we feel or why we behaved in a certain way which can foster greater self-compassion. It is also beneficial to identify such CBT cycles when we are struggling as we can then gain insight into how and where we can make changes to break free of such vicious cycles. If we make changes to one or more than one component of the cycle, this breaks the chain. Let’s now look at CBT tools that can help us to do just that.


CBT Tools

During CBT you will be introduced to various cognitive (which targets the ‘thoughts’ component) and behavioural tools (which targets, you guessed it, the ‘behaviour’ component!).


Cognitive Tool

In CBT you may be introduced to ‘cognitive restructuring’ or ‘thought challenging’ to help address troublesome thoughts. This is a tool where we learn to catch our tricky thoughts, to distance ourselves from them and to question their validity as well as helpfulness. The aim is to develop more balanced, helpful and accurate thoughts. Here is an example:


Thought: I’m a failure

Balanced Thought: I’m not a failure. I’ve done pretty well in various aspects of my life. It is not helpful for me to carry this thought with me and believe this thought, it only holds me back from things. I’ve unfairly learnt to think this way due to criticism I have received in the past as opposed to this thought being absolutely true.


Behavioural Tool

In terms of the behavioural work in CBT, firstly you will be helped to identify your behavioural patterns and analyse their advantages and disadvantages. All behavioural patterns are likely to still be helping you to some extent (you wouldn’t be adopting them if they were not helpful to a degree) but there may be drawbacks to them, one drawback being that they may be serving to maintain your difficulties. For example, if we worry that if people were to get to know us then they wouldn’t like us and we cope through our behaviour by avoiding others from getting close, this may provide a sense of relief in the short term. However, in the long term we may miss out on valuable relationships and we don’t learn that actually if we let someone in they may like us and this can weaken the initial worries of being unlikeable. After this behavioural analytical work you will decide with your therapist what behavioural changes it could be good to make.


Other CBT Tools/Concepts

So far we have discussed how CBT addresses difficulties in the present moment. However, in CBT it can often be helpful to link our past experiences to our present difficulties as well as to identify more deeply held beliefs we may hold about ourselves, others and the world. This can help us to gain a deeper understanding into our thinking and behavioural patterns in the here and now (and thus fostering even more self-compassion). There is also the opportunity to address our more deeply held beliefs, which is particularly helpful to do if they are strong and pervasive.


If you would like to consider CBT for depression, CBT for anxiety or any other issue you are facing please contact me via email: contact@hertstherapypractice.com or complete the webform. I offer therapy in-person in St Albans/Hertfordshire and online.




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