CBT, short for Cognitive Behavioral Therapy (known in Turkish as BDT), is a structured psychotherapy approach that focuses on how thoughts, emotions, bodily reactions and behaviors influence one another. This article covers how CBT works, who it may suit, its limitations and the state of the evidence, drawing on the sources listed at the end. For the general framework of psychotherapy, see What Is Psychotherapy?.
In brief:
- Focus: The cycles of thought, emotion and behavior that maintain present-day difficulties.
- Structure: It is collaborative and goal-oriented; applying what is learned between sessions is part of the process.
- Duration: According to the sources, it usually involves 5–15 sessions (NHS) or 6–20 sessions (Royal College of Psychiatrists); this varies with the person and the difficulty.
- Limits: It is not a quick fix and may not give the same result for everyone.
What is CBT?
Cognitive Behavioral Therapy is a structured psychotherapy approach that addresses together the patterns of thought, emotion, bodily reaction and behavior that maintain the difficulties a person experiences. According to this approach, how a person interprets an event can influence what they feel, their bodily reactions and their behaviors in response to that event. For this reason, CBT focuses not only on the events that are experienced but on how the person makes sense of these events and on the effects of this meaning-making in their life.
Is CBT a single method?
No. The Royal College of Psychiatrists (RCPsych) describes CBT not as a single therapy but as a group of talking therapies. NIMH also notes that many therapies are variations of established approaches such as CBT. For this reason, the details of CBT may differ with the difficulty being addressed and the way it is delivered; what is described in this article offers a general framework. For an overview of psychotherapy types, see Which Approaches Can Be Used in the Psychotherapy Process?.
What are the origins and core idea of CBT?
CBT is based on the cognitive therapy model developed by psychiatrist Aaron T. Beck in the 1960s and later took its current form by combining with behavioral approaches. The core idea of the model is that a person’s reactions are closely related not only to the situation they experience but also to how they perceive and interpret it. For this reason, CBT addresses automatic thoughts, the beliefs that underlie them, and how these are reflected in emotions, bodily reactions and behaviors together.
CBT is generally carried out as a collaborative, goal-oriented and structured process. Trying out the skills addressed in sessions in daily life is an important part of the process.
How does CBT work?
CBT focuses mainly on present-day problems, the cycles that maintain these problems and the coping skills a person can use in daily life. In this process, the client and the therapist work together to evaluate the situations the person finds difficult, their automatic thoughts, emotional reactions, avoidance behaviors and recurring behavior patterns. The aim is for the person to notice the patterns of thought and behavior that challenge them, to be able to evaluate them in a more realistic and functional way, and to develop new ways of coping in daily life.
Example: how does the cycle of thoughts, feelings and behavior work?
The example below is a general illustration prepared to explain the basic model of CBT; it does not constitute a personal assessment.
| Element | Example |
|---|---|
| Situation | A presentation will be given at work tomorrow. |
| Automatic thought | “I will definitely make a mistake and everyone will notice.” |
| Emotion and bodily reaction | Anxiety, a racing heart, muscle tension. |
| Behavior | Putting off preparation again and again, or looking for ways to avoid the presentation. |
| A more balanced thought | “I may feel nervous, but I have prepared, and if I make a small mistake I can carry on.” |
| Possible effect | The intensity of anxiety may change; preparing for and giving the presentation may become easier. |
In CBT work, this cycle is examined step by step; thoughts are evaluated for realism and usefulness, and new behaviors are tried out in small steps.
What is done in CBT sessions?
CBT sessions generally proceed within a certain structure. In the sessions, the difficulties the person experiences and the therapy goals are first evaluated. Then it is examined together by which cycles of thought, emotion, bodily reaction and behavior these difficulties are maintained. Techniques such as thought records, behavioral experiments, emotion regulation work, problem-solving skills, relaxation exercises, exposure work or behavioral activation may be used in sessions. The methods to be used are determined according to the person’s reason for seeking support, needs and therapeutic goals.
Work done outside of sessions is also important in CBT. The client may be asked to observe certain situations, keep thought-emotion-behavior records, try out new skills in daily life or work on the topics addressed in sessions. Although this work may look like “homework,” the main aim is to make it easier to carry the skills addressed in therapy into daily life.
In which areas is CBT used?
A person can benefit from the CBT process by noticing the thought patterns that challenge them, recognizing behavior cycles such as avoidance or procrastination, understanding their emotional reactions better and developing more functional ways of coping. CBT is an approach that can be used in different areas such as anxiety, stress, depressive symptoms, obsessive thoughts, phobias, panic symptoms, social anxiety, post-traumatic difficulties and some relationship/communication difficulties. However, as in every psychotherapy process, the suitability of CBT should be determined in line with the person’s needs, reason for seeking support and clinical assessment.
Who may CBT be suitable for?
RCPsych notes that CBT can be used with people of any age, including children. It may be suitable for people looking for a structured piece of work with concrete goals that focuses on a particular problem, and who are ready to practice between sessions. RCPsych also states that CBT has not been shown to be effective in people with severe memory problems, and that for people with alcohol or drug dependence it is more appropriate to get help with these problems before starting CBT for another problem. For selection criteria, see How Is the Suitable Way of Working Assessed?.
What is known about the effectiveness of CBT?
The NHS describes CBT as a recommended treatment for many mental health problems. RCPsych notes that the UK’s National Institute for Health and Care Excellence (NICE), which prepares health guidelines, recommends CBT as a first choice for a range of problems. The Beck Institute states that CBT has been found effective in more than 2,000 studies; this is the institute’s own statement and it does not cite specific studies. The Turkish Psychiatric Association also states that the method rests on a scientific basis and is effective in many areas. These are the organizations’ own assessments; effectiveness may vary with the type of difficulty, the person and participation in the process, and no approach gives the same result for everyone.
How many sessions does CBT generally take?
There is no single fixed number of sessions for CBT. The NHS mentions, depending on the problem being addressed, usually between 5 and 15 sessions; RCPsych mentions usually 6 to 20 sessions, held weekly or every two weeks and lasting 30 to 60 minutes each, and notes that a course may last from about 6 weeks to 6 months. The Turkish Psychiatric Association states that 6–10 sessions can be enough for some people, while in situations that need longer the process may last for months or even more than a year.
The process varies with the nature and severity of the difficulty, the goals and the approach used. RCPsych adds that in the first 2–4 sessions it is assessed whether CBT is a treatment the person can use and feels comfortable with, and that each session begins with agreeing together on what will be discussed that day. For this reason, the most accurate statement is that CBT is generally a shorter-term and structured therapy, but that the number of sessions is determined according to the person’s needs.
What are the limitations of CBT?
RCPsych states that CBT is not a quick fix and may not work for everyone, and adds that about one in four people drop out. Changing old habits takes time and practice; when between-session tasks seem too hard or do not seem to help, talking with the therapist is advised. The NHS notes that if CBT is not the best fit for a person’s needs, the therapist may recommend a different type of therapy.
Can CBT be carried out together with medication?
According to RCPsych, CBT can also be carried out alongside medication, depending on the problem, medical advice and personal choice; the Turkish Psychiatric Association likewise states that the two can be used together. NIMH says that psychotherapy can be used as an alternative to medication or alongside it. Decisions about medication belong to a psychiatrist; a psychologist does not prescribe or recommend medication.
How can gains be maintained after therapy ends?
The NHS notes that it is important to keep using the skills learned after treatment ends and that the therapist usually helps plan how to do this. RCPsych says that a personal “staying well” plan is created at the end of a course, that the skills can continue to be practiced and developed afterward, and that a short “refresher” course can be taken if needed. The Turkish Psychiatric Association describes booster sessions at 3, 6 and 12 months after the end; this practice may vary from one institution to another.
Common misunderstandings about CBT
- “CBT tells people to think positively.” The aim in CBT is not to force thoughts to be positive but to evaluate them for realism and usefulness.
- “CBT is not interested in the past.” The focus is mainly on the present; however, past experiences can be addressed when they help in understanding present-day patterns.
- “CBT works only with thoughts.” Alongside thoughts, behaviors, bodily reactions and skill-building are also part of the process.
- “CBT is applied in the same way to everyone.” Although it is a structured approach, goals, techniques and duration are determined according to the person.
- “CBT is quick and easy.” Changing old habits takes time and practice; RCPsych states that CBT is not a quick fix.
Expert note
In clinical work, CBT’s tools (thought records, behavioral experiments, skills practice) are not applied as a ready-made checklist; they are used in the context of a person’s life story, relationships and recurring patterns. The same method can therefore move toward different goals, and at a different pace, for two different people.
From a perspective that draws on both cognitive behavioral and psychodynamic theory, thoughts, feelings, behavior and relationship patterns are considered together. Which approach, or which combination of approaches, is suitable usually becomes clear only after an assessment; the information in this article does not replace that assessment.
Clinical Psychologist Özgün Emre Yaylacı
Frequently asked questions
What is the difference between CBT and psychodynamic psychotherapy?
CBT focuses more on the cycles of thought and behavior that maintain present-day difficulties and on structured techniques. Psychodynamic psychotherapy, on the other hand, gives more room to the person’s relationship patterns, the effect of past experiences on the present and the person’s understanding of their own inner world. For detailed information, see What Is Psychodynamic Psychotherapy? and What Is the Difference Between CBT and Psychodynamic Psychotherapy?.
Is work outside of sessions mandatory in CBT?
Work outside of sessions is an important part of the process; however, its scope and nature are determined together according to the person’s needs, daily life and therapy goals. The NHS and RCPsych note that applying what is learned between sessions is important for the process to work.
Can CBT be conducted through online sessions?
CBT can also be conducted through online sessions when its suitability has been evaluated; the NHS also notes that CBT can be delivered in person, online or by phone. For information on how online sessions proceed, see What Is Online Psychotherapy and How Do Sessions Proceed?.
Is CBT suitable for everyone?
The suitability of a psychotherapy approach is determined according to the person’s needs, reason for seeking support and clinical assessment. For this reason, it cannot be said that a single approach is suitable for everyone. RCPsych also notes that CBT may not work for everyone.
Can CBT be carried out together with medication?
According to RCPsych, CBT can be carried out alongside medication, depending on the problem, medical advice and personal choice. Decisions about medication belong to a psychiatrist.
How many sessions does CBT take?
There is no fixed number of sessions for CBT; the NHS usually mentions 5–15 sessions and RCPsych usually 6–20. The number of sessions varies with the person’s needs and the difficulty being addressed.
Sources
This article was prepared for general information; the following sources were used in preparing it (all in English except the one marked as Turkish):
- NHS (UK National Health Service): Cognitive behavioural therapy (CBT)
- Beck Institute for Cognitive Behavior Therapy: Understanding CBT
- Royal College of Psychiatrists: Cognitive behavioural therapy (CBT)
- NIMH (US National Institute of Mental Health): Psychotherapies
- Turkish Psychiatric Association: Cognitive Behavioral Psychotherapy (in Turkish)
This article was prepared by Clinical Psychologist Özgün Emre Yaylacı. Last updated: October 23, 2026. The content is for general information only and does not constitute diagnosis, treatment or personal guidance.
