Cognitive Behavioral Therapy, commonly referred to as CBT, is one of the most widely studied and practiced forms of talk therapy. It is based on the principle that the way you think directly affects how you feel and how you behave. By identifying and changing patterns of thinking that contribute to distress, you can begin to shift how you experience and respond to the situations in your life.
At Artisan Counseling, our licensed counselors use CBT as part of individual counseling to help clients develop practical skills they can apply both in session and in daily life.
CBT is a structured, goal-oriented form of therapy that focuses on the connection between thoughts, emotions and behaviors. It was developed in the 1960s by psychiatrist Aaron Beck and has since become one of the most researched approaches in the field of mental health.
The core idea behind CBT is that your thoughts are not always accurate. When you experience distress, your mind often produces automatic thoughts that feel true but may be distorted. These distortions, such as catastrophizing, black-and-white thinking or personalizing, can lead to patterns of anxiety, depression, avoidance and other difficulties.
CBT does not focus on changing your circumstances. It focuses on helping you examine how you interpret your circumstances and giving you tools to respond in ways that reduce suffering and support the outcomes you want.
Research consistently supports CBT as an effective treatment. A meta-analysis published in Cognitive Therapy and Research found that CBT produces significant improvements across anxiety disorders, depression, insomnia and a range of stress-related conditions. It is recognized by the American Psychological Association as an evidence-based practice.
CBT follows a structured framework, but the way it is applied depends on your specific concerns and goals.
The first step in CBT is learning to notice the thoughts that show up in response to situations. These are called automatic thoughts because they happen quickly and without deliberate effort. Many of them operate below your awareness until you learn to pay attention.
For example, if you receive feedback at work and your immediate thought is “I am terrible at my job,” that thought shapes how you feel (shame, anxiety) and how you behave (avoidance, withdrawal). CBT helps you slow down and examine that thought rather than accept it as fact.
Once you begin to notice your automatic thoughts, your counselor will help you evaluate them. This involves asking questions like:
This process is not about forcing positive thinking. It is about developing a more accurate and balanced way of interpreting your experiences.
CBT also focuses on behavior. When you avoid situations that cause anxiety or withdraw from activities you used to enjoy, those behaviors reinforce the cycle of distress. Your counselor may work with you on behavioral experiments, exposure exercises or activity scheduling to help break those patterns.
Over the course of treatment, you develop a set of skills you can use on your own. These may include thought records, relaxation techniques, problem-solving strategies and communication tools. The goal is for you to become your own counselor over time.
CBT has been studied across a wide range of mental health concerns. Many clients at Artisan Counseling use CBT as part of their treatment for the following:
Anxiety. Generalized anxiety, social anxiety, panic attacks and specific phobias all respond well to CBT. Therapy helps you identify the thoughts and avoidance behaviors that maintain your anxiety and gives you tools to manage it.
Depression. CBT addresses the negative thought patterns and withdrawal behaviors that are common in depression. Research supports its effectiveness both as a standalone treatment and alongside medication.
Stress. When stress becomes chronic, it affects how you think, sleep, eat and relate to others. CBT provides strategies to interrupt the cycle.
Insomnia. CBT for insomnia, known as CBT-I, is considered a first-line treatment. It addresses the thoughts and behaviors that interfere with sleep without the use of medication.
Anger management. CBT helps you identify the triggers and thought patterns that contribute to anger and develop strategies for responding differently.
Low self-esteem. Persistent negative beliefs about yourself can be examined and challenged through the CBT framework.
Grief. While grief is not a disorder, CBT can be helpful when grief becomes prolonged or when it leads to patterns of avoidance, guilt or rumination.
Substance use. CBT is one of the primary approaches used in substance use treatment. It helps clients identify triggers, develop coping strategies and change the thought patterns that support continued use.
CBT sessions are structured but conversational. Here is what the process generally looks like.
Early sessions. Your counselor will ask about what brought you to therapy, your history and your goals. Together, you will identify the thoughts, emotions and behaviors you want to focus on. Your counselor will explain how CBT works and what you can expect.
Mid-treatment. Sessions become more focused on skill-building. You and your counselor will work through specific situations using CBT tools. This may include completing thought records, practicing new responses or discussing homework from the previous week.
Homework & practice. CBT includes work between sessions. Your counselor may ask you to track your thoughts, try a behavioral exercise or practice a relaxation technique. The between-session work is where much of the progress happens.
Later sessions. As you build confidence in using the tools on your own, sessions may shift to less frequent intervals. Your counselor will help you develop a plan for maintaining your progress after therapy ends.
CBT is typically a shorter-term approach compared to other forms of therapy. Many clients complete a course of CBT in 12 to 20 sessions, though this varies depending on the concern and the individual.
CBT may be a good fit if you:
CBT is not the only option. At Artisan Counseling, our counselors are trained in multiple modalities and will work with you to determine the approach that fits your needs. If CBT is not the right fit, your counselor may recommend an alternative such as EMDR, DBT, somatic therapy or another method.
If you are unsure, that is okay. Your counselor will discuss your options with you during the first few sessions.
CBT is more structured and goal-oriented than many other approaches. It focuses specifically on the relationship between thoughts, feelings and behaviors and includes work between sessions. Other forms of therapy may focus more on the therapeutic relationship, emotional processing or past experiences.
No. Many clients begin CBT without a formal diagnosis. If your counselor determines that a diagnosis is appropriate, they will discuss it with you.
Most clients complete CBT in 12 to 20 sessions. Some concerns may require fewer sessions, while others may take longer. Your counselor will work with you to set a timeline based on your goals.
Yes. Between-session assignments are a core part of CBT. These are not graded or judged. They are designed to help you apply what you learn in session to your daily life.
Yes. Many of our counselors offer CBT through telehealth for clients located in Virginia. Research supports the effectiveness of CBT delivered through video sessions.
Yes. Your counselor may integrate elements of CBT with other modalities depending on your needs. This is common and often effective.
CBT is a standard form of therapy and is typically covered by most insurance plans. Contact your insurance provider or our office to confirm your benefits.