Cognitive Behavioural Therapy is one of the most evidence-based approaches in psychology. Here's what it actually involves.
If you've been considering therapy, you've probably come across the term CBT. Cognitive Behavioural Therapy is one of the most widely researched psychological approaches in the world, with robust evidence for its effectiveness across a range of difficulties — anxiety, depression, OCD, PTSD, eating difficulties, and more.
But what does it actually involve? And how do you know if it's right for you?
The core idea
CBT is built on a straightforward but powerful premise: that our thoughts, feelings, physical sensations, and behaviours are all interconnected. What we think affects how we feel. How we feel affects what we do. What we do affects what we think. And so on, in cycles that can either keep us stuck or help us move forward.
The goal of CBT is not to think positively — it's to understand these cycles and identify where they're working against you, then find ways to interrupt them.
What therapy sessions actually look like
CBT is a collaborative, active form of therapy. Sessions are structured — we'll typically review the week, identify patterns, work on specific techniques, and agree on things to try between sessions. It's not a passive process where you talk and I listen; it's a partnership.
I've been a CBT therapist for 17 years. In that time, I've learned that the approach works best when it's adapted to the individual — when it's built around your specific patterns, your life, your goals. Not a generic programme, but something genuinely tailored to you.
Is CBT right for you?
CBT tends to work particularly well for people who are dealing with specific difficulties — anxiety, low mood, perfectionism, people-pleasing — and who want practical tools alongside a deeper understanding of themselves. It's also relatively time-limited compared to some other forms of therapy, which many people find helpful.
It is not the right fit for everyone, and I'll always be honest about that. If something else would serve you better, I'll say so.
I offer a free 15-minute consultation to explore whether CBT might be the right approach for you. nataliemccandless.com