What is CBT — and is it right for you?

Cognitive Behavioural Therapy — CBT — is probably the most researched talking therapy in the world, and the one your GP is most likely to mention. But the name does it few favours. Here is what it actually involves.

The core idea

CBT rests on a simple observation: our thoughts, feelings, bodily sensations and behaviour are all connected, and they feed each other. A thought ("I'll embarrass myself") produces a feeling (dread), which produces a behaviour (declining the invitation), which quietly confirms the original thought. Around it goes.

CBT works by finding the loops that keep a problem alive and interrupting them — usually at the level of thinking patterns and behaviour, because those are the parts we can most directly change.

What it helps with

The evidence base is strongest for anxiety in all its forms — generalised worry, panic, social anxiety, health anxiety, phobias — and for depression. It is also used effectively for insomnia, obsessive-compulsive difficulties, trauma and eating difficulties, often blended with other approaches.

What sessions are like

CBT is structured and collaborative. We agree what we're working on and how we'll know it's improving. Sessions are typically weekly and around fifty minutes, and there is usually something to try between sessions — noticing a thought pattern, testing a prediction, experimenting with a small change. The practice between sessions is where much of the change happens.

Short-term by design

A course of CBT often runs between twelve and twenty sessions. Some focused difficulties respond faster; longer-standing patterns take longer. Because it teaches you a method rather than just providing relief, the skills tend to outlast the therapy.

Is it right for you?

CBT suits people who like a practical, present-focused approach. But it isn't the only door. Sometimes what's needed is depth rather than technique — understanding where a pattern began, not just managing it. That's where psychoanalytic work comes in, and in my practice I often draw on both. The honest answer is found in an initial assessment, where we look at what you're carrying and choose the approach that fits you — not the other way round.