Throughout most of this website, CBT is discussed as though it’s a single form of therapy. In reality, CBT can be thought of as an umbrella term for a group of therapies that share the key ingredients of CBT and that are based on the idea that we can improve our well-being by changing how we think about situations and by responding to our thoughts in more adaptive ways. Examples of therapies that fall under the CBT umbrella include rational emotive behaviour therapy, stress inoculation therapy, exposure therapy, schema therapy, behavioural activation, cognitive processing therapy, dialectical behaviour therapy, acceptance and commitment therapy, mindfulness-based stress reduction, compassion-focused therapy, and many others. As a CBT client, it’s not important for you to understand the differences between these therapies, but this list is shared simply to make the point that CBT includes a variety of options to meet your needs.

Definitely! It’s not unusual for people who are just starting therapy to have difficulty identifying their thoughts. Often times, they start out being much more aware of other aspects of their experiences, such as the intense physiological symptoms, painful emotions, or behavioural responses that are causing them problems. Your CBT therapist can help you quiet your physiological symptoms so you can focus on your thoughts, and your therapist can share strategies for how to use your emotions and behaviours as clues to figure out what’s going through your mind. With some practice, you’ll become aware of the thoughts that are popping into your mind to drive your emotional, behavioural, and physiological reactions, which will set the stage for you to benefit from all of the other strategies you’ll learn throughout CBT.

The quick answer is that it depends. Medication comes out on top for people with disorders involving psychosis, where people lose touch with reality such as during schizophrenia and bipolar disorder. CBT can be a useful addition for these individuals, but medication is considered the first-line intervention. In comparison, people with mental illnesses or other milder symptoms that do not involve psychosis tend to respond just as well (or better) to CBT than to medication, but with fewer side effects or risk for addiction. People may respond to medication a few weeks faster than they respond to CBT, and they may not have to invest as much time, effort, or money to achieve these benefits; however, medications stop working as soon as people stop taking them. In contrast, CBT clients find that their gains last (or increase) long after treatment ends as clients keep using their new strategies. (Check out this blog for a description about these different effects of medication and CBT on depression.) Although there are some situations where taking medication at the same time can make CBT less effective, many people benefit from combining medication with CBT, particularly when they have more severe cases of disorders such as obsessive-compulsive disorder, attention deficit hyperactivity disorder, and depression. The decision about whether to address mental health issues through medication, CBT, or a combination of the two is a highly personal decision, but your treatment provider(s) will help you monitor the outcome of your chosen course of action so that you can revise your treatment plan as needed.

The short answer? It certainly could be. CBT is the type of therapy with the strongest research support for helping with the widest variety of mental health needs, and it can be adapted to fit the varied needs and preferences of the diverse range of people seeking therapy. The long answer? Not everybody who participates in CBT finds it helpful or suitable for their goals. For example, CBT may be less beneficial to you if you’re looking for a therapy where you can come and talk to a supportive sounding board about your day-to-day experiences, without having any specific problems or goals in mind each session. Similarly, if you’re exclusively wanting to explore memories of the past or the meanings of your dreams (key word: exclusively), you may find the CBT therapist’s use of agendas and action plans to develop new ways of thinking or behaving as unnecessary and confining structure for your purposes. If you’re looking for a therapist to give you advice on what decisions to make in your life, you may find yourself frustrated by your CBT therapist, who will instead ask questions to help you weigh the information you have and arrive at your own decision. Granted, your CBT therapist won’t hold back on sharing any relevant psychoeducation with you, for example, information about mental health issues or strategies that have worked for others with similar problems. Finally, if you’re currently unable to commit more than the hour you spend in session each week to the change process, CBT might not be for you right now given that the majority of the gains from CBT happen during the action plans completed between sessions. You may find that you get more out of your investment if you wait to begin therapy until you can carve out time between sessions to practice what you’re learning. That said, your CBT therapist would be more than happy to help you find the time in your routine or to space your sessions out more so that you can make use of CBT now. So although there are some scenarios where CBT may be a less-than-ideal fit, keep in mind that a skilled CBT therapist will be able to collaborate with you on how to modify their style to fit your therapy goals. Perhaps the best tip at this stage—which is in keeping with CBT's general approach to testing beliefs—is to hold off deciding whether CBT is right for you until you've tried a few sessions, collected some data, and seen for yourself.

No, not all therapy described as CBT is the same. Because of CBT’s popularity, the CBT term ends up getting overused to describe therapies that have incorporated some of the techniques associated with CBT, but that lack many of CBT's core and essential features. Extensive training is required for therapists to develop the advanced skills required to balance the defining content and structure of CBT sessions with the effective interpersonal style that is equally important to ensure strong therapeutic alliance is established with clients. Often times, this balancing act is unsuccessful, with one side of the equation outweighing the other, where the end product is no longer the complete CBT package that has been extensively researched and shown to be effective for a variety of client problems. What ends up happening is that many people think they’re receiving CBT when, in fact, they’re not. At ThinkWell CBT, we share enough background information about CBT on our website for you to be an informed consumer of CBT, regardless of where you choose to seek therapy. When shopping for CBT, it can be helpful to ask a potential therapist about the formal training and supervision they’ve received to become competent in providing CBT. You can also inquire as to whether a potential therapist is certified with any of the professional organizations that evaluate CBT therapists’ training and skill level in delivering CBT, such as the Beck Institute for Cognitive Behavior Therapy, the Academy of Cognitive and Behavioral Therapies, or the Canadian Association of Cognitive Behavioural Therapies.