Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is an evidence-based talking therapy that helps you understand how thoughts, feelings and behaviours interact. It focuses on practical strategies to reduce symptoms and improve coping.

CBT is commonly used for anxiety, depression, panic, phobias and OCD, and is typically structured with clear goals and homework between sessions.

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CBT is a structured therapy that focuses on identifying unhelpful thought patterns and behaviours, testing them in real life, and building more helpful coping strategies. It is usually collaborative, goal-led and time-limited compared with some other therapies.

What happens in CBT?

Early sessions involve assessment and agreeing goals (for example reducing panic attacks, improving mood, or reducing avoidance). You may learn models that explain your symptoms, then practise techniques such as thought challenging, behavioural experiments, graded exposure, and problem-solving.

What can CBT help with?

Anxiety and worry
Panic attacks and panic disorder
Phobias and avoidance
Depression and low mood
OCD (often with exposure and response prevention)
Stress and coping skills

How long does CBT take?

Many CBT programmes run for a set number of sessions (for example 6–20), depending on the problem and severity. Progress is usually faster when you can practise skills between sessions. A good therapist will review outcomes regularly and adapt the plan if needed.

Choosing a CBT therapist in the UK

Look for someone trained in CBT with clear information on how they work, confidentiality, safeguarding and outcome tracking. If you have complex trauma or multiple issues, you may benefit from a therapist experienced in more integrative or trauma-informed CBT approaches.

History of Cognitive Behavioural Therapy

CBT developed in the 20th century through the integration of behavioural therapy and cognitive therapy approaches. It became one of the most researched psychological treatments, with structured models and techniques for specific difficulties.

In the UK, CBT is widely used in NHS and private settings and is commonly recommended for a range of anxiety and mood-related conditions.

Typical conditions that use Cognitive Behavioural Therapy

Condition	Evidence	Notes
Addiction / dependency support	strong	Core use for addiction recovery.
Anger issues	strong	Core use for anger issues.
Anxiety	strong	Core indication; structured skills and exposure-based work.
Body image concerns	strong	Core use for body image concerns.
Boundary issues	strong	Core use for boundary issues.
Chronic illness adjustment	strong	Core use for chronic illness adjustment.
Complex PTSD	strong	Core use: trauma-focused CBT for PTSD.
Compulsive behaviours	strong	Core use: CBT with ERP for OCD/compulsive behaviours.
Confidence building	strong	Core use for confidence building.
Depression	strong	Behavioural activation and cognitive strategies.
Difficulty reaching orgasm	strong	Core use for orgasm difficulties.
Emotional dysregulation (neurodiversity)	strong	Core use for emotional dysregulation.
Emotional eating	strong	Core use for emotional eating.
Emotional regulation difficulties	strong	Core use for emotional regulation difficulties.
Erectile dysfunction	strong	Core use for erectile dysfunction.
Exam stress	strong	Core use for exam stress.
Feeling overwhelmed	strong	Core use for feeling overwhelmed.
Gambling problems	strong	Core use for gambling problems.
Generalised anxiety disorder (GAD)	strong	Core use for GAD.
Guilt	strong	Core use for guilt.
Gut-brain stress symptoms	strong	Core use for gut-brain stress; IBS CBT well evidenced.
Health anxiety	strong	Core use for health anxiety.
Imposter syndrome	strong	Core use for imposter syndrome.
Insomnia	strong	Core use: CBT-I for insomnia.
Intimacy concerns	strong	Core use for intimacy concerns.
Intimacy difficulties	strong	Core use for intimacy difficulties.
Intrusive thoughts	strong	Core use for intrusive thoughts.
Irritable bowel syndrome (IBS)	strong	CBT for IBS; NICE-recommended.
Life transitions / adjustment issues	strong	Core use for life transitions.
Loneliness	strong	Core use for loneliness.
Long-term condition coping	strong	Core use for long-term condition coping.
Low confidence	strong	Core use for low confidence.
Low libido	strong	Core use for low libido.
Low mood	strong	Goal-led plans; track functioning and enjoyment.
Low mood in men	strong	Core use for low mood in men.
Low motivation	strong	Core use for low motivation.
Low self-esteem	strong	Core use for low self-esteem.
Motivation and goal setting	strong	Core use for motivation and goal-setting.
Non-restorative sleep	strong	Core use: CBT-I for non-restorative sleep.
Obsessive compulsive disorder (OCD)	strong	Often requires ERP; specialist experience helpful.
Painful sex (dyspareunia)	strong	Core use for dyspareunia.
Panic attacks	strong	Common CBT target; track frequency and avoidance.
Panic disorder	strong	Effective for panic; includes interoceptive exposure.
Parenting stress	strong	Core use for parenting stress.
Pelvic pain	strong	Core use for pelvic pain psychological support.
People pleasing	strong	Core use for people pleasing.
Perfectionism	strong	Core use for perfectionism.
Performance anxiety	strong	Core use for performance anxiety.
Phobias	strong	Exposure-based approaches widely used.
Postnatal emotional support	strong	Core use for postnatal emotional support.
Post-traumatic stress disorder (PTSD)	strong	Core use: trauma-focused CBT for PTSD.
Pregnancy anxiety support	strong	Core use for pregnancy anxiety.
Premature ejaculation	strong	Core use for premature ejaculation.
Procrastination	strong	Core use for procrastination.
Public speaking nerves	strong	Core use for public speaking nerves.
Relationship stress (men)	strong	Core use for relationship stress in men.
Resilience building	strong	Core use for resilience building.
Rumination / overthinking	strong	Core use for rumination and overthinking.
Seasonal affective disorder (SAD)	strong	Core use for SAD.
Self-harm thoughts (sensitive)	strong	Core use for self-harm thoughts.
Separation / divorce support	strong	Core use for separation/divorce support.
Sexual difficulties	strong	Core use for sexual difficulties.
Sexual performance anxiety (supportive)	strong	Core use for sexual performance anxiety.
Sexual wellbeing concerns (supportive)	strong	Core use for sexual wellbeing concerns.
Shame	strong	Core use for shame.
Skin picking (dermatillomania) support	strong	Core use for skin picking/dermatillomania.
Sleep anxiety	strong	Core use: CBT-I for sleep anxiety.
Social anxiety	strong	Core use for social anxiety.
Trauma after accident or assault	strong	Core use for trauma after accident/assault.
Trouble falling asleep	strong	Core use: CBT-I for sleep onset insomnia.
Trouble staying asleep	strong	Core use: CBT-I for sleep maintenance insomnia.
Trust issues	strong	Core use for trust issues.
Vaginismus	strong	Core use for vaginismus.
Weight management (behaviour change support)	strong	Core use for weight management behaviour change.
Work-life balance	strong	Core use for work-life balance.
Workplace stress	strong	Core use for workplace stress.
Acne-related confidence concerns	strong	Core use for acne-related distress.
ADHD (support / coaching alongside medical care)	strong	CBT adapted for ADHD; strong evidence.
Asthma-related anxiety support (adjunct)	strong	CBT for asthma-related anxiety.
Attachment issues	strong	CBT for attachment issues.
Autism / ASC support	strong	Autism-adapted CBT for co-occurring anxiety.
Bipolar disorder (support alongside medical care)	strong	CBT adapted for bipolar disorder.
Breathing pattern dysfunction support	strong	CBT for breathing pattern dysfunction anxiety.
Cancer emotional support (men)	strong	CBT for cancer-related anxiety and adjustment.
Career change support	strong	CBT for career change anxiety.
Caregiver stress	strong	CBT for carer stress.
Chronic fatigue syndrome / ME support (adjunct)	strong	CBT for ME/CFS psychological adjustment.
Co-parenting challenges	strong	CBT for co-parenting stress.
Cravings	strong	CBT for cravings; relapse prevention.
Domestic abuse recovery support (sensitive)	strong	CBT for domestic abuse recovery.
Eating disorder recovery support (alongside specialist care)	strong	CBT-E for eating disorder recovery.
Eczema stress impact support	strong	CBT for eczema psychological impact.
Executive dysfunction	strong	CBT for executive dysfunction secondary emotions.
Family conflict	strong	CBT for family conflict.
Fatherhood adjustment	strong	CBT for fatherhood adjustment.
Fatigue	strong	CBT for fatigue.
Fertility stress (emotional support)	strong	CBT for fertility stress.
Fibromyalgia support	strong	CBT for fibromyalgia psychological component.
Focus and concentration difficulties	strong	CBT for concentration difficulties.
Food-related anxiety (supportive)	strong	CBT for food-related anxiety.
Friendship difficulties	strong	CBT for friendship difficulties via social anxiety.
Grief and bereavement	strong	CBT for complicated grief.
Hair loss-related distress	strong	CBT for hair loss distress.
Headaches	strong	CBT for headache with psychological component.
High blood pressure stress support (adjunct)	strong	CBT for blood pressure stress.
Irritability	strong	Core use for irritability.
Jealousy	strong	CBT for jealousy.
Leadership coaching goals	strong	CBT for leadership development.
Learning difficulties support (non-diagnostic)	strong	CBT for learning difficulties secondary emotions.
Libido concerns (supportive)	strong	CBT for libido concerns.
Low energy	strong	CBT for low energy with psychological component.
Memory concerns (supportive)	strong	CBT for memory concern anxiety.
Menopause symptoms	strong	CBT for menopausal psychological symptoms.
Migraine support	strong	CBT for migraine management.
Multiple sclerosis support (adjunct)	strong	CBT for MS psychological symptoms.
Neuralgia support	strong	CBT for pain management in neuralgia.
Osteoarthritis support	strong	CBT for OA psychological component; pain management.
Parkinson’s support (adjunct)	strong	CBT for Parkinson's depression and anxiety.
PCOS support (adjunct)	strong	CBT for PCOS psychological support.
Perimenopause symptoms	strong	CBT for perimenopause psychological symptoms.
Peripheral neuropathy support (adjunct)	strong	CBT for peripheral neuropathy pain distress.
PMDD support (adjunct)	strong	CBT for PMDD.
Post-viral fatigue support	strong	CBT for post-viral fatigue psychological component.
Premenstrual syndrome (PMS)	strong	CBT for PMS psychological symptoms.
Psoriasis stress impact support	strong	CBT for psoriasis distress.
Relationship conflict	strong	CBT for relationship conflict.
Sedentary lifestyle support	strong	CBT for sedentary lifestyle behaviour change.
Sensory overload	strong	CBT for sensory overload anxiety.
Social isolation	strong	CBT for social isolation.
Sports injury recovery support	strong	CBT for sports injury psychological support.
Stammering (stuttering)	strong	CBT for stammering psychological component.
Stress	moderate	Useful for coping skills and problem-solving.
Stroke recovery support (adjunct)	strong	CBT for post-stroke psychological symptoms.
Time management	strong	CBT for time management difficulties.
TMJ / jaw tension	strong	CBT for TMJ stress component.
Vertigo support	strong	CBT for vertigo-related anxiety.
Acid reflux / heartburn support	moderate	CBT for stress-related reflux.
Back pain (upper)	moderate	CBT for chronic upper back pain distress.
Balance issues support	moderate	CBT for balance-related anxiety.
Chronic cough impact support	moderate	CBT for chronic cough anxiety.
Communication difficulties	moderate	CBT for communication anxiety.
Daytime sleepiness	moderate	CBT for psychological contributors to daytime sleepiness.
Diarrhoea	moderate	CBT for stress-related diarrhoea.
Dizziness support	moderate	CBT for dizziness-related anxiety.
Endometriosis support (adjunct)	moderate	CBT for endometriosis anxiety.
Hay fever impact support	moderate	CBT for hay fever psychological impact.
Hip pain	moderate	CBT for chronic pain psychological component.
Indigestion / dyspepsia	moderate	CBT for stress-related indigestion.
Joint pain	moderate	CBT for chronic joint pain distress.
Knee pain	moderate	CBT for chronic knee pain distress.
Language and communication difficulties (speech/language)	moderate	CBT for communication difficulties distress.
Lipolymphoedema support	moderate	CBT for lipolymphoedema distress.
Lymphoedema (lymphedema)	moderate	CBT for lymphoedema distress.
Menstrual cramps / painful periods	moderate	CBT for menstrual pain psychological component.
Nausea support	moderate	CBT for anticipatory nausea.
Plantar heel pain (plantar fasciitis)	moderate	CBT for plantar fasciitis distress.
Postural pain	moderate	CBT for chronic postural pain.
Rheumatoid arthritis support (adjunct)	moderate	CBT for RA psychological component.
Shoulder pain	moderate	CBT for chronic shoulder pain distress.
Sinus congestion support	moderate	CBT for chronic sinus congestion distress.
Tremor support	moderate	CBT for tremor-related anxiety.
Voice problems	moderate	CBT for voice problem performance anxiety.
Swelling (oedema)	limited	CBT for swelling-related health anxiety.

Frequently asked questions

How many CBT sessions will I need?

Often 6–20 sessions depending on goals and response.

Is there homework?

Yes. Brief practice tasks help apply skills in daily life.

Can CBT work online?

Many CBT elements translate well to video sessions; structure remains similar.