Cognitive behavioral therapy (CBT) is one of the most widely researched forms of psychotherapy. Most experts consider cognitive behavioral therapy techniques to be highly effective as it is commonly identified as the first evidence-based psychotherapy according to most clinical guidelines.
What Is Cognitive Behavioral Therapy (CBT)?
“CBT is a type of psychological therapy or talking therapy which has proved more effective in treating various psychiatric conditions than other types of therapies or medications,” explains Mind Journal. CBT is a psychosocial intervention which can help individuals to replace negative and unhelpful thought & behavior patterns with more positive ones. It can also help to improve our emotions 1 , mood and mental health issues. Initially developed as cognitive therapy for depression by psychiatrist Aaron Beck in the 1960s, CBT is also influenced by Rational Emotive Behavioral Therapy (REBT) developed by psychologist Albert Ellis in the 1950s. Cognitive behavioral therapy techniques can be recommended to children, adolescents, adults and older adults.
It can effectively be used for the treatment of various psychological conditions, like depression, anxiety disorders 2 , PTSD, OCD, schizophrenia, personality disorders, bipolar disorder, antisocial behaviors, substance use disorder 3 etc. CBT can also help to improve non-psychological conditions and situations such as, loss or grief, relationship problems 4 , insomnia, stress, migraines 5 , irritable bowel syndrome 6 , chronic pain 7 , chronic fatigue syndrome 8 and distress related to general medical conditions. CBT can also drastically improve functioning and quality of life 9 , according to studies 10 .
Cognitive Behavioral Therapy Is The “Gold Standard”
A recent 2018 research 11 reveals that according to numerous studies cognitive behavioral therapy techniques can be considered as the “gold standard of the psychotherapy field,” even though some experts may disagree. However, the researchers believe that CBT can be considered as the best standard available in the field at the moment. “Pointing to the available evidence, CBT is usually considered the gold standard for the psychotherapeutic treatment of many or even most mental disorders,” states a 2017 study. Moreover, according to the Division 12 Task Force on Psychological Interventions of the American Psychological Association, cognitive behavioral therapy techniques are listed as the only treatment with “strong research support” in around 80% of psychiatric disorders 12 in the listing.
Cognitive behavioral therapy is mostly considered as the gold-standard of psychotherapy primarily due to the following factors –
- CBT has been extensively researched & studied and it indicates that this type of psychotherapy is usually effective.
- CBT is integrated into the larger mainstream information processing paradigm.
- Currently, no other form of psychotherapy has more support from research and studies to validate their fundamental constructs.
- CBT has been found to be systematically better and more effective than other psychological treatments.
- CBT mechanisms and models of change have been found to be in accordance with accepted paradigms of human mind and behavior.
- CBT is integrated into the wider field of science, such as cognitive neurogenetics.
- CBT is constantly evolving based on both critical & cumulative research.
The researchers of the recent 2018 study state “CBT dominates the international guidelines for psychosocial treatments, making it a first-line treatment for many disorders, as noted by the National Institute for Health and Care Excellence’s guidelines and American Psychological Association. Therefore, CBT is, indeed, the gold standard in the psychotherapy field.” However, there is still scope for further improvement as in certain situations patients may not respond to cognitive behavioral therapy techniques or may relapse.
Efficacy Of Cognitive Behavioral Therapy Techniques
Numerous studies point towards the increasing use and efficacy of CBT over other approaches of psychotherapy or methods of treatment. Growing evidence suggests that CBT is one of the most effective treatment options for different mental health conditions and issues. Moreover, as the treatment is relatively of shorter duration, more patients are encouraged to stick to the treatment plan. Although some experts claim that CBT acts a “quick fix” and oversimplifies the issues, research shows that this form of psychotherapy can be considered as the best treatment for several psychiatric disorders. Here are a few reasons why CBT is widely recommended for most conditions:
1. CBT is highly satisfactory
A 2013 study 13 analyzed a heterogeneous population of patients treated with CBT to evaluate symptom reduction and level of satisfaction. The study found that this form of therapy can be effective even when conducted by “less experienced trainee therapists.” The researchers observed a statistically remarkable decrease in symptoms, improvement in the condition, enhanced satisfaction with life and overall patient satisfaction with the therapy. It was found that not only the patients were “very pleased with the therapy,” the therapists “were, to a great extent, satisfied with the treatment process itself.”
2. CBT can cure different conditions
According to a 2012 meta-analysis 14 on the efficacy of cognitive behavioral therapy techniques, this form of therapy can be recommended as the first-line intervention for different mental disorders. “Our review of meta-analytic studies examining the efficacy of CBT demonstrated that this treatment has been used for a wide range of psychological problems. In general, the evidence-base of CBT is very strong, and especially for treating anxiety disorders,” explains the scientific review. Around 269 meta-analytic reviews analyzed by the researchers showed that CBT can be beneficial for a range of mental health issues, including –
- Anxiety disorders
- Depression and dysthymia
- Bipolar disorder
- General stress
- Substance use disorder
- Somatoform disorders
- Personality disorders
- Eating disorders
- Criminal behaviors
- Anger and aggression
- Chronic pain and fatigue
- Distress related to pregnancy complications
- Distress due to general medical conditions
- Female hormonal conditions
Another 2018 review 15 which analyzed 41 studies found that CBT can significantly help to improve symptoms of obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and anxiety disorders. The therapy was found to be most effective for stress, anxiety and OCD. Research 16 conducted in 2010 indicates that CBT can also be helpful in treating mood disorders like depression. “Cognitive behavioral therapy (CBT) is efficacious in the acute treatment of depression and may provide a viable alternative to antidepressant medication (ADM) for even more severely depressed unipolar patients when implemented in a competent fashion,” explain the researchers. CBT can even help to reduce relapse after treatment.
Cognitive behavioral therapy techniques are also effective for obsessive compulsive disorder (OCD) according to another 2017 study 17 . An analysis of 43 OCD patients revealed that CBT also helped to improve brain function in respect to coping with and preventing compulsions. Evidence 3 also shows that is an effective option for overcoming substance use disorders and also helps in reducing relapse after treatment.
3. CBT is most effective for treating anxiety
According to a 2018 study 18 , long-term outcomes for group CBT (GCBT) and individual CBT (ICBT) for social anxiety disorder (SOP), separation anxiety disorder (SAD) and generalized anxiety disorder (GAD) were found to be effective. The study states “Cognitive behavioral therapy (CBT) has demonstrated favorable long-term outcomes in youth with anxiety disorders in efficacy trials.” Another 2019 study 19 on the effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders (AD) found that individual-based CBT and family-based CBT showed favorable outcomes. According to the researchers “Eighty-one studies were included, with 3386 CBT participants and 2527 control participants. The overall results indicated that CBT is an effective treatment for childhood AD.”
However, a 2010 study 20 found that although “CBT is effective for a range of psychiatric disorders,” it is superior to alternative therapies “only among patients with anxiety or depressive disorders.” The findings of the study suggest that cognitive behavioral therapy techniques can be regarded as the first-line psychosocial treatment for patients with anxiety and depressive disorders 21 , as efficacy of CBT in other mental health conditions may require further research.
4. CBT is helpful in personality disorders (PDs)
Research 22 supports that CBT is an effective treatment approach for “reducing symptoms and enhancing functional outcomes among patients with” personality disorders (PDs) as well. CBT methodologies focus on various practical goals, like skills training, learning-based procedures and homework assignments which help to cope with social dysfunction problems, prevent self-defeating behaviors and promote better living among patients with PDs. The researchers add “CBT approaches emphasize the connection between implicit, automatic thoughts and their underlying schemas, which are widely thought to be dysregulated and maladaptive in PDs.”
5. CBT can help with insomnia
Cognitive behavioral therapy techniques can prove to be effective for treating chronic insomnia, which affects around 6-10% of general people. According to a 2013 study 23 , cognitive behavioral treatment of insomnia (CBTi) focuses on improving specific associations, cognitions and behaviors. It has proven to be effective on different types of patients, particularly the ones with psychological and medical comorbidities. The study explains “CBTi offers effective treatment of comorbid insomnia and represents a particularly attractive treatment option because it does not carry some of the risks associated with medications (eg, dependency, polypharmacy, cognitive and psychomotor impairment).”
Multiple studies 24 have found CBTi to be highly effective for people with sleep disorders which impaired their daily functioning. A 2015 study 25 found that CBTi is even “effective for the treatment of adolescents with insomnia.”
6. CBT can improve cognitive function
Cognitive behavioral therapy techniques have also been found to be linked with better cognitive control network activity in major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), revealed a 2017 study 26 . This suggests that CBT helps to improve cognitive function in patients with MDD and PTSD. The study explains “we provided evidence that activation of cognitive control regions is similarly enhanced following treatment with CBT in both MDD and PTSD.”
Cognitive Behavioral Therapy Techniques Are Effective
Although CBT may not completely cure a disorder, it can certainly relieve the symptoms and empower the patient to cope with their condition or situation in a better, healthier way. This short-term therapy can be a helpful choice of treatment for a wide array of psychological conditions. However, it is important that you consult a licensed and certified therapist or mental health professional experienced with CBT for the best results.
- Benjamin, C. L., Puleo, C. M., Settipani, C. A., Brodman, D. M., Edmunds, J. M., Cummings, C. M., & Kendall, P. C. (2011). History of cognitive-behavioral therapy in youth. Child and adolescent psychiatric clinics of North America, 20(2), 179–189. https://doi.org/10.1016/j.chc.2011.01.011
- Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337–346. https://doi.org/10.31887/DCNS.2015.17.3/akaczkurkin
- McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511–525. https://doi.org/10.1016/j.psc.2010.04.012
- Shayan, A., Taravati, M., Garousian, M., Babakhani, N., Faradmal, J., & Masoumi, S. Z. (2018). The Effect of Cognitive Behavioral Therapy on Marital Quality among Women. International journal of fertility & sterility, 12(2), 99–105. https://doi.org/10.22074/ijfs.2018.5257
- Harris, P., Loveman, E., Clegg, A., Easton, S., & Berry, N. (2015). Systematic review of cognitive behavioural therapy for the management of headaches and migraines in adults. British journal of pain, 9(4), 213–224. https://doi.org/10.1177/2049463715578291
- Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag. 2017 Jul 19;10:231-237. doi: 10.2147/PRBM.S120817. PMID: 28790872; PMCID: PMC5530860.
- Broderick JE, Keefe FJ, Schneider S, Junghaenel DU, Bruckenthal P, Schwartz JE, Kaell AT, Caldwell DS, McKee D, Gould E. Cognitive behavioral therapy for chronic pain is effective, but for whom? Pain. 2016 Sep;157(9):2115-2123. doi: 10.1097/j.pain.0000000000000626. PMID: 27227692.
- O’Dowd H, Gladwell P, Rogers CA, Hollinghurst S, Gregory A. Cognitive behavioural therapy in chronic fatigue syndrome: a randomised controlled trial of an outpatient group programme. Health Technol Assess. 2006 Oct;10(37):iii-iv, ix-x, 1-121. doi: 10.3310/hta10370. PMID: 17014748.
- Nekouei, Z. K., Yousefy, A., & Manshaee, G. (2012). Cognitive-behavioral therapy and quality of life: An experience among cardiac patients. Journal of education and health promotion, 1, 2. https://doi.org/10.4103/2277-9531.94410
- Hofmann, S.G., Asnaani, A., Vonk, I.J.J. et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cogn Ther Res 36, 427–440 (2012). https://doi.org/10.1007/s10608-012-9476-1
- David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in psychiatry, 9, 4. https://doi.org/10.3389/fpsyt.2018.00004
- Leichsenring, F., Abbass, A., Hilsenroth, M. J., Luyten, P., Munder, T., Rabung, S., & Steinert, C. (2018). “Gold Standards,” Plurality and Monocultures: The Need for Diversity in Psychotherapy. Frontiers in psychiatry, 9, 159. https://doi.org/10.3389/fpsyt.2018.00159
- Hiltunen, A. J., Kocys, E., & Perrin‐Wallqvist, R. (2013). Effectiveness of cognitive behavioral therapy: An evaluation of therapies provided by trainees at a university psychotherapy training center. PsyCh Journal, 2(2), 101-112. https://doi.org/10.1002/pchj.23
- Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive therapy and research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
- Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and anxiety, 35(6), 502–514. https://doi.org/10.1002/da.22728
- Driessen E, Hollon SD. Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. Psychiatr Clin North Am. 2010 Sep;33(3):537-55. doi: 10.1016/j.psc.2010.04.005. PMID: 20599132; PMCID: PMC2933381.
- Moody, T., Morfini, F., Cheng, G. et al. Mechanisms of cognitive-behavioral therapy for obsessive-compulsive disorder involve robust and extensive increases in brain network connectivity. Transl Psychiatry 7, e1230 (2017). https://doi.org/10.1038/tp.2017.192
- Kodal, A., Fjermestad, K., Bjelland, I., Gjestad, R., Öst, L., Bjaastad, J. F., Haugland, B. S., Havik, O. E., Heiervang, E., & Wergeland, G. J. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of Anxiety Disorders, 53, 58-67. https://doi.org/10.1016/j.janxdis.2017.11.003
- Sigurvinsdóttir, A. L., Jensínudóttir, K. B., Baldvinsdóttir, K. D., Smárason, O., & Skarphedinsson, G. (2019). Effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders across different CBT modalities and comparisons: A systematic review and meta-analysis. Nordic Journal of Psychiatry, 74(3), 168-180. https://doi.org/10.1080/08039488.2019.1686653
- Tolin DF. Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review. Clin Psychol Rev. 2010 Aug;30(6):710-20. doi: 10.1016/j.cpr.2010.05.003. Epub 2010 May 25. PMID: 20547435.
- Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World psychiatry : official journal of the World Psychiatric Association (WPA), 15(3), 245–258. https://doi.org/10.1002/wps.20346
- Matusiewicz, A. K., Hopwood, C. J., Banducci, A. N., & Lejuez, C. W. (2010). The effectiveness of cognitive behavioral therapy for personality disorders. The Psychiatric clinics of North America, 33(3), 657–685. https://doi.org/10.1016/j.psc.2010.04.007
- Williams, J., Roth, A., Vatthauer, K., & McCrae, C. S. (2013). Cognitive behavioral treatment of insomnia. Chest, 143(2), 554–565. https://doi.org/10.1378/chest.12-0731
- Jungquist CR, O’Brien C, Matteson-Rusby S, Smith MT, Pigeon WR, Xia Y, Lu N, Perlis ML. The efficacy of cognitive-behavioral therapy for insomnia in patients with chronic pain. Sleep Med. 2010 Mar;11(3):302-9. doi: 10.1016/j.sleep.2009.05.018. Epub 2010 Feb 4. PMID: 20133188; PMCID: PMC2830371.
- de Bruin, E. J., Bögels, S. M., Oort, F. J., & Meijer, A. M. (2015). Efficacy of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Randomized Controlled Trial with Internet Therapy, Group Therapy and A Waiting List Condition. Sleep, 38(12), 1913–1926. https://doi.org/10.5665/sleep.5240
- Yang, Z., Oathes, D. J., Linn, K. A., Bruce, S. E., Satterthwaite, T. D., Cook, P. A., Satchell, E. K., Shou, H., & Sheline, Y. I. (2018). Cognitive Behavioral Therapy Is Associated With Enhanced Cognitive Control Network Activity in Major Depression and Posttraumatic Stress Disorder. Biological psychiatry. Cognitive neuroscience and neuroimaging, 3(4), 311–319. https://doi.org/10.1016/j.bpsc.2017.12.006