Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a form of psychotherapy that combines basic principles from cognitive psychology and behaviorism. It aims to reduce symptoms of various mental health conditions by challenging and adjusting convictions and assumptions, and learn better adapted behavior by trying and training new behaviours.

While CBT has philosophical precursors in Stoicism, it developed in three waves in the 20th century. The first wave consisted of the development of behaviorism in the 1920s and behavioral therapy in the 1950s and 1960s. The second wave focused on the importance of cognitions in the therapeutic process, resulting in the development of cognitive therapy by psychoanalyst Aaron Beck in the 1950s and the establishment of classical CBT, when cognitive and behavioral approaches were combined. The third wave took place in the 1980s and 1990s, when principles originating from Buddhism, especially mindfulness and acceptance, significantly contributed to the development of various new forms of CBT. Over time, cognitive behavior therapy became an umbrella-term for all cognitive-based psychotherapies.

CBT is a "problem-focused" and "action-oriented" form of therapy. The therapist's role is to assist the client in finding and practicing effective cognitive and behavioral strategies to address the identified obstacles and to alleviate symptoms of the disorder. CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of many psychological disorders. CBT focuses on challenging and changing these cognitive distortions (thoughts, beliefs, and attitudes) and their associated behaviors in order to improve emotional regulation and help the individual develop coping strategies to address problems.

CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies. These therapies include, but are not limited to, REBT, cognitive therapy, metacognitive therapy, metacognitive training, reality therapy/choice theory, cognitive processing therapy, EMDR, and multimodal therapy. New forms of CBT specifically influenced by mindfulness approaches include dialectical behavior therapy, mindfulness-based cognitive therapy, acceptance and commitment therapy, and compassion-focused therapy.

Though originally designed as an approach to treat depression, CBT is often prescribed for the evidence-informed treatment of many mental health and other conditions, including obsessive–compulsive disorder, generalized anxiety disorder, substance use disorders, marital problems, attention deficit hyperactivity disorder, and eating disorders. Along with interpersonal psychotherapy (IPT), CBT is recommended in treatment guidelines as a psychosocial treatment of choice. It is recommended by the American Psychiatric Association, the American Psychological Association, and the British National Health Service. CBT is also recommended as the first line of treatment for the majority of psychological disorders in children and adolescents, including aggression and conduct disorder.

Criticism of the therapy has been leveled at its lack of double-blind tested research, relatively high drop-out rates, and its tendency to target symptoms rather than the underlying condition.