How CBT Helps Positively Transform Thinking, Emotions, and Actions
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How CBT Helps Positively Transform Thinking, Emotions, and Actions


November 12, 2024

Cognitive Behavioral Therapy (CBT) is an evidence-based form of psychotherapy and counseling. In CBT, therapists collaborate with clients to help them reframe their thoughts, manage distressing emotions, and modify behaviors to achieve personal growth and wellness.

Key Points
  • CBT focuses on reframing unhelpful thoughts to improve emotions and behaviors.
  • It is used to treat issues such as anxiety, depression, PTSD, and chronic pain.
  • The approach is solution-focused, collaborative, and aimed at building practical skills.

CBT is based on a straightforward idea: changing unhelpful thinking patterns can lead to improvements in emotions and behavior.

“By making alterations to disruptive behavioral patterns, individuals can experience improvements in their cognitive and emotional functioning,” explained Mark Cassano, PsyD, an adjunct professor in the MS in Mental Counseling program at PCOM and Director of Behavioral Sciences for the Crozer Health Family Medicine Residency Program.

Understanding CBT

CBT builds on models such as the Diathesis-Stress Model, which examines the relationship between genetic predispositions and environmental factors, and the Cognitive Triad, which focuses on negative thought patterns about the self, world, and future.

CBT emphasizes understanding various types of thought:

  • Automatic Thoughts: Quick, evaluative thoughts or images that are situationally specific.
  • Intermediate Beliefs: Conditional rules and assumptions about how life operates.
  • Core Beliefs: Fundamental beliefs about the self, others, the world, or the future that often present as absolute, rigid, and deeply held.
  • Cognitive Distortions: Unhelpful patterns of thinking that reflect distorted and/or unhelpful perspectives of an individual’s reality.

One of the primary principles that underlies CBT is the connection between thoughts, feelings, and behaviors. These interconnected pieces contribute to how individuals perceive and respond to various different situations or moments in life.

Applications of CBT

CBT can be effective in treating a wide range of conditions. Mental health concerns commonly addressed include depression, anxiety disorders, PTSD, and OCD. It may also be helpful for managing behavioral health challenges such as chronic pain, insomnia, and stress related to physical illnesses like diabetes.

“CBT has been identified as one of the most evidence-based approaches to mental health treatment for a wide range of biopsychosocial concerns,” said Nic Schmoyer-Edmiston, PhD, NCC, an assistant professor in the MS in Mental Health Counseling program at PCOM.

Cognitive Behavioral Exercises

CBT sessions are tailored to each individual’s needs. According to Schmoyer-Edmiston and Cassano, common CBT exercises may include:

  • Behavioral Activation: Encourages individuals to engage in activities that elicit a sense of pleasure or accomplishment, promoting positive changes in mood and motivation.
  • Relaxation Techniques: Includes methods like deep breathing, progressive muscle relaxation, and guided imagery to reduce stress and promote a sense of calm.
  • Cognitive Reframing: Helps individuals identify and adjust unhelpful thoughts, replacing them with more constructive and adaptive perspectives.
  • Socratic Questioning: Involves guided questions from therapists to encourage clients to explore, understand, and challenge their thinking patterns.
  • Psychoeducation: Equips clients with knowledge about CBT concepts and strategies, enabling them to apply these tools in everyday situations.

These strategies enable clients to take an active role in managing their mental health.

What Makes CBT Different?

CBT takes a goal-oriented approach to personal growth and wellness. Sessions are focused on practical solutions. The therapist and client work together to develop skills that can be applied to real-life situations.

A man and a woman sitting on a sofa.
Key CBT techniques include behavioral activation, relaxation methods, and cognitive reframing.

“Because CBT is oriented toward a hypothesis-testing and educational model of care, clients will have the opportunity to test out their beliefs and experience situations that help them develop new perspectives on their life circumstances and practice coping skills aimed to manage ongoing distress,” Cassano said. “There is also a strong emphasis on the therapeutic relationship, with providers promoting a collaborative approach to the therapeutic process.”

CBT has been thoroughly researched and established as a first line treatment approach for a wide range of mental and behavioral health concerns, Cassano added. Because of this, CBT providers can be found in almost any clinical and education setting including outpatient clinics (both mental health and physical health), hospitals, schools, and organizations.

“Beyond developing a collaborative and supportive relationship with their treatment provider, individuals who receive a course of cognitive behavioral therapy will have the opportunity to heal and grow,” Cassano explained. “Clients learn skills and strategies to navigate their individual concerns so they can feel empowered to independently navigate future challenges as they arise.”

How to Become a Cognitive Behavioral Therapist

Training to become a cognitive behavioral therapist typically begins with a master’s degree. Programs such as PCOM’s MS in Mental Health Counseling integrate CBT methods into their curriculum to prepare students for practice.

“Early in their training, students are immersed in the basic tenets of CBT as they learn about the various facets of functioning as a well-rounded mental health counselor,” Cassano said. “The students begin their training at PCOM by completing courses in basic assessment and counseling skills, as well as learning the fundamentals of cognitive behavioral therapy.”

Coursework and clinical experiences that emphasize the cognitive behavioral methodology and conceptualization framework enhance those foundational skills.

Schmoyer-Edmiston notes that while obtaining a master’s and/or doctoral degree is a great way to become initially trained as a cognitive behavioral therapist, it is important to receive targeted CBT supervision while working towards licensure.

“This supervision allows for a more experienced CBT clinician to provide clinical insight and training to enhance a clinician’s CBT skill and knowledge,” Schmoyer-Edmiston added.

Continuing education, including workshops and certifications, is also important for therapists to stay informed about advancements in the field.

“Perhaps one of the most rewarding aspects of being a CBT provider is witnessing your clients grow and heal as they progress through the therapeutic process,” Cassano said. “Being that CBT tends to be goal-focused in nature, CBT providers have the privilege to guide and observe clients as they make positive changes to their life.”

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