A psychological, talking-based therapy that is in widespread and increasing use for a variety of disorders (e.g. DEPRESSION, anxiety and OBSESSIVE COMPULSIVE DISORDER). Its origin is credited to Aaron Beck (1960s), who noted his depressed patients’ thinking (i.e. cognition) was prone to distortion, misinterpretation or error. The assumption of CBT is that how a person perceives events (e.g. thoughts about bodily sensations in the case of panic) is associated with psychological distress and maladaptive behaviour. Thus, CBT assumes a relationship between thoughts, feelings and behaviour. CBT models of psychopathology incorporate behavioural principles of learning (e.g. escaping from a feared event in phobia) to explain why the condition might persist.

It is a collaboration between client and therapist to reach a shared understanding of the former's problem; therapy proceeds towards objective goals. Sessions are usually time-limited (typically between five to twenty, weekly or fortnightly sessions). Although therapy, unlike psychoanalysis, focuses on the ‘here and now’, consideration of earlier experience can help to explain the origin of current problems. The client is encouraged to practise skills learned in therapy in the form of homework and behavioural experiments. An additional aim is to empower the client to cope with future problems through strategies learned in therapy.

An example of a CBT approach for depression would involve the client in recognising situations that trigger negative thoughts and consequent negative emotional states. Negative thinking in this context is typically associated with errors and generalisations. The client is encouraged to test the validity of his or her negative thoughts, for example by being invited to consider alternative interpretations. The aim of this cognitive restructuring is to lighten the associated emotional state (i.e. improve mood). In the UK, the NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE (NICE) recommends CBT for several disorders. CBT is usually delivered by healthcare professionals who have undergone specialist training (e.g. clinical PSYCHOLOGISTs, counsellors, nurse specialists and psychiatrists). Therapy may be provided in a group format for some conditions. More recent innovations include modifications for use with children and older adults, and internet-based self-help guides for less severe problems. (See PSYCHOLOGY, PSYCHOTHERAPY.)