You have probably heard of cognitive behavioral therapy, or CBT. It is one of the most widely used and well-researched forms of therapy in the world. But if you are thinking about starting therapy, you might still be wondering what it actually involves, and whether it would help you.

This guide explains CBT in plain language: what it is, what happens in sessions, what it can help with and how it compares to other approaches.

What is cognitive behavioral therapy?

CBT is built on a simple idea: your thoughts, feelings and actions are connected, and each one affects the others.

When you are stressed or struggling, those connections can form a loop that keeps you stuck. An unhelpful thought leads to a difficult feeling, which leads to an action that makes the thought feel even more true.

CBT helps you notice that loop and change it. When you shift one part, like a thought or a habit, the others start to shift too.

What it looks like in real life

Imagine you have a big meeting at work tomorrow.

• Thought: "I'm going to say something wrong and everyone will think I'm incompetent."

• Feeling: Anxiety, a tight chest, trouble sleeping.

• Action: You avoid preparing because thinking about it feels overwhelming, or you call in sick.

The next time a meeting comes up, the anxiety feels even bigger, because avoiding it the first time made it seem more dangerous.

In CBT, you would work with your therapist to:

• Notice the thought and see it as a thought, not a fact.

• Question it. What is the evidence? Have past meetings really gone that badly? What would you tell a friend in the same situation?

• Find a more balanced thought, such as "I might feel nervous, but I've prepared and I know this material."

• Try a different action, like preparing in small steps or going to the meeting even though it feels uncomfortable.

Over time, these small changes break the loop and the anxiety loosens its grip.

Common thinking traps CBT helps you spot

CBT gives names to patterns of thinking that many people fall into, especially when they are anxious or low:

• All-or-nothing thinking: "If it's not perfect, it's a failure."

• Catastrophizing: Jumping straight to the worst possible outcome.

• Mind reading: Assuming you know what others think of you.

• Overgeneralizing: "This always happens to me."

• Should statements: Holding yourself to rigid rules that leave no room for being human.

Just being able to recognize these patterns can make them feel less powerful.

What happens in CBT sessions?

CBT is practical and structured. A typical course looks something like this:

• Setting goals. In your first sessions, you and your therapist talk about what brings you in and what you want to feel or do differently.

• Learning the patterns. You start to notice the thoughts, feelings and behaviors that keep you stuck.

• Practicing new skills. Sessions often include tools like thought records, problem-solving, relaxation techniques or gradually facing situations you have been avoiding.

• Practice between sessions. CBT works best when you use the skills in everyday life, so your therapist may suggest small exercises to try during the week.

• Checking progress. You and your therapist regularly look at what is working and adjust the plan.

Sessions usually last about 50 to 60 minutes. CBT is often shorter-term than some other therapies, and many people work through a course of treatment over a few months, though everyone's pace is different.

What can CBT help with?

CBT has strong research support for many common concerns, including:

• Anxiety, worry and panic attacks

• Depression and low mood

• Stress and burnout

• Phobias and fears

• Insomnia and sleep problems

• Obsessive-compulsive disorder (OCD)

• Low self-esteem

• Anger and irritability

It is used with adults, teens and children, and it can be adapted for individual, couples and family therapy.

CBT vs. other types of therapy

CBT is one of several evidence-based approaches. Your therapist may use it on its own or alongside others.

• Dialectical behavior therapy (DBT) grew out of CBT. It adds skills for managing intense emotions, tolerating distress, staying present and navigating relationships. It is often helpful for people whose emotions feel overwhelming or hard to control.

• EMDR therapy focuses on processing traumatic or distressing memories so they lose their emotional charge. It is often used for trauma and PTSD. Learn more about EMDR therapy.

• Talk therapy in a broader sense may focus more on exploring your history, relationships and feelings, with less structure than CBT.

You do not need to know which approach you want before you start. Your therapist will help you figure out what fits your needs and goals.

Is CBT right for me?

CBT may be a good fit if:

• You want a practical, goal-focused approach

• You find yourself stuck in the same worries or negative thoughts

• You want tools you can use on your own, between sessions and after therapy ends

• You are dealing with anxiety, depression, stress or a specific fear

• You like the idea of seeing measurable progress over time

If you are not sure, that is completely normal. A first appointment is a chance to talk it through.

CBT at Lartey Wellness Group

Our licensed therapists use CBT and other evidence-based approaches with individuals, couples, teens and families. You can meet with a therapist in person at our Laurel office or online anywhere in Maryland.

We accept Maryland Medicaid and most insurance plans, and many clients pay little or nothing for sessions. You can meet our clinicians or reach out to get started.

Request an appointment or call (800) 994-5403

If you are in crisis right now, call or text 988 for free, 24/7 support, or visit our crisis resources page.