cbt for presentation anxiety

Appointments at Mayo Clinic

Fear of public speaking: how can i overcome it, how can i overcome my fear of public speaking.

Fear of public speaking is a common form of anxiety. It can range from slight nervousness to paralyzing fear and panic. Many people with this fear avoid public speaking situations altogether, or they suffer through them with shaking hands and a quavering voice. But with preparation and persistence, you can overcome your fear.

These steps may help:

• Know your topic. The better you understand what you're talking about — and the more you care about the topic — the less likely you'll make a mistake or get off track. And if you do get lost, you'll be able to recover quickly. Take some time to consider what questions the audience may ask and have your responses ready.
• Get organized. Ahead of time, carefully plan out the information you want to present, including any props, audio or visual aids. The more organized you are, the less nervous you'll be. Use an outline on a small card to stay on track. If possible, visit the place where you'll be speaking and review available equipment before your presentation.
• Practice, and then practice some more. Practice your complete presentation several times. Do it for some people you're comfortable with and ask for feedback. It may also be helpful to practice with a few people with whom you're less familiar. Consider making a video of your presentation so you can watch it and see opportunities for improvement.
• Challenge specific worries. When you're afraid of something, you may overestimate the likelihood of bad things happening. List your specific worries. Then directly challenge them by identifying probable and alternative outcomes and any objective evidence that supports each worry or the likelihood that your feared outcomes will happen.
• Visualize your success. Imagine that your presentation will go well. Positive thoughts can help decrease some of your negativity about your social performance and relieve some anxiety.
• Do some deep breathing. This can be very calming. Take two or more deep, slow breaths before you get up to the podium and during your speech.
• Focus on your material, not on your audience. People mainly pay attention to new information — not how it's presented. They may not notice your nervousness. If audience members do notice that you're nervous, they may root for you and want your presentation to be a success.
• Don't fear a moment of silence. If you lose track of what you're saying or start to feel nervous and your mind goes blank, it may seem like you've been silent for an eternity. In reality, it's probably only a few seconds. Even if it's longer, it's likely your audience won't mind a pause to consider what you've been saying. Just take a few slow, deep breaths.
• Recognize your success. After your speech or presentation, give yourself a pat on the back. It may not have been perfect, but chances are you're far more critical of yourself than your audience is. See if any of your specific worries actually occurred. Everyone makes mistakes. Look at any mistakes you made as an opportunity to improve your skills.
• Get support. Join a group that offers support for people who have difficulty with public speaking. One effective resource is Toastmasters, a nonprofit organization with local chapters that focuses on training people in speaking and leadership skills.

If you can't overcome your fear with practice alone, consider seeking professional help. Cognitive behavioral therapy is a skills-based approach that can be a successful treatment for reducing fear of public speaking.

As another option, your doctor may prescribe a calming medication that you take before public speaking. If your doctor prescribes a medication, try it before your speaking engagement to see how it affects you.

Nervousness or anxiety in certain situations is normal, and public speaking is no exception. Known as performance anxiety, other examples include stage fright, test anxiety and writer's block. But people with severe performance anxiety that includes significant anxiety in other social situations may have social anxiety disorder (also called social phobia). Social anxiety disorder may require cognitive behavioral therapy, medications or a combination of the two.

Craig N. Sawchuk, Ph.D., L.P.

There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

Error Email field is required

Error Include a valid email address

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Thank you for subscribing!

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Sorry something went wrong with your subscription

Please, try again in a couple of minutes

• Social anxiety disorder (social phobia). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association, 2013. http://dsm.psychiatryonline.org. Accessed April 18, 2017.
• 90 tips from Toastmasters. Toastmasters International. https://www.toastmasters.org/About/90th-Anniversary/90-Tips. Accessed April 18, 2017.
• Stein MB, et al. Approach to treating social anxiety disorder in adults. http://www.uptodate.com/home. Accessed April 18, 2017.
• How to keep fear of public speaking at bay. American Psychological Association. http://www.apa.org/monitor/2017/02/tips-sidebar.aspx. Accessed April 18, 2017.
• Jackson B, et al. Re-thinking anxiety: Using inoculation messages to reduce and reinterpret public speaking fears. PLOS One. 2017;12:e0169972.
• Sawchuk CN (expert opinion). Mayo Clinic, Rochester, Minn. April 24, 2017.

Products and Services

• Newsletter: Mayo Clinic Health Letter — Digital Edition
• A Book: Mayo Clinic Family Health Book
• Anxiety disorders
• Cognitive behavioral therapy
• Specific phobias
• Sweating and body odor
• Tachycardia

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

• Opportunities

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press .

• Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence
• The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book
• Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance
• FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment
• Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book
• Fear of public speaking How can I overcome it

Help transform healthcare

Your donation can make a difference in the future of healthcare. Give now to support Mayo Clinic's research.

1164 Bishop St Suite 930, Honolulu, HI 96813 | Hawaii Counseling | Honolulu CBT | Honolulu Therapy | Hawaii CBT | Online Therapy Hawaii | Cognitive Behavior Therapy | Downtown Honolulu, near Kaka’ako, Waikiki, Diamond Head, Kahala, Aina Haina, and Hawaii Kai | Serving residents of Oahu and Hawaii 17 Nottingham St, London W1U 5EW, United Kingdom | London CBT | Online Therapy UK | Cognitive Behavior Therapy | Marylebone, London (W1)

4 Ways Therapy Can Help You Overcome Presentation Anxiety Using CBT

• September 6, 2021
• Anxiety Treatment

We’ve all been there. You’re standing in front of a group of people at work or school or Zoom, ready to present your ideas. You know your speech by heart and feel confident in the topic. And yet, you feel that sinking feeling of anxiousness sneak up on you.

Stage fight, presentation anxiety,  fear of public speaking  or whatever you want to call it, can make you feel as if you are not prepared at all. There is no worse feeling than knowing how hard you worked on something only to feel tongue-tied and nervous. But know this – it is possible to overcome presentation anxiety using CBT and many people have done exactly this. As difficult as it feels, please know that you are not alone in this struggle. 

Fortunately, overcoming presentation anxiety using CBT is very achievable. An extremely effective way to getting over presentation jitters is Cognitive Behavioral Therapy (CBT). CBT is a model of therapy which teaches you tools to challenges negative thoughts, cope with unpleasant feelings and end the cycle of unhelpful behaviors. The thing is, although it isn’t obvious, our thoughts, feelings, physical sensations, and behaviors are all interrelated. 

Doubtful anything can help your public speaking fear? Then, keep reading below to find out 4 ways therapy can help you overcome presentation anxiety using CBT. 

CBT Will Challenge Your Negative Thoughts

Right before a presentation, it’s common to begin thinking negatively. The inner critic in your head may place seeds of doubt in your head about the presentation. “Did I prepare enough? What if I don’t remember my speech? What if no one enjoys the topic?” — the list can go on and on. Unfortunately, the longer that presentation anxiety isn’t treated, the more likely it will be to spread. Many people with presentation anxiety (which is very normal and surprisingly common) end up struggling with insomnia the night before any big presentations. 

One the seeds of doubt are planted, you can begin to spiral out of control with even more negative thinking. “Will I stumble over my words? What if they laugh at me? What if my boss does not go for my idea?”

Thankfully, therapy can help you overcome presentation anxiety using CBT once and for all. CBT helps people to recognize these negative thoughts and then counteract them with supportive and positive ones. Instead of doubting whether you are prepared, CBT will help you remember that you know this topic by heart which will boost your confidence. In place of fearing stuttering over your words or mispronouncing a word, it will help you remember that it’s ok to mess up — and that no one will judge you for it.

CBT Will Help You Transform Your Emotions

CBT is a fantastic method that explains how our thoughts, emotions, and behavior/actions influence one another.

As the negative thoughts overtake you before the presentation, your emotions and feelings will begin to feel out whack. When negative thoughts cycle through your head, you may begin to feel nervous. You can start to worry excessively or downright fear the upcoming speech. With your emotions being unregulated and uncontrollable, they often lead to even more erratic negative thoughts.  The cycle of anxiety is truly a vicious one.

CBT helps calm your mind and body down so that these emotions don’t worsen your anxiety symptoms. CBT teaches you how to regulate your emotions so that they don’t worsen the negative thoughts or feed into how you react.

With CBT, You’ll Begin To React Differently To Stress

Your heart may begin to race as it gets closer to your presenting time, and it may feel as if it is hard to catch your breath. When your emotions are unregulated, and out of control, your nervous system will begin to react accordingly, affecting your behaviors.

Standing in front of the group, as you excessively worry about messing up, can unintentionally cause you to mess up! For example, worrying and stressing out so much during a presentation at work or school can actually increase the chances of you messing up. It isn’t that you are self-sabotaging. You are just so focused on the what if scenarios and possible negative outcomes that you lose your focus on the speech itself.

Your behavior and reactions will be modified through CBT. You will learn how regulating your emotions can help calm your thoughts, which helps your emotions and your behavior, so instead of a vicious cycle you end up with a positive spiral upward.

CBT Can Give You Confidence In Yourself

CBT will help you to not only challenge the negative thoughts in your head but gives you confidence in yourself. As your negative outlook is replaced with supportive, helpful and more positive thoughts, you will find that you are more assured in your presentation abilities. You’ll know that not only did you prepare enough for the speech, but you’ll be able to deliver it with confidence when you the fear of public speaking no longer has any power over your life.  Click to read more about this highly effective Anxiety Treatment .

I am a Licensed Mental Health Counselor in Hawaii and an Accredited CBT Therapist in the UK with over 15 years of experience. I specialize in anxiety treatments and have received advanced specialist training in Cognitive Behavior Therapy and Compassion Focused Therapy . Please feel free to contact me at my  Honolulu  or  London  clinic to set up an Online  CBT Test Drive .

CBT Test Drive

The right approach, tools and fit is a game changer. For this reason, I offer an Initial Test Drive session to see if working together could be a great fit for you. Each Test Drive lasts between 45-60 minutes and takes place within my Video Consulting Room. Based on the latest evidence, science, and my experience, I will aim to make concrete suggestions as to what I think can be most helpful for you.

Honolulu Hawaii Cognitive Behavioral Therapy Counseling Therapy CBT London UK 17 Nottingham St, London W1U 5EW, United Kingdom - Marylebone, London (W1), near Harley Street, Baker Street, Regent’s Park, Oxford Circus and St John’s Wood (NW8) areas. Serving all residents of London, as well as across the UK and Europe 1164 Bishop St Suite 930, Honolulu, HI 96813 - Located in Downtown, Honolulu, near Kaka'ako, Waikiki, Diamond Head, Kahala, Aina Haina and Hawaii Kai. Honolulu Therapy | Hawaii Counseling | Hawaii Cognitive Behavior Therapy | Honolulu CBT | Hawaii CBT | Online Therapy | Serving all residents of Hawaii © 2022 CBT Gym | CBT Honolulu Hawaii Counseling | Cognitive Behavioral Therapy (CBT) | Counseling | London, UK CBT | Cancellation Policy

Privacy overview.

Oratory Club

Public Speaking Helpline

CBT for Public Speaking Anxiety

Cognitive Behavioral Therapy (CBT) is an effective method for alleviating anxiety related to public speaking. Public speaking anxiety can be a significant barrier to personal and professional growth.

Many individuals find it challenging to speak in front of an audience due to fear, self-doubt, and excessive nervousness. This anxiety can lead to avoidant behavior or negatively impact performance during presentations. Cognitive Behavioral Therapy (CBT) is a evidence-based approach that helps individuals manage and overcome public speaking anxiety.

Through CBT, individuals can identify and challenge negative thought patterns, develop coping strategies, and gradually expose themselves to speaking situations. This therapy aims to reframe negative beliefs and teach individuals how to manage anxiety symptoms effectively. By working with a trained therapist, individuals can develop the skills and tools needed to confidently engage in public speaking. CBT has been proven to be an effective, long-term solution for public speaking anxiety, enabling individuals to deliver presentations with calmness and confidence. So, if you’re struggling with public speaking anxiety, consider CBT as an effective option to help you overcome your fears and achieve success in your speaking engagements.

Table of Contents

Recognizing Public Speaking Anxiety

Public speaking anxiety is a common issue that many individuals face. Cognitive Behavioral Therapy (CBT) is a highly effective approach to help individuals overcome their fear of public speaking and gain confidence in their speaking abilities.

Public speaking anxiety is a common issue that affects many individuals, causing feelings of fear and nervousness when presenting or speaking in front of an audience. This type of anxiety can be overwhelming and have a significant impact on personal and professional life.

If you suffer from public speaking anxiety, it is essential to recognize the signs and symptoms, understand the contributing factors, and explore ways to manage it effectively.

Factors Contributing To Public Speaking Anxiety:

• Lack of experience: Limited exposure to public speaking can contribute to anxiety, as individuals may feel unfamiliar and uncomfortable in this setting.
• Fear of judgment: The fear of being judged by others and the pressure to perform perfectly can intensify anxiety levels.
• Negative self-talk: Having negative thoughts and beliefs about one’s abilities can fuel anxiety. Internal dialogue that focuses on potential mistakes or failures can heighten nervousness.
• Perceived risks: The perceived risk of embarrassment, ridicule, or failure during a presentation can trigger anxiety.
• Previous negative experiences: Past negative experiences, such as being criticized or receiving poor feedback, can increase anxiety levels when facing similar situations.

Understanding The Impact Of Public Speaking Anxiety:

• Professional limitations: Public speaking anxiety can hinder career growth and advancement opportunities that require effective communication skills.
• Academic challenges: Individuals with public speaking anxiety may struggle to participate in classroom discussions, present research findings, or deliver presentations, which can affect academic performance.
• Social implications: Public speaking anxiety can impact personal relationships as individuals may avoid social gatherings or participation in group activities that involve public speaking.
• Emotional distress: Anxiety-related symptoms such as increased heart rate, sweating, trembling, and a sense of dread can significantly impact emotional well-being.

Signs And Symptoms Of Public Speaking Anxiety:

• Physical manifestations: Racing heart, sweating, trembling, dry mouth, shallow breathing, and stomach discomfort are common physical symptoms experienced during public speaking anxiety.
• Cognitive symptoms: Negative thoughts, racing mind, difficulty concentrating, and memory blanks can occur due to heightened anxiety levels.
• Emotional responses: Feelings of fear, nervousness, irritability, restlessness, and a sense of impending doom are common emotional responses associated with public speaking anxiety.
• Behavioral cues: Avoidance of public speaking opportunities, excessive preparation, repetitive behaviors (such as hand gestures or body movements), and speech impairment (such as stuttering or speaking too quickly) may be observed.

Recognizing these factors, understanding the impact, and identifying signs and symptoms of public speaking anxiety are crucial steps towards addressing and managing this issue effectively. In the following sections, we will explore various strategies and techniques to overcome public speaking anxiety and develop confidence in public speaking.

Stay tuned!

Exploring The Cognitive-Behavioral Therapy Approach

Explore how cognitive-behavioral therapy (CBT) can help manage public speaking anxiety. Learn effective techniques and strategies to overcome fear and gain confidence in public speaking situations. Discover the power of CBT in transforming your mindset and improving your presentation skills.

Living with public speaking anxiety can be a daunting experience. The fear of speaking in front of an audience can not only hinder personal growth but also impact professional opportunities. If you find yourself struggling with public speaking anxiety, cognitive-behavioral therapy (CBT) might be the solution you’ve been searching for.

This approach focuses on identifying and challenging negative thought patterns and behaviors, helping you overcome your fear and regain confidence in public speaking situations. In this section, we will delve deeper into CBT and how it can effectively address public speaking anxiety.

Introduction To Cognitive-Behavioral Therapy (Cbt)

CBT is a goal-oriented and evidence-based form of psychotherapy that targets the connections between our thoughts, feelings, and behaviors. It aims to help individuals develop healthier and more adaptive ways of thinking and behaving. When applied to public speaking anxiety, CBT focuses on identifying and challenging irrational thoughts and beliefs that contribute to the fear of public speaking.

By doing so, it allows individuals to develop new coping strategies and improve their overall experience during public speaking engagements.

How Cbt Can Help With Public Speaking Anxiety

CBT can provide individuals suffering from public speaking anxiety with valuable tools and techniques to effectively manage their fear. Some of the key benefits of using CBT for public speaking anxiety include:

• Identifying and challenging negative thoughts: CBT helps individuals recognize their negative thought patterns related to public speaking and challenge their accuracy and validity.
• Replacing irrational beliefs with realistic ones: By challenging irrational beliefs and replacing them with realistic and rational thoughts, CBT helps individuals shift their perspective on public speaking from a fear-inducing activity to a manageable one.
• Developing coping strategies: CBT equips individuals with a range of coping mechanisms, such as relaxation exercises, breathing techniques, and visualization, to reduce anxiety levels before and during public speaking engagements.
• Exposure therapy: Within the framework of CBT, exposure therapy gradually exposes individuals to speaking situations, starting with less anxiety-provoking scenarios and gradually progressing towards more challenging ones. This helps individuals build confidence and desensitize themselves to their fear of public speaking.

Cbt Techniques For Managing Anxiety

CBT offers several effective techniques to manage anxiety associated with public speaking. These techniques include:

• Cognitive restructuring: This technique involves challenging and restructuring negative thoughts related to public speaking. By analyzing the evidence supporting these thoughts and identifying more balanced perspectives, individuals can reduce anxiety and improve their overall confidence.
• Systematic desensitization: This technique involves gradually exposing individuals to their fear of public speaking. Starting with low-pressure speaking situations and gradually progressing to more anxiety-provoking ones, individuals learn to manage their anxiety response and build confidence over time.
• Relaxation techniques: CBT teaches individuals various relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, and mindfulness, to help manage anxiety symptoms during public speaking engagements.
• Skills training: CBT can include skill-building exercises to enhance communication and public speaking abilities. These exercises focus on developing effective public speaking techniques, such as using appropriate body language, maintaining eye contact, and improving vocal projection.

By utilizing these CBT techniques, individuals can address their public speaking anxiety and regain control over their fear, ultimately leading to improved confidence and performance.

Understanding Negative Thoughts And Beliefs

Understanding negative thoughts and beliefs is crucial for overcoming public speaking anxiety through cognitive-behavioral therapy (CBT). By identifying and challenging these negative beliefs, individuals can develop healthier thought patterns that alleviate anxiety and improve public speaking skills. CBT provides practical techniques for changing negative thinking, building confidence, and promoting positive self-beliefs.

Public speaking anxiety can be a crippling fear for many individuals, causing excessive nervousness and distress when speaking in front of others. Cognitive-behavioral therapy (CBT) offers effective techniques to address and overcome this anxiety. One crucial aspect of CBT for public speaking anxiety involves understanding and challenging negative thoughts and beliefs that contribute to the fear.

By identifying and reframing these thoughts, individuals can gain self-empowerment and confidently navigate public speaking situations. Let’s explore the role of negative thoughts in public speaking anxiety and how to address them effectively.

The Role Of Negative Thoughts In Public Speaking Anxiety:

• Negative thoughts play a significant role in exacerbating public speaking anxiety. They trigger intense emotions such as fear, self-doubt, and even panic.
• These thoughts often involve catastrophizing scenarios, imagining worst-case outcomes, and focusing on perceived flaws or criticisms from others.
• Negative thoughts create a vicious cycle of anxiety, as they contribute to increased physiological symptoms like sweaty palms, racing heart, and trembling, further reinforcing the fear.

Identifying And Challenging Negative Beliefs:

• Identifying negative beliefs is the first step towards addressing them. Pay attention to the thoughts that arise when thinking about public speaking and note them down.
• Common negative beliefs may include: “I always mess up when speaking in public,” “People will judge me harshly,” or “My voice sounds terrible.”
• Challenge these negative beliefs by examining evidence to the contrary. Look for examples of successful past presentations or positive feedback from others.
• Ask yourself if these beliefs are based on facts or distorted perceptions. Often, negative beliefs are influenced by irrational thinking patterns, such as mind-reading or overgeneralization.

Reframing Negative Thoughts For Self-Empowerment:

• Reframing negative thoughts involves replacing them with more rational and empowering alternatives.
• Begin by identifying the underlying core beliefs that contribute to negative thoughts about public speaking. For example, the belief that “I must always be perfect” can lead to anxiety and self-criticism.
• Challenge these core beliefs by developing realistic and constructive alternatives. For instance, replace perfectionistic thinking with the belief that “Making mistakes is a normal part of learning and growth.”
• Practice self-compassion and remind yourself that nobody expects you to be flawless. Embrace the idea that every speaker has their strengths and weaknesses.
• Use positive affirmations to reinforce these new beliefs. Repeat statements such as “I am confident and capable of delivering a compelling presentation” regularly.

By understanding the role of negative thoughts in public speaking anxiety, identifying and challenging negative beliefs, and reframing those thoughts for self-empowerment, individuals can make significant progress in overcoming their fear. CBT techniques provide a framework for reshaping the way we think about public speaking, enabling us to approach it with confidence and ease.

So, let’s take the first step towards conquering public speaking anxiety by addressing our negative thoughts and beliefs head-on.

Developing Effective Public Speaking Skills

Developing effective public speaking skills can be achieved through Cognitive-Behavioral Therapy (CBT) techniques tailored for public speaking anxiety. These techniques empower individuals to overcome their fears, build confidence, and learn strategies that enhance their performance in public speaking engagements.

Building Confidence Through Preparation And Practice:

• Identifying the key points of your speech:
• Create a clear outline of your speech to ensure you cover all essential elements.
• Break down complex topics into manageable sections for easier delivery.
• Rehearsing your speech:
• Practice your speech multiple times to build familiarity and confidence.
• Time yourself to ensure you stay within the allotted time frame.
• Record and review your practice sessions to identify areas for improvement.
• Visualizing success:
• Imagine yourself delivering a successful speech to boost your confidence.
• Visualize positive reactions from the audience, reinforcing your belief in your public speaking abilities.

Overcoming Avoidance And Exposure Therapy:

• Understanding the root causes of anxiety:
• Explore the underlying reasons behind your fear of public speaking.
• Recognize and challenge any negative beliefs or past experiences related to public speaking.
• Gradual exposure to public speaking:
• Start with small, comfortable speaking engagements, such as speaking in front of friends or a supportive group.
• Gradually increase the difficulty and size of the audience to desensitize yourself to the fear.
• Utilizing relaxation techniques:
• Practice deep breathing exercises to calm your nerves before and during your speech.
• Incorporate mindfulness techniques to stay present and focused during your presentation.

Strategies For Effective Message Delivery And Body Language:

• Engaging the audience:
• Begin with a captivating opening to grab the audience’s attention and generate interest.
• Use storytelling techniques and anecdotes to make your message relatable and memorable.
• Body language and non-verbal cues:
• Maintain good posture and stand tall to convey confidence and authority.
• Make eye contact with the audience to establish a connection and build trust.
• Utilizing vocal techniques:
• Vary your tone, pitch, and pace to add emphasis and maintain the audience’s interest.
• Practice articulation and enunciation to ensure your message is clear and easily understood.

By implementing these strategies, you can develop effective public speaking skills, build confidence, overcome anxiety, and deliver impactful presentations. Remember, preparation, practice, and gradual exposure are key to conquering your fear of public speaking.

Managing Physical Symptoms Of Anxiety

Learn effective CBT techniques for managing physical symptoms of anxiety during public speaking. Gain confidence, reduce stress, and improve your presentation skills with practical strategies tailored to your needs. Expert guidance to help you overcome anxiety and excel in public speaking engagements.

Recognizing Physical Symptoms Of Anxiety:

• Shortness of breath: During public speaking, anxiety can cause individuals to experience difficulty breathing or shortness of breath. This can lead to a rapid heartbeat and increased feelings of anxiety.
• Dizziness and lightheadedness: Anxiety can also manifest as dizziness or lightheadedness. These physical symptoms can be unsettling and make it challenging to concentrate during a presentation.
• Muscle tension: Anxiety often leads to muscle tension, especially in the neck, shoulders, and jaw areas. This tension can result in discomfort and make it difficult to relax while speaking in front of others.
• Sweating: Excessive sweating is another common physical symptom of anxiety. The fear and nervousness associated with public speaking can trigger excessive perspiration, which can be embarrassing and cause further anxiety.
• Trembling or shaking: Anxiety can cause individuals to experience trembling or shaking of the hands, voice, or other parts of the body. These physical manifestations can be noticeable to others and potentially affect the speaker’s confidence.

Seeking Professional Help For Public Speaking Anxiety

Overcome public speaking anxiety with professional Cognitive Behavioral Therapy (CBT). Gain confidence and develop effective communication skills through targeted therapy sessions. Experience a transformative approach to conquer public speaking anxiety and excel in every presentation.

Public speaking anxiety can be a challenging hurdle to overcome on your own. If you find that your fear of speaking in public is significantly impacting your personal or professional life, it may be time to consider seeking professional help.

Cognitive Behavioral Therapy (CBT) has been proven to be an effective treatment for public speaking anxiety. Below, we will explore when to consider professional help, how to identify qualified CBT therapists, and what to expect during CBT sessions.

When To Consider Professional Help:

• When public speaking anxiety is causing significant distress and interfering with your daily life.
• When you have tried self-help techniques but have not seen any improvement in your anxiety symptoms.
• When you have a high-stakes public speaking event coming up that you feel ill-equipped to handle.
• When your fear of public speaking is affecting your relationships, career, or overall confidence.

Identifying Qualified Cbt Therapists:

• Look for therapists who specialize in anxiety disorders or specifically mention expertise in public speaking anxiety.
• Check the therapist’s credentials and ensure they have the necessary qualifications and licensing.
• Read reviews or ask for recommendations from friends, family, or healthcare professionals.
• Make sure the therapist has experience in using CBT techniques to treat public speaking anxiety.
• Consider scheduling a consultation session to determine if the therapist is a good fit for you.

What To Expect During Cbt Sessions:

• Initially, your therapist will conduct an assessment to determine the severity of your public speaking anxiety and identify any underlying factors.
• You will work together to set specific goals for your treatment.
• CBT sessions will involve discussion, education, and learning techniques to challenge negative thoughts and beliefs related to public speaking.
• Your therapist may use exposure therapy exercises to gradually expose you to public speaking situations while providing guidance and support.
• Homework assignments will be given to practice the skills learned in therapy and reinforce positive behaviors.

Remember that seeking professional help is not a sign of weakness but a brave step towards overcoming your public speaking anxiety. A qualified CBT therapist can provide you with the guidance, tools, and support you need to regain your confidence and conquer your fear of public speaking.

Resources For Public Speaking Anxiety

Discover valuable resources to overcome public speaking anxiety through cognitive behavioral therapy (CBT). Gain practical techniques and helpful tips to build confidence and deliver compelling presentations. Boost your speaking skills today with evidence-based strategies for conquering speech anxiety!

Public speaking anxiety can be a daunting challenge to overcome, but with the right resources and support, you can develop the skills and confidence needed to excel in this area. Here are some valuable resources to consider:

• “The Art of Public Speaking” by Dale Carnegie: This classic book provides practical tips on how to engage and captivate an audience, as well as techniques for managing anxiety.
• “Talk Like TED: The 9 Public-Speaking Secrets of the World’s Top Minds” by Carmine Gallo: Drawing on extensive research, this book reveals the strategies used by some of the most successful TED speakers, helping you deliver impactful presentations.

Websites And Podcasts For Further Information

• Toastmasters International: This global organization offers a supportive environment for improving public speaking skills through structured programs and regular practice sessions. Their website includes helpful resources and a directory to find local clubs.
• The Speaking of Anxiety Podcast: Hosted by a licensed therapist, this podcast addresses various anxiety-related topics, including public speaking. It provides insights, tips, and interviews with experts to help you navigate and overcome speaking anxieties.
• Harvard Business Review: The HBR website features numerous articles and blog posts on public speaking and effective communication. It offers valuable insights from industry leaders and communication experts to refine your skills.

Support Groups And Online Communities

• Anxiety and Depression Association of America (ADAA): ADAA offers online support groups specifically catering to anxiety disorders, including public speaking anxiety. These communities provide a safe space to share experiences, gain support, and learn coping strategies from others facing similar challenges.
• Meetup: This platform allows you to join or start local public speaking anxiety support groups. Meeting regularly with like-minded individuals can provide encouragement, feedback, and opportunities to practice in a supportive environment.

Additional Self-Help Techniques And Tools

• Breathing exercises: Deep breathing techniques help calm nerves and reduce physical symptoms of anxiety. Practice diaphragmatic breathing by inhaling deeply through your nose, holding for a few seconds, and exhaling slowly through your mouth.
• Visualizations: Imagine yourself successfully delivering a speech or presentation. Visualize the positive outcome, vividly imagining how it feels to engage the audience and confidently express yourself.
• Mindfulness and meditation: These practices can promote relaxation and help you stay present during public speaking engagements. Explore mindfulness apps like Headspace or Calm, which offer guided meditations to manage anxiety.
• Practice and preparation: The more you rehearse your speech or presentation, the more confident you will feel. Practice in front of a mirror, record yourself, or seek feedback from trusted individuals to improve your delivery.
• Professional Help: If public speaking anxiety severely impacts your life, consider seeking professional help from a therapist or counselor. Cognitive Behavioral Therapy (CBT) has shown promising results in addressing anxiety disorders, including public speaking anxiety.

Remember, conquering public speaking anxiety takes time and patience. Utilize these resources and techniques consistently to build your confidence and become a compelling speaker.

Credit: www.verywellmind.com

Frequently Asked Questions On Cbt For Public Speaking Anxiety

How can cbt help with public speaking anxiety.

Cognitive Behavioral Therapy (CBT) helps with public speaking anxiety by addressing negative thoughts and beliefs, teaching relaxation techniques, and gradually exposing individuals to speaking situations. It helps in changing the perception of public speaking and building confidence through problem-solving and skill-building exercises.

What Are The Common Symptoms Of Public Speaking Anxiety?

Common symptoms of public speaking anxiety include increased heart rate, sweating, trembling, dry mouth, difficulty breathing, and feeling nauseous. Additionally, individuals may experience racing thoughts, negative self-talk, and intense fear of being judged or embarrassed in front of others.

Can Cbt Be Effective In Overcoming Public Speaking Anxiety?

Yes, CBT can be highly effective in helping individuals overcome public speaking anxiety. By identifying and challenging negative thoughts, developing coping strategies, and gradually exposing individuals to speaking situations, CBT can help individuals build confidence, reduce anxiety, and improve their public speaking skills.

Is Public Speaking Anxiety A Common Problem?

Yes, public speaking anxiety is a common problem and affects many individuals. It is estimated that up to 75% of people experience some level of anxiety when speaking in public. However, with the right techniques and support, this fear can be managed and overcome.

Cognitive Behavioral Therapy (CBT) has proven to be an effective treatment for public speaking anxiety. By addressing the negative thoughts and beliefs associated with public speaking, CBT helps individuals reframe their mindset and develop more confident and positive thinking patterns.

Through practice and exposure, CBT empowers individuals to challenge and overcome their fears, allowing them to effectively communicate and engage with others in public speaking situations. CBT techniques, such as cognitive restructuring, relaxation exercises, and systematic desensitization, provide practical strategies for managing anxiety and improving overall performance.

It is important for individuals experiencing public speaking anxiety to seek professional help from a licensed therapist trained in CBT. With the right support and guidance, individuals can successfully overcome their fear of public speaking and experience increased confidence and success in their personal and professional lives.

Remember, don’t let anxiety hold you back – explore the benefits of CBT and take control of your public speaking fears today.

Similar Posts

How can an introvert become comfortable with public speaking.

Introverts can become comfortable with public speaking by practicing regularly and focusing on their strengths when communicating with an audience. Public speaking comfort for introverts can be achieved through consistent practice and leveraging personal strengths. Public speaking can be a daunting task for introverts, who typically prefer solitude and find their energy drained in social…

Who are the Best Public Speaking Coaches?

The best public speaking coaches are Tony Robbins and Amy Cuddy. They have extensive experience and a proven track record of success in helping individuals improve their public speaking skills, confidence, and presence on stage. Public speaking is a skill that can greatly enhance your personal and professional life. Whether you’re giving a presentation at…

Is Anxiety in Public Speaking Normal?

Yes, anxiety in public speaking is normal and a common experience for many people. Public speaking anxiety, also known as glossophobia, affects individuals regardless of their level of experience or expertise in public speaking. It is a natural response to the fear of being judged or evaluated by others while giving a speech or presentation….

Best Public Speaking Coaches

The best public speaking coaches are highly skilled professionals who help individuals improve their communication and presentation skills. With their expertise and guidance, they can assist in building confidence, enhancing delivery techniques, and refining content to ensure impactful and effective speeches. Personalized coaching sessions tailored to individual needs and goals are key to their success…

Why You Need to Be a Decent Speaker?

Being a decent public speaker is essential for effective communication and building connections with others. Mastering this skill can boost your confidence, enhance your career prospects, and allow you to effectively convey your ideas and thoughts to a broader audience. It enables you to engage, persuade, and inspire others, ultimately helping you to achieve personal…

When Do Debaters Give Rebuttal Arguments?

When do debaters give their rebuttal arguments? This is a question that often arises when diving into the world of debating. Well, buckle up, because I’m here to give you the lowdown on when these fiery rebuttals take place. Now, imagine a debate as a thrilling game of back-and-forth, where debaters spar with words instead…

Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders

Information & authors, metrics & citations, view options, cognitive interventions, behavioral interventions, cbt for specific disorders, panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, prolonged grief disorder, transdiagnostic approaches to cbt for anxiety disorders, complementary approaches for cbt, mindfulness, pharmacotherapy, d-cycloserine in conjunction with exposures, novel delivery methods, conclusions, information, published in.

• Anxiety and anxiety disorders
• Psychotherapy

Competing Interests

Export citations.

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu .

To download the citation to this article, select your reference manager software.

There are no citations for this item

View options

Login options.

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Purchase Options

Purchase this article to access the full text.

PPV Articles - Focus

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR ® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Share article link

Copying failed.

PREVIOUS ARTICLE

Next article, request username.

Can't sign in? Forgot your username? Enter your email address below and we will send you your username

If the address matches an existing account you will receive an email with instructions to retrieve your username

Create a new account

Change password, password changed successfully.

Your password has been changed

Reset password

Can't sign in? Forgot your password?

Enter your email address below and we will send you the reset instructions

If the address matches an existing account you will receive an email with instructions to reset your password.

Your Phone has been verified

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use , this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.

• LB Slimming Gummies
• Anxiety Treatment: Effective Strategies For Managing Symptoms
• Body+ Kapseln
• Green Gummies
• Neo Tropfen
• Keto-XP Fruchtgummis
• Liver Ignite
• Sumatra Slim Belly Tonic
• HepaLiv Avis
• Yummy Slim Gummies
• G7 Green Gummies Avis
• Neo Drops Avis
• Shape Capsules Avis
• KetoXplode Gevaarlijk
• Shape Kapseln
• BioXtrim Gummies
• Neo Drops Ervaringen
• Naturhof Leberkur
• Shape Capsules Ervaringen
• LeberSan Aktiv
• PhenQ Reviews
• B Extra Weight Loss Capsules Reviews
• BioXtrim Ervaringen
• NMN Supplement
• Genuine Purity NMN
• Best CBD Gummies For Anxiety
• Best Adderall Alternatives
• Best CBD Gummies for Sleep
• Best CBD Gummies for Men
• Best Testosterone Pills
• Best OTC Phentermine Alternatives
• Best Kratom Powder
• Best Berberine Supplements
• Best Online TRT Clinics
• Fountain TRT
• Ikaria Juice
• Quietum Plus
• Best Testosterone Booster
• Fast Lean Pro
• Kerassentials
• Best HGH Supplements
• Bio Complete 3

• Mental Health

Cognitive Behavioral Therapy (CBT): Effective Anxiety Treatment

Cognitive Behavioral Therapy (CBT) refers to a broad range of psychological treatments for anxiety disorders . Generally speaking, these clinical approaches seek to alleviate both negative cognitions (i.e., thoughts, beliefs) and maladaptive behaviors associated with mental disorders 1 .

CBT seeks to blend the best parts of behavior and cognitive therapies 2 . From the perspective of CBT, one must address both the maladaptive behaviors and the cognitions associated with mental disorders to provide adequate treatment 3 . For instance, imagine a man named Fred. Fred suffers from severe social anxiety . Consequently, when at parties, he finds himself constantly thinking, “I am so awkward. Everyone thinks I’m weird.” To cope with these distressing thoughts, he drinks too much, which makes him feel substantially worse the next day.

To help Fred, a therapist using CBT will encourage him to challenge his negative thoughts and develop a more positive appraisal of his actions. In addition, the therapist will also help him develop coping mechanisms that do not rely on alcohol. In this way, CBT can help reduce both sources of stress for Fred and hopefully help him experience significantly less anxiety in social situations.

What makes CBT unique?

If a friend, therapist, or medical professional has suggested you investigate CBT to help with anxiety or an anxiety-related disorder, there is a reason. Namely, it works . Early behavior therapists demanded empirical evidence for any proposed new therapy 4 . In other words, they needed scientific evidence that a therapy helped patients or clients before applying it clinically.

Most therapies under the umbrella of CBT have maintained this strict scientific rigor, and consequently, we know that they actually help people cope with their disorders. In particular, over the past 10 years, there have been two large scale meta-analyses 5-6 , examining the effectiveness of CBT across numerous studies. Whereas a typical study may examine only 100 participants, meta-analyses combine data from upwards of hundreds of studies, sometimes including thousands of individual participants, into a single analysis.

This approach gives researchers tremendous power to see whether a given clinical approach is truly effective across circumstances. In regards to CBT for anxiety, both of these papers concluded that CBT was “highly effective” at treating anxiety disorders 5-6 , including generalized anxiety disorder (GAD), panic disorder , social anxiety disorder, and post-traumatic stress disorder (PTSD).

What does CBT look like?

CBT can take many forms and is often tailored to the needs of individual clients. However there are some consistent approaches that therapists use. Listed below are a few common types of therapy and techniques that an individual might encounter while participating in CBT.

I nterpersonal Therapy

Interpersonal Psychotherapy (IPT) is a “time-limited” form of psychotherapy that, within a few sessions, seeks to identify interpersonal problems which are causing psychological distress and develop a plan of action to address the source of these problems 7 . This model specifically holds that interpersonal problems (e.g., difficulties with a boss, fight with a family member) can be connected to psychological symptoms. Consequently, therapists using IPT seek to alleviate problematic symptoms, give clients interpersonal skills to aid their current situation, and boost the client’s sources of social support. In this way, IPT improves the client’s experience of their disorder while giving them real-world skills to help them address the problems at hand.

Thought Diaries/Thought Records

Thought diaries or thought records are a straightforward approach to addressing the negative cognitions often associated with anxiety disorders 8 . In this technique, clients are asked to write down their negative thoughts (e.g., “I will fail this upcoming exam.”), the situation in which they had the thought (e.g., talking with a family member about school), the emotions associated with the thought (e.g., fear, anxiety), how they attempted to cope (e.g., breathing exercises), and the eventual outcome of the event (e.g., “I initially felt really scared, but after doing breathing exercises, I was less worried about the exam.”). This technique can be incredibly useful for helping clients identify the specific situations that cause them anxiety and which techniques work to help them calm their worries.

Modern Exposure Therapies

Exposure therapies were pioneered by Joseph Wolpe, a South African behavior therapist 9 . Exposure therapy was originally designed to treat clients with phobic fears and makes use of a therapeutic approach known as systematic desensitization. In this model, therapists slowly expose clients to the target of their fear in increasing degrees.

For example, for an individual with spider phobia, a therapist will begin by simply showing them pictures of spiders, then proceed to showing them fake spiders, then present them with a real, living spider, and, finally, the therapist will ask them to directly approach and touch the spider. During this process, the therapist leads clients through techniques such as progressive muscle relaxation until they feel calm and no longer experience fear in response to the feared target. Though originally developed strictly as a behavior therapy, modern variants include cognitive techniques to help clients reduce their mental experience of fear.

History of CBT

Though it came to fruition in the 1970’s and 1980’s, CBT has roots in the work of behavior therapists in the early 20 th century. Behavior therapy grew out of the behaviorist school of thought, which argued that psychologists should focus only on “observable” behaviors rather than speculate regarding the content of a person’s thoughts 10 .

Following this vein, behavior therapy approached mental disorders by addressing specifically the negative behaviors associated with those disorders. For instance, Mary Cover Jones, the “mother of behavior therapy,” developed a technique to reduce a fear of bunnies in a child by rewarding that child with candy in the presence of a bunny 11-12 . In essence, she simply replaced negative fear-related behaviors with positive behaviors associated with eating candy.

Behavior therapists made crucial advancements in the treatment of mental disorders. However, many clinicians during the 1970’s began to feel that the behaviorist perspective did not adequately describe their clients’ experiences. One such professional, a psychiatrist by the name of Aaron Beck, noted that his depressed patients experienced unrealistically negative and self-defeating “automatic thoughts” 13-16 . Whereas a non-depressed individual might brush-off a minor failure, Beck found that his depressed patients interpreted their negative experiences more globally, using categorical statements such as, “I never do anything right.”

Previously, behavior therapists ignored such thoughts. Beck, though, saw them as a crucial feature of the disorder and sought to engage with clients, challenging these extreme thoughts to reduce the distress they caused. Based on this work, Beck founded Cognitive Therapy, which serves as the basis of many of the most influential therapies present today.

New Approaches to CBT

Over the past 40 years, a growing number of CBT-based approaches have emerged, using a diverse range of techniques. Perhaps the two most popular variants in recent years have been Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT). Though these therapies differ in many ways, they share the core goal of addressing problematic thoughts and behaviors by helping individuals restructure their responses to negative thoughts and events, while redirecting their energies to more positive behaviors.

In particular, both approaches utilize mindfulness techniques, such as meditation, to help individuals focus their thoughts on the moment 17-18 . Though the efficacy of both of these approaches are still being examined 4 , a growing literature suggests that they are extremely effective in reducing the experience of anxiety among their clients 19-20 .

1. Oltmanns, T. F., & Emery, R. E. (2010). Abnormal psychology. Upper Saddle River, N.J: Prentice Hall.

2. Rachman, S. (2009). Psychological treatment of anxiety: The evolution of behavior therapy and cognitive behavior therapy. Annual review of clinical psychology, 5, 97-119.

3. Hollon, S. D., & Beck, A. T. (1994). Cognitive and cognitive-behavioral therapies.

4. Öst, L. G. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour research and therapy, 46(3), 296-321.

5. Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical psychology review, 26(1), 17-31.

6. 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.

7. Interpersonal Psychotherapy Institute. About IPT. Retrieved July 26, 2016 from https://iptinstitute.com/about-ipt/

8. Rees, C. S., McEvoy, P., & Nathan, P. R. (2005). Relationship between homework completion and outcome in cognitive behaviour therapy. Cognitive Behaviour Therapy, 34(4), 242-247.

9. Wolpe, J. (1958). Psychotherapy and reciprocal inhibition. Stanford, CA: Stanford University Press.

10. Watson, J. B. (1913). Psychology as the behaviorist views it. Psychological review , 20 (2), 158.

11. Jones, M. C. (1924). The elimination of children’s fears. Journal of Experimental Psychology , 7 (5), 382.

12. Jones, M. C. (1924). A laboratory study of fear: The case of Peter. The Journal of Genetic Psychology , 31 , 308-315.

13. Beck, A. T. (1991). Cognitive therapy: A 30-year retrospective. American psychologist , 46 (4), 368.

14. Beck, A. T. (2005). The current state of cognitive therapy: a 40-year retrospective. Archives of General Psychiatry , 62 (9), 953-959.

15. Okami, P. (2013). Psychology: Contemporary Perspectives (Book Including the Bonus Chapter): Oxford University Press.

16. Beck Institute. History of Cognitive Behavior Therapy. Retrieved July 26, 2016 from https://www.beckinstitute.org/about-beck/our-history/history-of-cognitive-therapy/

17. Hayes, S. C., & Shenk, C. (2004). Operationalizing mindfulness without unnecessary attachments. Clinical psychology: Science and practice , 11 (3), 249-254.

18. Singh, N. N., Lancioni, G. E., Wahler, R. G., Winton, A. S., & Singh, J. (2008). Mindfulness approaches in cognitive behavior therapy. Behavioural and Cognitive Psychotherapy , 36 (06), 659-666.

19. Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2013). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice , 1049731513503047.

20. Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy , 10 (1), 125-162.

Sam Hunley received his doctorate from Emory University in cognitive psychology. He received his Bachelor of Science in psychology from Furman University in 2012 and his master’s in psychology from Emory in 2014. Working with  Dr. Stella Lourenco , Sam studies how humans think about and perceive the space immediately surrounding the body, and he is specifically interested in how anxiety and phobic fears affect the way we see the space around us. Sam and Dr. Lourenco collaborate to write articles for Anxiety.org. After graduating, Sam accepted a position as a Presidential Management Fellow.

LEAVE A REPLY Cancel reply

Save my name, email, and website in this browser for the next time I comment.

Subscribe Today

GET EXCLUSIVE FULL ACCESS TO PREMIUM CONTENT

Expert content on a wide variety of health topics. Always stay up to date!

* About our Privacy Policy

Exclusive content

Effective training to increase testosterone levels – we have all the answers 2024, the best testosterone supplements – increase your testosterone levels naturally 2024, testosterone injections – benefits, facts, side effects 2024.

More article

Women and low testosterone – what you need to know 2024.

Our content does not constitute medical advice and is for informational purposes only. Consult a licensed health care professional for medical advice/diagnosis.

Anxiety.org is a website that aims to provide comprehensive education on various health topics and help people navigate the overwhelming information overload. It presents the latest medical knowledge in a clear and accessible way, based on evidence-based sources.

Emotional Support Animal

HEART HEALTH

KIDNEYS STONE

WEIGHT MANAGEMENT

©Anxiety.org - About Us -  Contact -  Terms of Use - Privacy Policy - Write for Us

• Bipolar Disorder
• Therapy Center
• When To See a Therapist
• Types of Therapy
• Best Online Therapy
• Best Couples Therapy
• Managing Stress
• Sleep and Dreaming
• Understanding Emotions
• Self-Improvement
• Healthy Relationships
• Student Resources
• Personality Types
• Sweepstakes
• Guided Meditations
• Verywell Mind Insights
• 2024 Verywell Mind 25
• Mental Health in the Classroom
• Editorial Process
• Meet Our Review Board
• Crisis Support

What Is Cognitive Behavioral Therapy (CBT)?

Michela Buttignol for Verywell Mind / Stocksy

• Effectiveness
• Considerations
• Getting Started

Cognitive behavioral therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change the destructive or disturbing thought patterns that have a negative influence on their behavior and emotions.

Cognitive behavioral therapy combines cognitive therapy with behavior therapy by identifying maladaptive patterns of thinking, emotional responses, or behaviors and replacing them with more desirable patterns.

Cognitive behavioral therapy focuses on changing the automatic negative thoughts that can contribute to and worsen our emotional difficulties, depression , and anxiety . These spontaneous negative thoughts also have a detrimental influence on our mood.

Through CBT, faulty thoughts are identified, challenged, and replaced with more objective, realistic thoughts.

Everything You Need to Know About CBT

This video has been medically reviewed by Steven Gans, MD .

Types of Cognitive Behavioral Therapy

CBT encompasses a range of techniques and approaches that address our thoughts, emotions, and behaviors. These can range from structured psychotherapies to self-help practices. Some of the specific types of therapeutic approaches that involve cognitive behavioral therapy include:

• Cognitive therapy centers on identifying and changing inaccurate or distorted thought patterns, emotional responses, and behaviors.
• Dialectical behavior therapy (DBT)  addresses destructive or disturbing thoughts and behaviors while incorporating treatment strategies such as emotional regulation and mindfulness.
• Multimodal therapy suggests that psychological issues must be treated by addressing seven different but interconnected modalities: behavior, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.
• Rational emotive behavior therapy (REBT) involves identifying irrational beliefs, actively challenging these beliefs, and finally learning to recognize and change these thought patterns.

While each type of cognitive behavioral therapy takes a different approach, all work to address the underlying thought patterns that contribute to psychological distress.

Cognitive Behavioral Therapy Techniques

CBT is about more than identifying thought patterns. It uses a wide range of strategies to help people overcome these patterns. Here are just a few examples of techniques used in cognitive behavioral therapy. 

Identifying Negative Thoughts

It is important to learn what thoughts, feelings, and situations are contributing to maladaptive behaviors. This process can be difficult, however, especially for people who struggle with introspection . But taking the time to identify these thoughts can also lead to self-discovery and provide insights that are essential to the treatment process.

Practicing New Skills

In cognitive behavioral therapy, people are often taught new skills that can be used in real-world situations. For example, someone with a substance use disorder might practice new coping skills and rehearse ways to avoid or deal with social situations that could potentially trigger a relapse.

Goal-Setting

Goal setting can be an important step in recovery from mental illness, helping you to make changes to improve your health and life. During cognitive behavioral therapy, a therapist can help you build and strengthen your goal-setting skills .

This might involve teaching you how to identify your goal or how to distinguish between short- and long-term goals. It may also include helping you set SMART goals (specific, measurable, attainable, relevant, and time-based), with a focus on the process as much as the end outcome.

Problem-Solving

Learning problem-solving skills during cognitive behavioral therapy can help you learn how to identify and solve problems that may arise from life stressors, both big and small. It can also help reduce the negative impact of psychological and physical illness.

Problem-solving in CBT often involves five steps:

• Identify the problem
• Generate a list of potential solutions
• Evaluate the strengths and weaknesses of each potential solution
• Choose a solution to implement
• Implement the solution

Self-Monitoring

Also known as diary work, self-monitoring is an important cognitive behavioral therapy technique. It involves tracking behaviors, symptoms, or experiences over time and sharing them with your therapist.

Self-monitoring can provide your therapist with the information they need to provide the best treatment. For example, for people with eating disorders, self-monitoring may involve keeping track of eating habits, as well as any thoughts or feelings that went along with consuming a meal or snack.

Additional cognitive behavioral therapy techniques may include journaling , role-playing , engaging in relaxation strategies , and using mental distractions .

What Cognitive Behavioral Therapy Can Help With

Cognitive behavioral therapy can be used as a short-term treatment to help individuals learn to focus on present thoughts and beliefs.

CBT is used to treat a wide range of conditions, including:

• Anger issues
• Bipolar disorder
• Eating disorders
• Panic attacks
• Personality disorders

In addition to mental health conditions, cognitive behavioral therapy has also been found to help people cope with:

• Chronic pain or serious illnesses
• Divorce or break-ups
• Grief or loss
• Low self-esteem
• Relationship problems
• Stress management

Get Help Now

We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

Benefits of Cognitive Behavioral Therapy

The underlying concept behind CBT is that thoughts and feelings play a fundamental role in behavior. For example, a person who spends a lot of time thinking about plane crashes, runway accidents, and other air disasters may avoid air travel as a result.

The goal of cognitive behavioral therapy is to teach people that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.

CBT is known for providing the following key benefits:

• It helps you develop healthier thought patterns by becoming aware of the negative and often unrealistic thoughts that dampen your feelings and moods.
• It is an effective short-term treatment option as improvements can often be seen in five to 20 sessions.
• It is effective for a wide variety of maladaptive behaviors.
• It is often more affordable than some other types of therapy .
• It is effective whether therapy occurs online or face-to-face.
• It can be used for those who don't require psychotropic medication .

One of the greatest benefits of cognitive behavioral therapy is that it helps clients develop coping skills that can be useful both now and in the future.

Effectiveness of Cognitive Behavioral Therapy

CBT emerged during the 1960s and originated in the work of psychiatrist Aaron Beck , who noted that certain types of thinking contributed to emotional problems. Beck labeled these "automatic negative thoughts" and developed the process of cognitive therapy. 

Where earlier behavior therapies had focused almost exclusively on associations, reinforcements , and punishments to modify behavior, the cognitive approach addresses how thoughts and feelings affect behaviors.

Today, cognitive behavioral therapy is one of the most well-studied forms of treatment. It has been shown to be effective in the treatment of a range of mental conditions, including anxiety, depression, eating disorders, insomnia, obsessive-compulsive disorder , panic disorder, post-traumatic stress disorder , and substance use disorder.

• Research indicates that cognitive behavioral therapy is the leading evidence-based treatment for eating disorders .
• CBT has been proven helpful in those with insomnia, as well as those who have a medical condition that interferes with sleep, including those with pain or mood disorders such as depression.
• Cognitive behavioral therapy has been scientifically proven to be effective in treating symptoms of depression and anxiety in children and adolescents.
• A 2018 meta-analysis of 41 studies found that CBT helped improve symptoms in people with anxiety and anxiety-related disorders, including obsessive-compulsive disorder and post-traumatic stress disorder.
• Cognitive behavioral therapy has a high level of empirical support for the treatment of substance use disorders, helping people with these disorders improve self-control , avoid triggers, and develop coping mechanisms for daily stressors.

CBT is one of the most researched types of therapy, in part, because treatment is focused on very specific goals and results can be measured relatively easily.

Verywell Mind's Cost of Therapy Survey , which sought to learn more about how Americans deal with the financial burdens associated with therapy, found that Americans overwhelmingly feel the benefits of therapy:

• 80% say therapy is a good investment
• 91% are satisfied with the quality of therapy they receive
• 84% are satisfied with their progress toward mental health goals

Things to Consider With Cognitive Behavioral Therapy

There are several challenges that people may face when engaging in cognitive behavioral therapy. Here are a few to consider.

Change Can Be Difficult

Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simply becoming aware of these thoughts does not make it easy to alter them.

CBT Is Very Structured

Cognitive behavioral therapy doesn't focus on underlying, unconscious resistance to change as much as other approaches such as  psychoanalytic psychotherapy . Instead, it tends to be more structured, so it may not be suitable for people who may find structure difficult.

You Must Be Willing to Change

For cognitive behavioral therapy to be effective, you must be ready and willing to spend time and effort analyzing your thoughts and feelings. This self-analysis can be difficult, but it is a great way to learn more about how our internal states impact our outward behavior.

Progress Is Often Gradual

In most cases, CBT is a gradual process that helps you take incremental steps toward behavior change . For example, someone with social anxiety might start by simply imagining anxiety-provoking social situations. Next, they may practice conversations with friends, family, and acquaintances. By progressively working toward a larger goal, the process seems less daunting and the goals easier to achieve.

How to Get Started With Cognitive Behavioral Therapy

Cognitive behavioral therapy can be an effective treatment choice for a range of psychological issues. If you or someone you love might benefit from this form of therapy, consider the following steps:

• Consult with your physician and/or check out the directory of certified therapists offered by the National Association of Cognitive-Behavioral Therapists to locate a licensed professional in your area. You can also do a search for "cognitive behavioral therapy near me" to find local therapists who specialize in this type of therapy.
• Consider your personal preferences , including whether face-to-face or online therapy will work best for you.
• Contact your health insurance to see if it covers cognitive behavioral therapy and, if so, how many sessions are covered per year.
• Make an appointment with the therapist you've chosen, noting it on your calendar so you don't forget it or accidentally schedule something else during that time.
• Show up to your first session with an open mind and positive attitude. Be ready to begin to identify the thoughts and behaviors that may be holding you back, and commit to learning the strategies that can propel you forward instead.

What to Expect With Cognitive Behavioral Therapy

If you're new to cognitive behavioral therapy, you may have uncertainties or fears of what to expect. In many ways, the first session begins much like your first appointment with any new healthcare provider.

During the first session, you'll likely spend some time filling out paperwork such as HIPAA forms (privacy forms), insurance information, medical history, current medications, and a therapist-patient service agreement. If you're participating in online therapy, you'll likely fill out these forms online.

Also be prepared to answer questions about what brought you to therapy, your symptoms , and your history—including your childhood, education, career, relationships (family, romantic, friends), and current living situation.

Once the therapist has a better idea of who you are, the challenges you face, and your goals for cognitive behavioral therapy, they can help you increase your awareness of the thoughts and beliefs you have that are unhelpful or unrealistic. Next, strategies are implemented to help you develop healthier thoughts and behavior patterns.

During later sessions, you will discuss how your strategies are working and change the ones that aren't. Your therapist may also suggest cognitive behavioral therapy techniques you can do yourself between sessions, such as journaling to identify negative thoughts or practicing new skills to overcome your anxiety .

If you are having suicidal thoughts, contact the  National Suicide Prevention Lifeline  at  988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our  National Helpline Database .

Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: A review of meta-analyses . Cognit Ther Res . 2012;36(5):427-440. doi:10.1007/s10608-012-9476-1

Merriam-Webster. Cognitive behavioral therapy .

Rnic K, Dozois DJ, Martin RA. Cognitive distortions, humor styles, and depression . Eur J Psychol. 2016;12(3):348-62. doi:10.5964/ejop.v12i3.1118

Lazarus AA, Abramovitz A. A multimodal behavioral approach to performance anxiety . J Clin Psychol. 2004;60(8):831-40. doi:10.1002/jclp.20041

Lincoln TM, Riehle M, Pillny M, et al. Using functional analysis as a framework to guide individualized treatment for negative symptoms . Front Psychol. 2017;8:2108. doi:10.3389/fpsyg.2017.02108

Ugueto AM, Santucci LC, Krumholz LS, Weisz JR. Problem-solving skills training . Evidence-Based CBT for Anxiety and Depression in Children and Adolescents: A Competencies-Based Approach . 2014. doi:10.1002/9781118500576.ch17

Lindgreen P, Lomborg K, Clausen L.  Patient experiences using a self-monitoring app in eating disorder treatment: Qualitative study .  JMIR Mhealth Uhealth.  2018;6(6):e10253. doi:10.2196/10253

Tsitsas GD, Paschali AA. A cognitive-behavior therapy applied to a social anxiety disorder and a specific phobia, case study . Health Psychol Res. 2014;2(3):1603. doi:10.4081/hpr.2014.1603

Kumar V, Sattar Y, Bseiso A, Khan S, Rutkofsky IH.  The effectiveness of internet-based cognitive behavioral therapy in treatment of psychiatric disorders .  Cureus . 2017;9(8):e1626.

Trauer JM, Qian MY, Doyle JS, Rajaratnam SMW, Cunnington D. Cognitive behavioral therapy for chronic insomnia: A systematic review and meta-analysis .  Ann Intern Med . 2015;163(3):191. doi:10.7326/M14-2841

Agras WS, Fitzsimmons-craft EE, Wilfley DE.  Evolution of cognitive-behavioral therapy for eating disorders .  Behav Res Ther . 2017;88:26-36. doi:10.1016/j.brat.2016.09.004

Oud M, De winter L, Vermeulen-smit E, et al.  Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis . Eur Psychiatry . 2019;57:33-45. doi:10.1016/j.eurpsy.2018.12.008

Carpenter J, Andrews L, Witcraft S, Powers M, Smits J, Hofmann S. Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials .  Depress Anxiety . 2018;35(6):502–14. doi:10.1002/da.22728

National Institute on Drug Abuse (NIDA).  Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine) .

Gaudiano BA. Cognitive-behavioural therapies: Achievements and challenges . Evid Based Ment Health . 2008;11(1):5-7. doi:10.1136/ebmh.11.1.5

Beck JS. Cognitive Behavior Therapy: Basics and Beyond .

Coull G, Morris PG. The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: A systematic review . Psycholog Med . 2011;41(11):2239-2252. doi:10.1017/S0033291711000900

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Focus (Am Psychiatr Publ)
• v.19(2); Spring 2021

Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders

Cognitive-behavioral therapy (CBT) is a first-line, empirically supported intervention for anxiety disorders. CBT refers to a family of techniques that are designed to target maladaptive thoughts and behaviors that maintain anxiety over time. Several individual CBT protocols have been developed for individual presentations of anxiety. The article describes common and unique components of CBT interventions for the treatment of patients with anxiety and related disorders (i.e., panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, prolonged grief). Recent strategies for enhancing the efficacy of CBT protocols are highlighted as well.

Anxiety disorders are among the most prevalent of mental disorders and are associated with high societal burden ( 1 ). One of the most well-researched and efficacious treatments for anxiety disorders is cognitive-behavioral therapy (CBT). At its core, CBT refers to a family of interventions and techniques that promote more adaptive thinking and behaviors in an effort to ameliorate distressing emotional experiences ( 2 ). CBT differs from other therapeutic orientations in that it is highly structured and often manualized. CBT sessions often occur weekly for a limited period (e.g., 12–16 weeks), and a small number of booster sessions are sometimes offered subsequently to reinforce independent use of skills. A cognitive-behavioral conceptualization of anxiety disorders includes identification of dysfunctional thinking patterns, distressing feelings or physiological experiences, and unproductive behaviors. When each of these three components interact and mutually reinforce one another, distressing and impairing levels of anxiety can be maintained over time. Although there are several CBT interventions for different types of anxiety, some common techniques and treatment goals form the basis of the CBT philosophy.

Cognitive Interventions

One of the primary CBT strategies is cognitive intervention. In brief, CBT holds that one’s emotional experience is dictated by one’s interpretation of the events and circumstances surrounding that experience ( 2 , 3 ). Anxiety disorders are associated with negatively biased cognitive distortions (e.g., “I think it’s 100% likely I will lose my job, and no one will ever hire me again”). The objective of cognitive interventions is to facilitate more adaptive thinking through cognitive restructuring and behavioral experiments. Cognitive restructuring promotes more adaptive and realistic interpretations of events by identifying the presence of thinking traps. These cognitive traps are patterns of biased thinking that contribute to overly negative appraisals. For example, “black-and-white thinking” describes the interpretation of circumstances as either all good or all bad, without recognition of interpretations between these two extremes, and “overgeneralization” describes the making of sweeping judgments on the basis of limited experiences). Through identification of thinking traps, cognitive restructuring can be used to promote more balanced thinking, encouraging patients to consider alternative interpretations of circumstances that are more helpful and less biased by anxiety (e.g., “Maybe thinking the chance of losing my job is 100% is overestimating the likelihood that it will actually happen. And, it’s not a forgone conclusion that even if I lose my job, I will never find another one for the rest of my life.”). Similarly, behavioral experiments can be used to facilitate cognitive change. Behavioral experiments involve encouraging patients to empirically test maladaptive beliefs to determine whether there is evidence supporting extreme thinking. For example, if a patient believes that he/she/they is romantically undesirable and that asking someone on a date will cause the other person to react with disgust and disdain, then the patient would be encouraged to test this belief by asking someone on a date. Some combination of cognitive restructuring and behavioral experiments are often implemented in CBT across all anxiety disorders.

Behavioral Interventions

There are several behavioral strategies in CBT for anxiety disorders, yet the central behavioral strategy is exposure therapy. Exposure techniques rely on learning theory to explain how prolonged fear is maintained over time. Specifically, heightened anxiety and fear prompt individuals to avoid experiences, events, and thoughts that they believe will lead to catastrophic outcomes. Continued avoidance of feared stimuli and events contributes to the maintenance of prolonged anxiety. Consistent with the premises underlying extinction learning, exposure exercises are designed to encourage a patient to confront a feared situation without engaging in avoidance or subtle safety behaviors (i.e., doing something to make an anxiety-inducing situation less distressing). After repeated exposures to a feared situation (e.g., heights) without engaging in avoidance or safety behaviors (e.g., closing one’s eyes to avoid looking down), the patient will learn that such a situation is less likely to be associated with disastrous outcomes, and new experiences of safety will be reinforced. Similar to the behavioral experiments described in the cognitive intervention section above, which test whether a faulty thought is true or false, exposure exercises offer the opportunity for patients to test their negative beliefs about the likelihood of a bad outcome by exposing themselves to whatever situations they have been avoiding. Thus, cognitive approaches and exposure exercises are complementary techniques that can benefit individuals with anxiety disorders. In the following sections, different aspects of CBT will be explored and emphasized insofar as they relate to specific presentations of anxiety.

CBT for Specific Disorders

Panic disorder.

Panic disorder, as defined by the DSM-5 , is characterized by recurrent, unexpected panic attacks accompanied by worry and behavioral changes in relation to future attacks. Panic attacks are marked by acute, intense discomfort, with symptoms including heart palpitations, sweating, and shortness of breath. Individuals with panic disorder exhibit cognitive and behavioral symptoms, such as catastrophic misinterpretations of their symptoms as dangerous (e.g., “my heart pounding means I will have a heart attack”) and avoidance of situations or sensations that induce panic ( 4 ). Cognitive-behavioral treatments thus target these symptoms. For example, cognitive restructuring is used to help patients reinterpret their maladaptive thoughts surrounding panic (e.g., “if I get dizzy, I will go crazy”) to be more flexible (e.g., “if I get dizzy, it may just mean that I spun around too fast”). Behavioral treatments for panic include exposure to the situations (i.e., in-vivo exposure, which might include driving in traffic or riding the subway) and bodily sensations (i.e., interoceptive exposure, which would include physical exercises to bring on physical symptoms) that trigger panic in order to reduce the fear and anticipatory anxiety that maintain the symptoms. The aim of these exposures is to illustrate that the situations and sensations are benign and not indicative of danger.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about several life domains (e.g., finances, health, career, the future in general). Treatment for GAD involves a wholesale approach to target excessive worry with a combination of cognitive and behavioral strategies ( 5 ). Although cognitive restructuring exercises are indeed emphasized throughout the treatment to target dysfunctional thoughts, usually further cognitive treatments are included to address worry behavior in addition to thought content. Individuals with GAD rarely achieve complete remission after restructuring only one of their negative thoughts. The CBT conceptualization of worry describes worry as a mental behavior or process, characterized by repetitive negative thinking about catastrophic future outcomes. To target worrying as a process, cognitive techniques, such as mindfulness, are emphasized. Rather than targeting the content of worry (e.g., “I think I will definitely lose my job if I do not prepare for this meeting”), mindfulness exercises target the worry behavior by promoting the opposite of repetitive negative thinking (i.e., nonjudgmental and nonreactive present moment awareness), thereby facilitating greater psychological distance from negative thoughts. Exposure therapy is often implemented as imaginal exposures for GAD, because individuals with GAD rarely have an external object that is feared. Such imaginal exposures will encourage patients with GAD to write a detailed narrative of their worst-case scenario or catastrophic outcome and then imagine themselves undergoing such an experience without avoiding their emotions. Cognitive restructuring and imaginal exposure exercises can benefit patients with GAD by targeting their tendency to give catastrophic interpretations to their worries, whereas mindfulness can be helpful in targeting worry as a mental behavior itself ( 5 ).

Social Anxiety Disorder

Social anxiety disorder involves a fear of negative evaluation in social situations and is accompanied by anxiety and avoidance of interpersonal interactions and performance in front of others. The primary treatment approach for social anxiety disorder consists of exposure exercises to feared social situations ( 6 ). Cognitive restructuring is used in conjunction with exposure exercises to reinforce the new learning and shift in perspective occurring through exposure therapy. Typically, exposure exercises for social anxiety disorder come in two stages ( 6 ). The first stage of exposures often targets patients’ overestimation that something bad will happen during a social interaction. For instance, patients with this disorder may fear that they will make many verbal faux pas (e.g., saying “uh” more than 30 times) during a conversation. An exposure exercise may consist of recording the patient having a 2-minute conversation and listening to the recording afterward to see whether the feared outcome actually occurred. The second stage of exposure exercises (i.e., social cost exposures) consists of having patients directly making their worst-case social anxiety scenario come true to determine how bad and intolerable it actually is. Such a social cost exposure might involve encouraging a patient to embarrass her- or himself on purpose by singing “Twinkle, Twinkle Little Star” in a crowded public street. After fully confronting a social situation that the patient predicted would be very embarrassing, the patient can then determine whether such a situation is as devastating and intolerable as predicted. After repeated social cost exposures, patients with social anxiety disorder experience less anxiety in embarrassing social situations and are more willing to adopt less catastrophic beliefs about the meaning of making mistakes in social situations.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is characterized by obsessions (i.e., unwanted thoughts or images that are intrusive in nature) and compulsions (i.e., actions or mental behaviors that are performed in a rule-like manner to neutralize the obsession). A CBT conceptualization of OCD considers compulsions as a form of emotional avoidance. Although both cognitive interventions and exposure exercises are helpful for individuals with OCD, the latter are often emphasized. The gold-standard CBT treatment for OCD is exposure and ritual prevention therapy ( 7 ). The primary idea underlying exposure and ritual prevention is to expose individuals with OCD to the feared circumstance associated with the obsession and prevent them from performing the compulsive ritual that gives them comfort through avoidance. For example, patients who experience frequent obsessions about whether their doors are locked or their appliances are off (e.g., “If my door is unlocked, then my house might be robbed or something bad might happen.”) will often feel compelled to perform a compulsion (e.g., ritualistic checking) to avoid the likelihood of having their obsession come true. Exposure and ritual prevention would be used to expose such patients to a feared situation, such as leaving their door unlocked on purpose, and resisting the compulsion to check the door or to lock it. During these exposures, the patients would be asked to embrace the uncertainty surrounding the possibility of the feared outcome coming true (i.e., someone entering the house). Repeated sessions of exposure and ritual prevention will facilitate corrective learning about the likelihood that feared outcomes will occur.

Posttraumatic Stress Disorder

As defined by the DSM-5 , posttraumatic stress disorder (PTSD) can arise after a traumatic event in which an individual directly experiences, witnesses, or learns about the actual or threatened death, serious injury, or sexual violence toward a loved one. After the traumatic stressor event, an individual with PTSD may experience intrusion symptoms (e.g., upsetting dreams or flashbacks of the event), avoidance of reminders of the event, changes in cognitions and affect (e.g., distorted beliefs about oneself, others, and the world), and changes in physiological arousal (e.g., jumpiness, irritability) ( 4 ). Gold-standard treatments for PTSD involve targeting the cognitive and behavioral symptoms that maintain the disorder ( 8 ). PTSD treatments target negative changes in cognition by restructuring the thoughts and beliefs surrounding the traumatic event. For example, evidence-based treatments alter persistent negative beliefs about the world (e.g., “I was assaulted; therefore, the world is dangerous”) to be more flexible (e.g., “even though I was assaulted, there are safe places for me to be”). In challenging these beliefs, the patient may be better able to foster flexible thinking, positive affect, trust, and control in their lives. PTSD treatments are also designed to help patients confront the upsetting memories and situations associated with the traumatic event. Through in-vivo exposures (i.e., approaching situations that are reminders of the trauma) and imaginal exposures (i.e., confronting upsetting memories of the trauma), the patient can begin to behaviorally approach, rather than avoid, reminders of the event to overcome their fears of the trauma and the associated symptoms.

Prolonged Grief Disorder

After losing a loved one, many individuals experience grief symptoms, such as thoughts (e.g., memories of the deceased, memories of the death), emotions (e.g., yearning, emotional pain), and behaviors (e.g., social withdrawal, avoidance of reminders). For most bereaved individuals, these symptoms decrease over time; however, some individuals experience a debilitating syndrome of persistent grief called prolonged grief disorder. This disorder is a direct consequence of the loss, thereby differentiating it from depression and PTSD. Evidence-based and efficacious treatment options for prolonged grief disorder draw from interpersonal therapy, CBT, and motivational interviewing, with additional psychoeducation components ( 9 ). These treatments aim to facilitate the natural bereavement process as individuals accept and integrate the loss. Strategies can be either loss-related or restoration-related. Specific loss-related strategies that draw from CBT include imaginal and situational revisiting (e.g., retelling the story of the loss, going to places that have been avoided since the loss) and a grief monitoring diary. Restoration-related strategies include short- and long-term planning, self-assessment and self-regulation, and rebuilding interpersonal connections.

Transdiagnostic Approaches to CBT for Anxiety Disorders

Throughout the past several decades, there has been a proliferation of CBT approaches that have been individualized to specific anxiety disorder presentations (e.g., panic disorder, specific phobias, social anxiety disorder). Each disorder-specific treatment manual is written to consider unique applications of CBT strategies for the presenting disorder. However, in recent years, there has been increased interest in considering transdiagnostic approaches to the treatment of anxiety and related disorders ( 10 ). The commonalities among individual anxiety disorders and the high levels of comorbidity have contributed to the rationale for a unified CBT approach that can target transdiagnostic mechanisms underlying all anxiety disorders. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has been the most studied transdiagnostic treatment for anxiety disorders, and recent evidence ( 10 ) corroborates the equivalent efficacy of the UP relative to disorder-specific treatment protocols for individual anxiety disorders.

The UP consists of five core modules that target transdiagnostic mechanisms of emotional disorders, particularly neuroticism and emotional avoidance, underlying all anxiety disorders. Specifically, the modules are mindfulness of emotions, cognitive flexibility, identifying and preventing patterns of emotion avoidance, increasing tolerance of emotion-related physical sensations, and interoceptive and situational emotion-focused exposures ( 10 ). Each module may be used flexibly for individual patients. The first two modules are more cognitive in nature, whereas the latter modules are more behavioral and emphasize the treatment of avoidance. The first module emphasizes mindfulness of emotions, which consists of allowing oneself to fully and nonjudgmentally experience emotions and allow them to come and go while remaining focused on the present. The second module fosters cognitive flexibility by identifying thinking traps that lead to overly negative thoughts and interpretations and by teaching restructuring strategies to generate alternative interpretations of circumstances that are less biased and more adaptive. The third module promotes the identification of emotion-driven behaviors (i.e., actions that a given emotion compels a person to do, such as avoidance behaviors in response to fear) and the adoption of alternative actions (i.e., behaviors that are different from or the opposite of the emotion-driven behavior). For example, if social anxiety prompts an individual to avoid eye contact as an emotion-driven behavior, then an alternative action would be to intentionally maintain eye contact with another speaker to counteract this subtle form of avoidance. The final two modules consist of exposure exercises to develop better tolerance of unwanted physical symptoms produced by anxiety (e.g., increased heart rate) and to reduce fear in anxiety-provoking situations.

Because the UP contains many of the core components of disorder-specific protocols and has demonstrated equivalent efficacy, such a treatment approach may reduce the need for excessive reliance on disorder-specific protocols ( 10 ). Furthermore, the UP can be extended to other emotional disorders, such as depression.

Complementary Approaches for CBT

Mindfulness.

Mindfulness-based interventions function both as transdiagnostic adjunctive treatments to CBT for patients with anxiety and stress disorders as well as stand-alone treatments. Mindfulness is the practice of nonjudgmental awareness of the present moment experience. The aim of these interventions is to reduce emotional dysregulation and reactivity to stressors. Common mindfulness-based interventions include manualized group skills training programs called mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy ( 11 ). MBSR involves eight, 2–2.5-hour sessions with an instructor, in conjunction with a daylong retreat, weekly homework assignments, and practice sessions. Modules are designed to train participants in mindful meditation, interpersonal communication, sustained attention, and recognition of automatic stress reactivity. Mindfulness-based cognitive therapy has a structure similar to MBSR but includes cognitive therapy techniques to train participants to recognize and disengage from negative automatic thought patterns ( 12 ). These interventions omit aspects of traditional CBT (e.g., cognitive restructuring). Mindfulness-based interventions have been explored as both brief and Internet-delivered interventions and have been integrated into other evidence-based practices (e.g., dialectical behavior therapy and acceptance and commitment therapy).

Pharmacotherapy

There has been much interest in determining whether combination strategies of CBT and pharmacotherapy yield greater efficacy than either one alone for individuals with anxiety disorders. A comprehensive meta-analysis ( 13 ) examining this combination strategy suggested that adding pharmacotherapy to CBT may produce short-term benefit, yet such improvements diminished during 6-month follow-up. This combination strategy was more efficacious for individuals with panic disorder or GAD than for individuals with other presentations of anxiety. Moreover, the meta-analysis ( 13 ) indicated that the effect size for CBT combined with benzodiazepines was significantly greater than that for CBT combined with serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants. Another important consideration for pharmacotherapy in the treatment of individuals with anxiety disorders is to ensure that anxiolytic medications, such as benzodiazepines, are administered carefully in the context of exposure therapy. Anxiolytic medications taken to temporarily reduce anxiety may undermine quality exposure therapy sessions by preventing patients from fully learning whether they can tolerate fear without resorting to avoidance behaviors. Thus, although pharmacotherapy appears to improve outcomes in combination with CBT for patients with anxiety disorders, further research is needed to determine the durability of these effects.

D-Cycloserine in Conjunction With Exposures

One approach for improving patient outcomes is to target the extinction learning process underlying exposure exercises. There has been recent interest in cognitive enhancers, such as d-cycloserine (DCS) or methylene blue, as pharmacological adjuncts to exposure therapy ( 14 , 15 ). In preclinical studies, DCS has demonstrated evidence as a cognitive enhancer, consolidating new learning during extinction training. Specifically, the efficacy associated with DCS depends on the efficacy of the exposure exercise. For instance, during a successful exposure exercise, in which anxiety levels decrease substantially, the administration of DCS may confer additional benefit by consolidating this learning. However, if an exposure exercise was unsuccessful and fear levels never decreased, then DCS might consolidate the fear memory, thereby exacerbating the severity of the anxiety disorder ( 14 ). Recently, however, there has been evidence ( 16 ) suggesting that the efficacy of cognitive enhancers, such as DCS, has been declining, possibly because of changes in dose and dose timing. More research needs to be undertaken to understand under what circumstances (e.g., length of exposure session, amount of fear reduction, timing of dose) DCS would offer the greatest therapeutic effect in conjunction with exposure therapy.

Novel Delivery Methods

Internet-delivered CBT (I-CBT) is an alternative modality for the delivery of CBT for patients with anxiety and related disorders. I-CBT is a scalable alternative to in-person treatment, with the Internet used as an accessible and cost-effective method of delivery for evidence-based treatment. In I-CBT, CBT modules are delivered via computer or an application on a mobile device, with the support of a therapist or through a self-guided system. I-CBT has been shown ( 17 – 19 ) to be superior to waitlist and placebo conditions in the treatment of adults with a range of anxiety and trauma disorders, including anxiety and PTSD. Results ( 18 ) have indicated that I-CBT is similarly effective at reducing panic disorder symptoms as face-to-face CBT. The results of another trial ( 20 ) have indicated that I-CBT is also effective at reducing symptoms of OCD and social anxiety disorder.

In addition to Internet and mobile application platforms for CBT, virtual reality technology offers novel avenues to access cognitive-behavioral interventions ( 21 ). One key advantage is that recent advances in the sensory vividness of virtual reality platforms have facilitated more meaningful exposure exercises. For example, virtual reality flight simulators can be leveraged to expose a patient with flight phobia to several flight conditions with enhanced sensory detail (e.g., sounds of liftoff or landing, vibrations, images of clouds through a window, images of in-cabin atmosphere). This technology could obviate the need to purchase several expensive flights to participate in exposure exercises, thereby permitting more frequent exposure opportunities.

Conclusions

CBT is an effective, gold-standard treatment for anxiety and stress-related disorders. CBT uses specific techniques to target unhelpful thoughts, feelings, and behaviors shown to generate and maintain anxiety. CBT can be used as a stand-alone treatment, may be combined with standard medications for the treatment of patients with anxiety disorders (e.g., selective serotonin reuptake inhibitors), or used with novel interventions (e.g., mindfulness). Furthermore, this treatment is flexible in terms of who may benefit from it. Overall, whenever a patient is experiencing some form of emotional psychopathology (e.g., an anxiety or depression disorder) or distressing emotions that do not meet disorder threshold but cause distress or interference in daily activities, referral to a CBT provider is indicated to pursue a course of treatment to actively address such symptoms and problems.

The authors report no financial relationships with commercial interests.

CBT Explained: An Overview & Summary of CBT (Incl. History)

With a deeper understanding of personal cognition and its relationship to behavior, people can change their lives through changing the way they think.

Increasing mindfulness with regard to conscious thought and interrupting automatic negative thoughts can lead people into a healthier outlook and better understanding of their power over their future reactions.

This therapy has been proven effective in preventing relapse in patients with depression and anxiety. It has also been proven to aid patients with a variety of other psychological problems.

Educating patients with the techniques and strategies of this approach will help them in handling future situations. Equipping patients with these tools give CBT the power for self-motivated emotional and psychological healing.

Before you read on, we thought you might like to download our three Positive CBT Exercises for free . These science-based exercises will provide you with a detailed insight into Positive CBT and will give you the tools to apply it in your therapy or coaching.

This Article Contains:

What is cognitive behavioral therapy, an overview and summary of cbt, a look at the psychology, key concepts and principles of the approach, common therapy techniques used, the pros and cons, the history of cbt, the founders and pioneers, a closer look at aaron beck, a take-home message.

Cognitive Behavioral Therapy can be defined as the intentional combination of demonstrated readiness and methodological rigor of behavioral procedures with the cognitive-behavioral processes that influence adjustment (Benjamin et al., 2011). In other words, CBT is utilizing the accurate understanding of our thoughts to purposefully change reactions and behaviors. Our internal thoughts are viewed as mechanisms for change.

This type of therapy is a short-term, goal oriented form of treatment that can be thought of as a combination of behavioral therapy and psychotherapy. The treatment takes a hands-on, practical approach to problem-solving. Psychotherapy focuses on the personal meaning of thought patterns that are believed to have developed in childhood. Behavioral therapy emphasizes the close relationship between personal problems, behavior, and thoughts.

CBT is a way of focusing on the cognitive processes that produce feelings. The approach helps by changing people’s behavior and attitudes with a deeper understanding of thoughts, images, beliefs, and attitudes. The treatment is customized for each patient with regard to differences in personalities and specific needs. CBT can be viewed as an umbrella term for many different forms of therapies aimed at correcting dysfunctional cognition and maladaptive behaviors.

Attitudes grooved in neural pathways during childhood become automatic thoughts. The thoughts resulting in disruption in daily life are negative thoughts around situations that created them.

CBT allows patients to interrupt these thoughts with a deeper understanding of the errors or distortions in the perception of these automatic thoughts. This type of therapy helps patients to correct misinterpretations of the thoughts that have caused disruption in their daily lives.

Cognitive Behavioral Therapy is utilized in treating multiple types of psychiatric problems . The treatment is typically done between 3 and 6 months, depending on the problem. The following is a list of psychological problems where CBT has been utilized.

• eating disorders
• anger management
• marital crisis
• obsessive-compulsive disorder
• schizophrenia
• post-traumatic stress disorder
• chronic pain

There are 5 five areas that are believed to be interconnected and affecting one another. For instance, how one feels about a certain situation can cause physical and emotional feelings, resulting in varying behaviors in response.

• physical feelings

Download 3 Free Positive CBT Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to find new pathways to reduce suffering and more effectively cope with life stressors.

Download 3 Free Positive CBT Tools Pack (PDF)

By filling out your name and email address below.

There is a great deal of overlap in the concepts of positive psychology and cognitive behavioral therapy (Karwoski, Garratt, & Ilardi, 2006). Both approaches see the interaction between client and provider as collaborative. Here are other areas where the conceptual principles overlap .

• Strong Therapeutic Alliance
• Cognitive reappraisal
• Focus on decisive goals
• Focus is on the here and now

While positive psychology has developed intervention techniques derived from other therapeutic approaches, several interventions overlap with techniques of CBT.

• Scheduling of pleasant activities
• Identifying and reviewing successes
• Monitoring of mood
• Relaxation training
• Training in problem-solving

Cognitive Behavioral Therapy, like other therapies, focuses on reducing the presence of negative emotions. Positive psychology can be presented as the catalyst that CBT needs to endure as a formidable treatment for psychological problems. The reduction of negative emotions does not create the presence of positive emotions .

Introducing positive psychology interventions in addition to reducing negative emotions with CBT has proven to be an effective way to reduce rates of relapse in depressed patients.

While CBT has been proven through various meta-analyses to be an effective treatment for various psychological disorders, it continues to be highly unavailable to those who would most benefit from its introduction (Shafran et al., 2009).

For instance, those suffering from PTSD are most frequently being given supportive counseling, as opposed to the long-term effective strategies provided by cognitive behavioral therapy. There is a widespread lack of training for providers in this type of therapy as well.

There is a gap between research trials and clinical practice. It has much to do with the belief that participants in the trials are suffering from less severe cases of psychological disorders. More and more evidence is being presented for the case that CBT is effective in more severe cases, however. With the increased availability of appropriate training and effective presentation of the techniques, a wider patient base may be reached.

An additional gap in the usage of CBT is within the area of sport psychology (McArdle & Moore, 2012). A strong case can be made for the introduction of the skills of this therapy to athletes. Unthreading negative self-thoughts can, in turn, produce the outcome of improved sports performance.

The patient’s active participation in therapy is a key principle in CBT. Without it, this goal-oriented and problem focused approach would not be effective. Sessions in CBT are well structured and the client’s better understanding of the role of cognition in correcting behavioral dysfunctions is paramount to their success. This educative approach allows the client-therapist relationship to deepen, which is also an important principle in this therapy.

CBT is a time limited approach, and work outside of the therapy office is vital to success. While this approach is initially present focused, an emphasis on adaptive thinking allows for relapse prevention. It allows the patient to be taught techniques to change their thinking, mood, and behavior with the understanding that they will be utilized in their future.

In cognitive behavior therapy, psychological problems are believed to develop through the use of cognitive distortions . Aaron Beck’s work suggests that by correcting these distortions, a more accurate experience of events is created. Through this work, a patient is better able to develop skills to properly process exposure to life events.

Here is a list of Cognitive Distortions (Burns, 1980).

• Personalization means the attribution of the negative feelings of others and the world around them. For instance, a gymnastics coach is cross, so a gymnast automatically feels it is her fault.
• Fallacy of change is assuming that other people will change to suit them if pressured enough. This is a common distortion found in relationships. For instance, a woman feeling that if her partner improved himself, she would be happier.
• Emotional reasoning is the distortion that occurs when feelings are considered as facts. For example saying, “I feel that way, it must be true.”
• Fallacy of Fairness is a distortion that measures all things by an imaginary ruler of fairness. A person may feel resentful because they feel that they have a clear definition of fairness, but that others might not agree with them.
• Polarization or “Black and White” Thinking is a distortion that occurs when things are all or nothing. Someone might believe they have to be perfect, or they are a failure.
• Overgeneralization means coming to broad negative conclusions based on a single, insignificant event. An example would be telling yourself you’re a terrible baker based on failing at one recipe attempt.
• Control fallacies are distortions in which a person would feel that everything that happens to you is a result of external actions or of their own behavior. For instance, believing that your work is not good because you’re dealing with disruptive coworkers.
• Jumping to Conclusions is a distortion that occurs when assumptions about another’s feelings or beliefs are made. An example might be a child feeling that they know how someone else feels about them. It can also be described as perceived mind reading.
• Catastrophizing is a distortion that assumes the expectation that the worst is going to happen. An example is believing that a small error at work is going to result in you being fired.
• Always Being Right is a distortion that occurs when the person is always putting others on trial to prove their opinions are absolutely correct.
• Filtering is a distortion that includes both Minimization and Magnification . Minimization means underplaying the significance of an event. For instance, you are praised for your job performance, but you see it as trivial. Magnification means exaggerating the importance of an undesirable event. For instance, allowing getting cut off by another driver as the impetus to ruin your entire day. Filtering also includes selective abstraction. This is focusing on a single aspect of a situation and ignoring others.
• Blaming occurs when a person holds someone else responsible for their emotional pain, or hold themselves responsible for every problem.
• Global labeling is a distortion that occurs when a person generalizes single qualities into a global judgment. For instance, “I failed a test, therefore I’m stupid.”
• Heaven’s Reward Fallacy is the distortion that self-sacrifice will eventually pay off.
• Shoulds are distortions that occur when a person has hard set rules about how every person should behave. An example would be saying, “I should work out. I shouldn’t be so lazy.” The resulting emotional consequence is guilt.

Regardless of whether one practices CBT alone or with a therapist, applying the techniques in real-life situations is key to long-term effectiveness and a reduction of symptoms of psychological problems.

It’s for this reason that CBT therapists are increasingly adopting a blended care approach to conducting CBT that encourages clients to practice interventions in the course of their daily lives with the aid of portable technologies.

For example, using the e-therapy platform Quenza (pictured here), a CBT therapist can assign their client meditations, reflection exercises, and a range of other activities which clients can complete on the go via their smartphone or tablet.

Some of the most common CBT therapists will assign are highlighted here.

Albert Ellis developed the ABC technique that is still utilized in CBT today. The ABC Technique of Irrational Beliefs analyzes the first three steps in which someone might develop an irrational belief: A) Activating event B) Belief C) Consequences (Oltean, Hyland, Vallières, & David, 2017).

• Activating Event. This is an event that would lead someone to a type of high emotional response, and/ or negative dysfunctional thinking.
• Beliefs. The client would write down the negative thoughts that occurred to them around the activating event.
• Consequences. These are the negative feelings and behaviors that occurred as a result. The beliefs are to be viewed as a bridge to the negative feelings and behaviors that occurred as a result of the activating event.

Ellis believed that it was not the activating event (A) that causes the negative beliefs and consequences (C), but rather how the patient interprets or misinterprets the meaning of the event (B) that helps cause the consequences (C).

Helping a patient reinterpret their irrational belief system helps to forge new ways for them to interpret their beliefs resulting in alternative behaviors. A person can utilize this technique, even in the absence of a therapist.

Journaling for the awareness of cognitive distortions is a powerful way to better understand personal cognition. A person keeps track of their automatic thoughts and an analysis of the presence of various distortions is detected.

Once better understood, a person can utilize different methods to reevaluate these automatic thoughts with evidence. Well trained practitioners in CBT can aid someone who has difficulty in unraveling these distortions.

Rescripting is a technique used to help patients suffering from nightmares (Davis & Wright, 2006). When the emotion that is brought to the surface from the nightmare is exposed, a therapist can help the patient to redefine the emotion desired and to develop a new image to elicit that emotion.

Exposure therapy is used in OCD and anxiety phobias. Exposing yourself to the trigger reduces the response to the trigger. Many therapists recommend mild exposure 3 times daily. While this may be uncomfortable during the first exposures, the increase in exposure reduces phobic reactions.

The Worst Case/ Best Case/Most Likely Case Scenario technique is used to help people overcome fear or anxiety. Allowing the brain to ruminate to the point of ridiculousness allows the person to “play out” the fear to an unrealistic end. Then the person is brought to the best case and again allowed to let their thoughts “play out” to the ridiculous. Then, a most likely scenario is explored with actionable steps attached, so that control over behavior is realized.

A recent, popular technique being utilized in CBT is called Acceptance and Commitment Therapy . It differs from traditional CBT in that it is not trying to teach people to better control their thoughts around their activating events; instead this approach is teaching people to “just notice,” accept and embrace the feelings around the activating events. This approach utilizes techniques from CBT as well, but ACT focuses on freeing the patient from the grip of the event itself.

Mindfulness techniques like deep breathing and Progressive Muscle Relaxation (PMR) play a big role in CBT. These techniques allow the person to be present in the moment and calmly soothe the unfocused mind. With the relaxation comes the stronger ability to tune in and alter automatic negative thoughts.

Cognitive restructuring is a CBT technique that helps people examine their unhelpful thinking. It helps them to redevelop ways to react in situations that have in the past proven problematic. Keeping a daily record of the automatic negative thoughts creates a way to find the patterns in these thoughts. With an identified pattern, alternative reactions and adaptive thoughts can be forged.

Treating thoughts as guesses is a technique that helps to gather evidence to combat automatic negative thoughts. When a person takes their thoughts to “court” proof of truth must be found for the thought to be held as accurate. If any proof against the thought is found, it must be tossed and replaced with a more accurate thought.

A cognitive pie chart is a fun way for kids to utilize CBT . The first step is identifying the automatic negative thoughts. For example, “I’m dumb because I failed a test.” Step two is devising a list of alternative explanations to those ANTs. Finding as many alternatives as possible is helpful. The third step is giving each explanation a percentage in the contribution to the outcome of failing the test. Step four is placing these explanations in a pie chart.

Activity Scheduling is a powerful technique in CBT. It helps people engage in activities that they are not normally used to doing. It presents as a way to slowly reintroduce rewarding behavior that has been excluded from people’s routines. The technique is helpful in increasing positive emotion when performed incrementally.

Graded exposure is a technique used to help expose anxiety sufferers to contact with what is feared. The underlying theory is that people who avoid situations that induce fear or anxiety will increase the anxiety. The slowly increased exposure aids to decrease that fear.

Many deficits in social skills can be improved through CBT techniques. Modeling, role playing, and instruction can be used to increase social skills like communication and assertiveness. Communication skills, or rather the lack of, are a massive obstacle for many. Improving these skills bolsters confidence and abilities to interact with others, dramatically reducing levels of anxiety inducing situations.

World’s Largest Positive Psychology Resource

The Positive Psychology Toolkit© is a groundbreaking practitioner resource containing over 500 science-based exercises , activities, interventions, questionnaires, and assessments created by experts using the latest positive psychology research.

Updated monthly. 100% Science-based.

“The best positive psychology resource out there!” — Emiliya Zhivotovskaya , Flourishing Center CEO

There are advantages and disadvantages to the approach of CBT. Like any therapy, there is always a risk of a negative emotion returning. Let’s have a look at what’s good, and what could hold progress back in treatment.

Here is a list of pros:

• Compared to other “talking” therapies, CBT can be completed in a relatively short period of time.
• Can be helpful in treating some mental health disorders where medication alone has not helped improve symptoms.
• In order to make changes in how you feel, CBT focuses on altering thoughts and behaviors.
• Strategies are helpful and practical. They can help people cope with future stresses.
• Can improve the quality of life.
• It can be provided in a variety of formats including in-person, online, or workbooks . It can even be useful in a group setting.
• It can be used in almost any age group.
• It may improve emotional processing (Baker et al., 2011)

Here is a list of cons:

• The patient has to be committed to the process. There is no magic wand that a therapist might wave to make a patient’s problems go away.
• A drawback might be that the individual’s needs are met through the therapy, but a patient’s environment (family, interactions), that might have a significant impact on the patient’s well-being, is not addressed.
• CBT could prove more difficult for people suffering from severe mental health difficulties or those with a learning disability.
• As CBT addresses the sources of anxiety or other stress causing emotions, the initial exposure to this type of treatment could prove uncomfortable.
• This treatment does not fully address possible underlying causes of negative emotions, as it focuses on the present problems.
• Doing the work in real life takes time.

The evolution of cognitive behavioral therapy can be traced back to developments in psychology as early as 1913. The work of behaviorist John B. Watson (1913) laid the foundation for later advancement in the field.

Behaviorism is the theory of learning on the idea that all behaviors are acquired through conditioning. This conditioning happens when people interact with their environment, cueing signals to shape their actions. BF Skinner’s conditioning theories also had foundational influence over the development of cognitive behavioral therapy (Bjork, 1997).

Before cognitive behavioral therapy, there was an approach called behavior therapy that was controversial at the time of its development. One of the first treatments in this approach was done with youth and the correction of enuresis (bed-wetting; Bolla, Sartore, & Correale, 1938). Initial respondent conditioning strategies for better understanding anxiety were also vital in creating theories behind CBT. Extinction, habituation, and counter conditioning were all discovered with respondent conditioning.

Operant learning theory also played a large role in behavioral therapy and childhood CBT development. Out of this theory developed positive and negative reinforcement in children’s development. The deeper understanding of the cognition behind behavior contributed to the deeper understanding of their use in CBT.

In the 1950s, Albert Ellis practiced Rational Emotive Behavior Therapy. The goal was to help patients identify their irrational thoughts. Through this identification, encouragement for the challenge of the thought and a shift to a more rational one would be made. The therapy was thought to give patients a more rational view of the world and their place in it.

The practice of cognitive behavioral therapy was first developed in the 1960s. Dr. Aaron T. Beck at the University of Pennsylvania designed and carried out experiments to test psychoanalytic concepts and found some surprising results. What he found was that in depressed patients, there were consistent instances of a stream of negative thoughts that seemed to emanate spontaneously.

Dr. Beck categorized these automatic negative thoughts into three categories. The patients were having negative ideas about themselves, the world, and/ or the future. With these findings, he began to theorize alternative ways of viewing depression.

The theory of cognitive distortions by Beck and the theory of irrational thinking by Dr. Albert Ellis helped to better explain psychological problems. Beck theorized that in childhood, the development of maladaptive processes led to these problems. His theory was based around the cognitive triad. Dr. Ellis’s theory was based around a set of defined irrational beliefs, also known as common irrational assumptions.

With his approach, Dr. Beck began to help his patients reevaluate their thoughts about themselves. He found that by doing so, his patients were developing a better resilience for handling daily functions of life. Patients found that this therapy resulted in long-lasting change.

The efficacy of this therapy has been examined in many meta-analyses (Butler, Chapman, Forman, & Beck, 2006). Since its introduction, it has grown into a viable treatment modality for a variety of mental health problems. There are therapists who now specialize in this therapeutic approach.

The practice of CBT grew in the mid-1970s to aid in the treatment of higher functioning patients. This transition did not happen automatically, but rather through the trial and error and the development in areas of behavioral therapy and a better understanding of emotional self-control.

As the practice of CBT became stronger over time, new expansions and developments in the field began to emerge. The Tripartite Model (Clark & Watson, 1991) is one of these developments. This model proposes that there is a significant overlap in the negative affect presented in patients with depression and anxiety.

Barlow’s triple vulnerability model of emotional disorders has further expanded work in CBT (Ranjbari, Karimi, Mohammadi, & Norouzi, 2018). The model focuses on children’s perception of control over their environments. In this approach, parents are trained to help children better understand and function in their environments.

The wealth of knowledge of CBT and its application with children is shown throughout psychology. the efficacy of treatment in children and adolescents is far-reaching. This type of therapy helps kids better understand their environment and their role in mastering it.

A new “third” wave of CBT is developing, as a result of various empirical studies failing to prove the hypotheses developed around the efficacy of CBT (Gaudiano, 2008). The shift is within the language of cognition. The approach is acceptance-based strategies. The theory places less stress on altering the cognitive distortions, as the alteration may not be deemed necessary.

With an acceptance-based strategy, the patient is becoming aware of the distortion without trying to control it. The focus is rather on the commitment to the change in behavior.

Cognitive behavioral therapy exercises (FEEL BETTER!)

Development of cognitive behavioral therapy progressed over time. Dr. Albert Ellis was a pioneer in behavior therapy in the 1950s. His work with irrational thinking was foundational in the development of CBT. His ABC technique of Irrational Beliefs is still utilized in CBT today.

The work of Joseph Wolpe and Arnold Lazarus in the 1960s also contributed to the evolution of CBT. Their work in behavior therapy techniques to reduce neuroses is foundational. Their theory of systematic desensitization led to the development of many of the techniques still utilized in this approach today.

Dr. Aaron Beck is the founding father of the cognitive behavior therapy movement. His work began as a clinician in the 1960s. His approach to psychotherapy at that time was radical and groundbreaking. Scientific evidence for his approach has been proven time and again. The efficacy of his theories is far-reaching in the field of psychology.

Dr. Judith Beck has made a significant impact on cognitive behavior therapy as well. She followed her father’s path in research and development of treatments significant in cognitive behavioral therapy. Her work in the area of copping and mechanisms for change advanced the science in a progressive direction.

17 Science-Based Ways To Apply Positive CBT

These 17 Positive CBT & Cognitive Therapy Exercises [PDF] include our top-rated, ready-made templates for helping others develop more helpful thoughts and behaviors in response to challenges, while broadening the scope of traditional CBT.

Created by Experts. 100% Science-based.

Dr. Aaron T Beck is given the title of Father of Cognitive Behavior Therapy. He was also named one of the top 5 most influential psychotherapists of all time. Beck is also named as an American in history that shaped the history of psychiatry.

Dr. Beck has published over 600 articles. He has authored or co-authored 25 books. The work he did in developing various scales for measuring depression is still in use today.

His work in cognitive behavioral therapy grew from the work of other psychologists like George Kelly and the vocabulary of Frederic Bartlett and Jean Piaget. The cognitive constructs theory of Kelly and the vocabulary created by Bartlett around the theories of schemas and the vocabulary of Piaget’s theory of cognitive development were very influential in Beck’s initial work in CBT.

As a clinical psychologist, Dr. Beck was noticing a remission of patients’ symptoms. With this realization, came the understanding that his patients were presenting with repeated stories around activating events that he later labeled automatic negative thoughts.

Through his work with depressed patients, Dr. Beck developed the Negative Cognitive Triad. He found 3 types of dysfunctional beliefs, or thoughts, that depressed people were experiencing. His findings suggested that these types of thoughts dominated the thinking of people with depression.

• “I am defective or inadequate.”
• “All of my experiences result in defeats or failure.”
• “The future is hopeless.”

Dr. Beck believed that a close, personal relationship with the patient was crucial. The development of a trusting relationship was necessary to allow for the exploration of automatic negative thoughts. The mere admission of these thoughts was unsettling for some of his patients. The reframing of these thoughts through work with Dr. Beck resulted in significant numbers of patients’ self-reported improvement.

The Beck Institute for Cognitive Behavior Therapy was founded to further investigate the usage of his groundbreaking theory in helping people suffering from various psychological disorders. The institute was founded with his daughter, Dr. Judith Beck, to further investigate and serve a worldwide resource for CBT.

Mental health is a field of study that has come with a tremendous stigma. The rates of psychological disorders are astoundingly high, yet the number of people in treatment for these disorders is astoundingly low because of that stigma. If learning the concepts of cognitive behavioral therapy could help all people, through the examination of their cognitive distortions, an impact on reducing that stigma might be made.

All humans are flawed. There is not a single human alive that doesn’t have cognitive distortion from time to time. Developing a deeper understanding of what these distortions are and creating a way to reframe thoughts, behaviors, and actions can help all humans. What an incredible impact mental well-being training could have on the world! Thanks for reading.

If you are having thoughts of self-harm, please seek help. If depression and anxiety are disrupting your daily life, please seek help. No stigma is worth continued suffering.

We hope you found this article useful. For more information, don’t forget to download our three Positive CBT Exercises for free .

• Baker, R., Owens, M., Thomas, S., Whittlesea, A., Abbey, G., Gower, P., … & Thomas, P. W. (2012). Does CBT facilitate emotional processing? Behavioural and Cognitive Psychotherapy ,  40 (1), 19-37.
• 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 ,  20 (2), 179-189.
• Bjork, D. W. (1997).  B. F. Skinner: A life. Washington, DC: American Psychological Association.
• Bolla, G., Sartore, G., & Correale, A. (1938). Psychotherapy and Enuresis.  American Journal of Orthopsychiatry ,  8 (3), 436-59.
• Burns, D. D. (1980).  Feeling good: The new mood therapy.  New York, NY: New American Library.
• Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review ,  26 (1), 17-31.
• Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100 (3), 316-336.
• Davis, J. L., & Wright, D. C. (2006). Exposure, relaxation, and rescripting treatment for trauma-related nightmares.  Journal of Trauma & Dissociation ,  7 (1), 5-18.
• Gaudiano, B. A. (2008). Cognitive-behavioural therapies: Achievements and challenges. Evidence-Based Mental Health, 11 (1), 5-7.
• Karwoski, L., Garratt, G. M., & Ilardi, S. S. (2006). On the integration of cognitive-behavioral therapy for depression and positive psychology.  Journal of Cognitive Psychotherapy ,  20 (2), 159-170.
• McArdle, S., & Moore, P. (2012). Applying evidence-based principles from CBT to sport psychology.  The Sport Psychologist ,  26 (2), 299-310.
• Oltean, H. R., Hyland, P., Vallières, F., & David, D. O. (2017). An empirical assessment of REBT models of psychopathology and psychological health in the prediction of anxiety and depression symptoms.  Behavioural and Cognitive Psychotherapy ,  45 (6), 600-615.
• Ranjbari, T., Karimi, J., Mohammadi, A., & Norouzi, M. R. (2018). An evaluation of the contributions of the triple vulnerability model to the prediction of emotional disorders.  Iranian Journal of Psychiatry and Clinical Psychology ,  23 (4), 408-423.
• Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., … Wilson, G. T. (2009). Mind the gap: Improving the dissemination of CBT. Behaviour Research and Therapy, 47 (11), 902-909.
• Watson, J. B. (1913). Psychology as the behaviorist views it.  Psychological Review, 20 (2), 158-177.

Share this article:

Article feedback

What our readers think.

Very interested And how can I be well connected to the counsellor because I am a student of guidance and counseling

I’m trying to cite this article but there is no publication date.

Hi Kimberly,

This article was published the 6th of May, 2019.

Hope this helps!

– Nicole | Community Manager

This has been really useful thank you

can I cite this in app style?

Of course! Here’s how you’d do that (in APA 7th):

Miller, K. (2019, May 6). CBT explained: An overview and summary of CBT. PositivePsychology.com . https://positivepsychology.com/cbt/

Let us know your thoughts Cancel reply

Your email address will not be published.

Save my name, email, and website in this browser for the next time I comment.

Related articles

The Positive CBT Triangle Explained (+11 Worksheets)

Cognitive behavioral therapy (CBT) is a popular and highly effective intervention model for dealing with multiple mental health conditions (Early & Grady, 2017; Yarwood et [...]

Fundamental Attribution Error: Shifting the Blame Game

We all try to make sense of the behaviors we observe in ourselves and others. However, sometimes this process can be marred by cognitive biases [...]

Halo Effect: Why We Judge a Book by Its Cover

Even though we may consider ourselves logical and rational, it appears we are easily biased by a single incident or individual characteristic (Nicolau, Mellinas, & [...]

Read other articles by their category

• Body & Brain (52)
• Coaching & Application (39)
• Compassion (23)
• Counseling (40)
• Emotional Intelligence (21)
• Gratitude (18)
• Grief & Bereavement (18)
• Happiness & SWB (40)
• Meaning & Values (26)
• Meditation (16)
• Mindfulness (40)
• Motivation & Goals (41)
• Optimism & Mindset (29)
• Positive CBT (28)
• Positive Communication (23)
• Positive Education (36)
• Positive Emotions (32)
• Positive Leadership (16)
• Positive Parenting (14)
• Positive Psychology (21)
• Positive Workplace (35)
• Productivity (16)
• Relationships (46)
• Resilience & Coping (38)
• Self Awareness (20)
• Self Esteem (37)
• Strengths & Virtues (29)
• Stress & Burnout Prevention (33)
• Theory & Books (42)
• Therapy Exercises (37)
• Types of Therapy (54)

3 Positive CBT Exercises (PDF)

Cognitive Behavioral Therapy App Improves Anxiety in Young Adults

• Share to Facebook
• Share to Twitter
• Share to LinkedIn
• Share on Email

Initial results suggest the Maya app appeals to a younger population comfortable with technology and may be an effective tool to bridge the gap for people with anxiety waiting to see a therapist. Credit: Shutterstock

Researchers at Weill Cornell Medicine and NewYork-Presbyterian found that a self-guided cognitive behavioral therapy (CBT) app, called Maya, significantly reduced anxiety in young adults struggling with mental health challenges. The decrease in anxiety symptoms was clinically and statistically significant at six weeks and continued at the 12-week follow-up period with improvement levels similar to anxiety medication studies.

The study , published Aug. 20 in JAMA Network Open, looked at how young adults ages 18 to 25 would respond to CBT from an app called Maya, which Weill Cornell Medicine researchers began developing in 2019 in collaboration with members of Weill Cornell Information Technologies & Services. CBT is a gold standard psychotherapeutic intervention that provides users with skills to support them in shifting their thinking, completing challenging behaviors and learning coping skills. Nearly all of the 59 enrollees, 98 percent, participated for the full six weeks of the main study period and completed, on average, approximately 11 of the 12 intervention sessions.

Dr. Faith Gunning

While Maya is not a replacement for seeking professional help, it teaches strategies based in CBT. The app provides skill-building tools and real-time feedback that can help reduce stress and negative thoughts.cen

“We hear a lot about the negative impact of technology use on mental health in this age group,” said the study’s senior author Dr. Faith Gunning , associate professor of psychology in psychiatry and vice chair for research in the Department of Psychiatry at Weill Cornell Medicine. “But the ubiquitous use of cell phones for information may provide a way of addressing anxiety for some people who, even if they have access to mental health providers, may not go. If the app helps reduce symptoms, they may then be able to take the next step of seeing a mental health professional when needed.”

Targeting Anxiety in Emerging Adults

Maya was designed to target anxiety in early adulthood, when people experience stressful transitions, including starting a new job, moving away from home or graduating from college. Research has shown that anxiety disorders among young people ages 18 to 25 are increasing more than any other age group.

Maya is an interactive platform that guides users through videos, exercises and educational content to support them in learning and implementing new skills. While CBT techniques are effective at treating anxiety symptoms, the researchers note that a shortage of available clinicians makes it difficult to find appointments, especially since the pandemic. In the meantime, a self-guided mobile app may help until a mental health clinician is available, and appeal to a younger population comfortable with digital tools.

Dr. Jennifer Bress

“We think there is promise in these apps, but they’re only helpful if people use them,” said co-first author  Dr. Jennifer Bress , the Peter Edwin Stokes, M.D. Clinical Scholar in Psychobiology, an assistant professor of psychology in psychiatry at Weill Cornell Medicine and a psychologist at NewYork-Presbyterian Westchester Behavioral Health. “We wanted to develop an evidence-based app to see empirically whether we were actually engaging people and addressing their anxiety.” While there is ample evidence from clinical studies that CBT is effective for treating anxiety, testing the app itself through clinical trials is an important step to ensure its efficacy.

Since people often download an app, try it a few times and then delete it, this app added features to encourage engagement such as interactive exercises, videos and a user interface that test groups found to be visually appealing. 

Designed to Engage

To see if they could further motivate users, the authors randomly assigned the 59 participants in the study to three groups with different incentives. They included an opportunity to win points, the potential to lose points and a way to earn points that paired participants with a person in their life who encouraged them throughout the process. Participants received virtual “medals” for obtaining specified levels of points.

Surprisingly, the researchers found that using the Maya app reduced anxiety no matter which incentive people received.

Dr. Avital Falk

“These results indicate that the app can be an accessible and impactful tool for those looking for support around anxiety. It is incredible to see our ideas come to life,” noted Dr. Avital Falk , the Charisse Chinery Clinical Scholar in Psychiatry, associate professor of psychology in clinical psychiatry and director of the Division of Digital and Treatment Innovation. Dr. Falk, who is also the Director of the Pediatric OCD, Anxiety, and Tic disorders ( POCAT ) program,  in collaboration with The Center for Youth Mental Health at NewYork-Presbyterian, was co-first author and designed the app’s content.

“It will be challenging to meet the mental health needs of society based on the number of clinical providers we have,” said Dr. Gunning, who is also the George Alexopoulos, M.D. Honorary Director of the Institute of Geriatric Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian and a psychologist at NewYork-Presbyterian Westchester Behavior Health. “Our initial results suggest the app may be an effective tool to bridge the gap for people waiting to see a therapist.”

Many Weill Cornell Medicine physicians and scientists maintain relationships and collaborate with external organizations to foster scientific innovation and provide expert guidance. The institution makes these disclosures public to ensure transparency. For this information, see profile for Dr. Faith Gunning and Dr. Jennifer Bress .

This study was funded by The Center for Youth Mental Health at NewYork-Presbyterian, the Khoury Foundation, the Paul and Jenna Segal Foundation, the Saks Fifth Avenue Foundation, the Weill Cornell Medicine Children ’ s Health Council Investigator ’ s Fund, Mary and Jonathan Rather, the Pritzker Neuropsychiatric Disorders Research Consortium, and the National Institutes of Health K23 MH116105. 

Related News

• The Role of an Energy-Producing Enzyme in Treating Parkinson’s Disease
• Study Finds Potential Link Between DNA Markers and Aging Process
• NIH Grant Will Support Lymphoma Research

Back to News

Weill Cornell Medicine Office of External Affairs New York, NY --> Phone: (646) 962-9476

My Account Info

Manage your Membership information, email preferences, and more.

Membership in ABCT grants you access to three journals.

Join us for ABCT’s 58th Annual Convention in Philadelphia, PA, November 14 – November 17, 2024.

We are now accepting Abstract submissions for Continuing Education Ticketed Sessions at the 2024 ABCT Convention in Philadelphia, PA.

Welcome from the Program Chairs

Muniya Khanna, Ph.D., Program Chair Founder, Director, The OCD & Anxiety Institute Chief Digital Officer, Lumate Health

Abby Bailin, Ph.D., Associate Program Chair Research Associate, The University of Texas at Austin

Maria Alba, Psy.D., Associate Program Chair Attending Psychologist, Montefiore Medical Center

Welcome to the 2024 Annual Convention of the Association for Behavioral and Cognitive Therapies (ABCT)! As we gather in the vibrant city of Philadelphia, we are thrilled to explore the theme that binds us together: “Opening Our Doors: Inspiring Community Engagement, Advocacy, and Innovation to Advance CBT.”

Just as Philadelphia is steeped in a rich history of revolution and progress, so too is ABCT entrenched in the advancement of cognitive and behavioral science. Our history serves as a guiding light, illuminating the path toward a future where we strive to do better each day. We extend our warmest invitation to all of you to join us in this endeavor, as we embark on a journey of learning, collaboration, and growth.

At this convention, we aim to open our doors wide, inviting individuals from all walks of life to participate in the exchange of knowledge and ideas. Whether you are a seasoned practitioner, a dedicated researcher, an impassioned advocate, or a curious student, there is a place for you here. Together, we will present, connect, learn, and inspire one another, all while honoring the legacy of those who have paved the way before us.

Throughout the conference, we will delve into three key pillars: Community Engagement, Advocacy, and Innovation. We are particularly excited to hear from you on topics such as:

• Community Engagement: Share with us how your work intersects with the community, and how community-based work is shaping the future of CBT.
• Advocacy: Let us know about your advocacy that promotes equity, diversity, and social justice within the realm of CBT practice, research, and beyond.
• Innovation: Explore the cutting-edge technologies and novel approaches that are revolutionizing the field of cognitive and behavioral therapy, while ensuring ethical considerations and inclusivity remain at the forefront.

To emphasize important aspects of our theme, we are honored to have invited talks by prominent experts in both scientific research and practical application. We are excited to introduce our lineup of outstanding keynote speakers:

Cathy Creswell, Ph.D.

Saturday, november 16, 2:00 – 3:00 pm.

“Digital Transformation to Increase Access to Psychological Therapies: What We Have Learned From the English Health System”

Jennifer Havens, M.D.

Friday, november 15, 10:00 – 11:00 am.

“Realizing the Potential of Child Mental Health Services in the 21 st Century”

Stefan Hofmann, Ph.D. | ABCT 2023 Lifetime Achievement Award Recipient

Saturday, november 16, 12:30 – 1:30 pm.

In addition to these keynote addresses, please mark your calendars for our additional invited talks. The Advanced Clinician Seminar Series is a new clinical format designed specifically for our advanced clinicians seeking content and consultation commensurate with their level of expertise. This year, we will offer three of these seminars featuring a skilled clinician and moderator to offer consultation, case conceptualization, and treatment planning on attendees’ most complex cases. Attendees will be expected to identify as advanced clinicians, bring structured case presentations for possible discussion, and fully participate in a more seminar-style discussion.

Judith Beck, Ph.D.

Sunday, november 17, 10:30 am – 12:30 pm.

“Adapting Cognitive Behavior Therapy for Personality Disorders”

Anthony Chambers, Ph.D., ABPP

Saturday, november 16, 4:30 – 6:00 pm.

Rebecca Sachs, Ph.D., ABPP

Friday, november 15, 2:00 – 3:30 pm.

“Specialized Care for Complex Cases in Neurodivergent Youth With Anxiety or OCD”

We are also excited for our invited Clinical Grand Rounds, “ A Demonstration by Three Experts in CBT, DBT, and ACT,” featuring Drs. Judith Beck, Jill Rathus, and Lisa Coyne (Friday, November 15, 11:30 AM – 12:30 PM).

Together, let us envision a future where CBT is accessible to all and where our communities thrive. As we convene in Philadelphia, we also recognize the importance of giving back to the community that graciously hosts us. To that end, we are hosting the inaugural ABCT Day of Service , partnering with Cradles to Crayons, which provides children experiencing homelessness low-income situations with essential items they need to thrive. ABCT Day of Service offers an exciting chance for conference attendees to make a meaningful impact in Philadelphia. It’s not just about attending sessions; it’s about rolling up our sleeves and giving back. Imagine connecting with fellow participants while crafting handwritten notes to youth or finding items for donation. It’s a hands-on way to build relationships, create positive change, and leave a sustainable impression. Join us for ABCT Day of Service on Thursday and be part of something truly special!

It has been a privilege to serve as your program chairs for the 2024 ABCT Annual Convention. We are deeply grateful for the opportunity extended to us by President Dr. Sandra Pimentel and the ABCT Board. Special thanks to our predecessors, the 2023 program chairs, Drs. Emily Bilek and Krystal Lewis, whose exemplary leadership guided us as we transitioned into our roles. Convention planning is a collaborative endeavor, and we also wish to recognize the unwavering dedication of the 2024 Convention Committee in organizing such an exceptional event. The invaluable support from ABCT Central Office staff, particularly Mary Jane Eimer and Stephen Crane, has been instrumental in ensuring the success of both the Annual Convention and our organization. Last, we extend deep appreciation to the Program Committee members who volunteered their time as scientific reviewers. This outstanding scientific program is a testament to the contributions of many hands, and we thank everyone involved.

In closing, we extend our heartfelt gratitude to each and every one of you for being a part of this transformative experience. Whether you are presenting groundbreaking research, leading insightful discussions, or simply joining us in the spirit of collaboration, your presence enriches our collective journey. 

We hope you enjoy the conference, make lasting connections, and leave inspired to continue advancing the field of cognitive and behavioral therapy. Our doors are open, and we cannot wait to embark on this journey together. 

Warm regards,  Muniya, Abby, and Maria