Several people have asked for a comprehensive list of CBT techniques. What is CBT in psychology? CBT techniques refers to cognitive behavioral therapy techniques. CBT is a very popular form of therapy because it has been proven effective for a large number of people suffering from anxiety, depression, and other mental illnesses.
This article is meant to help provide a brief introduction to CBT as well as some resources on where you can get cognitive behavioral therapy. I also link to a brief CBT manual and some worksheets for therapists (which other people might be interested in as well). Finally, I provide the much-anticipated list of CBT techniques at the end of the article.
What is cognitive behavioral therapy?
CBT, a combination of cognitive and behavioral therapies (surprise! hence the name), is used to treat mood and anxiety disorders. Fundamentally, CBT rests on the notion that since it is hard to directly alter emotions, we can instead target emotions indirectly by changing the way people think and behave. As you can imagine, there are many CBT techniques that can achieve this and I will provide a list of CBT techniques further down in this article. This list of cognitive behavioral therapy techniques is not exhaustive, but includes the most important ones.
Who can CBT help?
Cognitive behavioral therapy is helpful for a wide range of problems, but is not suitable for every type of problem. In the manual, “A Therapist’s Guide to Brief CBT” on page 8, there is an excellent chart that goes over what disorders are more suited to CBT techniques.
According to that chart, the following are well-suited to cognitive behavioral therapy techniques:
- Assertiveness issues
- Exercise motivation
- Social Isolation
- New Diagnosis of COPD
- Coping with Chemotherapy
- Caregiver Burden
In addition, the chart suggests the following MAY or may not benefit from CBT:
- Specific phobias
- Crisis intervention
Finally, the chart suggests that the following are NOT suitable for CBT, at least short-term CBT. I think it might be arguable, but here they are:
- Alcohol Dependence
- Paranoid Personality Disorder
- Chronic PTSD
- Somatoform Disorder
So, that gives you an idea of what can and cannot be helped with CBT.
How is cognitive behavioural therapy administered?
Before I provide a list of CBT techniques, I would like to consider how CBT is administered. You can practice these cognitive behavioral therapy techniques with a counsellor, psychologist or other mental health professional. They might give you CBT within the session, but also as homework exercises to work on between sessions.
Alternately, you can do cognitive behavioral therapy techniques on your own with the guidance of a book. There are several good books on CBT. My personal favorite is The Feeling Good Handbook by David Burns (affiliate link).
As well, there are smart phone and tablet apps for CBT. Also, there are some well-reviewed on-line CBT programs. I have heard good things about two in particular (both of which are, as of the time of this writing, free of charge):
Lastly, if you are a therapist or a real do-it-yourselfer, here is a link to some CBT handouts that you can use to work through your problems.
List of CBT Techniques
CBT is more than just a list of CBT techniques. It is really a way of thinking, and I would like to discuss that a little before I list any techniques. The way of thinking is basically this: when you have a mood disorder such as anxiety or depression, one of the main problems come from cognitive distortions (more on those below). By identifying and finding a way to move past the cognitive distortion, we are able to hopefully overcome the negative mood that it creates.
What is a cognitive distortion?
Briefly, cognitive distortions are just errors in the way we think. For example, one cognitive distortion is “mind reading”. In this one, we assume we know what another person is thinking or feeling about us, based on their non-verbal behaviour. This one can be a tricky one for some people because sometimes people are sensitive and good at picking up on non-verbal cues.
However, the types of things we learn from CBT are: 1. If that person has something negative to say, they are going to have to outright say it — we will not be held “hostage” to passive-aggressive non-verbal attacks if that is even what they are really doing. 2. We might be right that we are getting a negative non-verbal cue from someone, but we may be wrong in attributing it to ourselves — for example, maybe someone has a brother who is dying of cancer and they are thinking about that while they are trying to talk to us.
A List of CBT techniques is more than just a list of cognitive distortions
This is why it is hard to make a list of CBT techniques. One can make a list of CBT distortions, but the techniques — well, there are many ways to wake ourselves up from the distorted belief systems that we are living in. Another example: suppose that my car won’t start and I have to be somewhere important by a certain time. Because my car won’t start, I miss the meeting and therefore miss an important opportunity. I start to feel bad about myself. Maybe I left my headlights on and caused the car to not start. I might call myself “stupid” or “a loser”. That is called “labeling”. With cognitive therapy, I would come to realize that even if I did make a mistake, that is a normal part of being human. I am not stupid or a loser just because I make a mistake.
Part of how emotional disorders build is by this process of catastrophizing. What I mean by that is that little things might go wrong and we assume more things will go wrong or that things always go wrong for us, that we are unworthy, that we are somehow lacking. We take an event — probably an unpleasant event — and ascribe it with a personal meaning. In fact we allow the event to define our sense of self-worth. When I put it like that, it sounds a little crazy, doesn’t it? However, people do that all the time.
What are the main cognitive distortions in cognitive behavioral therapy?
As I mentioned, CBT techniques are applied to cognitive distortions. These cognitive distortions are inaccurate or distorted thoughts that serve to bolster negative thought patterns and/or emotions. Because cognitive distortions represent some fallacy in our thinking, they lead us to incorrect assumptions about our lives and about what will happen in our futures.
These are the main cognitive distortions that are corrected by cognitive behavioral therapy techniques:
- Overgeneralization: In the cognitive distortion of overgeneralization a single incident is generalized to make a general conclusion. For example, if you have one bad exam, you might conclude (falsely) that you are going to fail the course. In a more radical example of overgeneralization, you might take that one bad exam mark and conclude that you won’t graduate.
- Filtering: Filtering is focusing on the negative and ignoring the positives. In the cognitive distortion of filtering, the positives are literally filtered out.
- Splitting: Also known as dichotomous thinking, polarized thinking, or “black and white” thinking, splitting is when you see things in all or nothing terms. If you find yourself using expressions like “always,” “never,” “every time,” etc., you are likely splitting. For example, you might see yourself as a total success or a total failure.
- Discounting the positives: This cognitive distortion involves not noticing or minimizing the positive events or accomplishments in your life.
- Control Fallacies: Always assigning an internal or external locus of control to events. In other words in this distortion the person either always assumes things are out of their control or always assumes they can control everything. The reality is that we have control over some things and not others.
- Jumping to Conclusions: In this cognitive distortion you jump to a conclusion with little or no evidence to back it up. Two specific types of jumping to conclusions are mind-reading and fortune telling. In mind-reading the person imagines that they know what other people’s (negative) thoughts about them are. In fortune-telling, they predict the (negative) outcome of events.
- Personalization: In personalization a person assumes the blame for something that is not their fault.
- Fairness Fallacy: It is considered a cognitive distortion to expect life to be fair. Because life is not fair. Unfortunately.
- Karma Fallacy: Related to the fairness fallacy, the karma fallacy is the belief that people will get what they deserve. While that may or may not be true in the long run, believing karma will level the playing field in short order is a cognitive distortion.
- Labeling / Mislabeling: This could be considered a more extreme case of the cognitive distortion of overgeneralization. In labeling, a person assigns a label to themselves or others based on flimsy evidence. For example, if a person was trying to lose weight and ate some ice cream, if they called themselves a “cow,” that would be labeling. Mislabeling is really the same thing because these labels are clearly incorrect. However, the term “mislabeling” is usually used to describe other people’s behaviour rather than our own. For example, if someone cuts you off in traffic and you say they must have gotten their driver’s license as the prize in a Cracker Jack box, that is labeling.
- Blaming: This is the opposite of personalization. In blaming, the person abdicates responsibility for a problem and puts all the blame on the other person (or people) involved. The person does not look at what role they had to play in the matter.
- Shoulds: When a person tells themselves they “should” have done something differently, this is considered a cognitive distortion. The main reason it is a cognitive distortion is that it does not tend to lead to improved behavior, but rather to rumination, guilt, and unhappiness. “Should” and “must” are similar in this regard.
- Emotional Reasoning: In emotional reasoning people assume that if they feel a certain way, it must be true. For example, “I feel stupid, therefore I am stupid.”
- Fallacy of Change: This cognitive distortion rests on two ideas: first is the idea that, through manipulation, we can change others to behave as we would like them to, and second, that by changing others, we can make ourselves happy.
- Always Being Right: In this cognitive distortion it is more important to be right than anything else including other people’s feelings.
Those are the main cognitive distortions that can be corrected or improved by the cognitive behavioral therapy techniques listed below.
List of CBT techniques (Cognitive behavioral therapy techniques):
- Journaling or in some way keeping a record of your moods and/or thoughts, especially noting the time, the extent of the mood or thought, and what led to it. This is the “data gathering” phase. This journaling process is sometimes referred to as a thought record and belongs at the top of any list of CBT techniques.
- Unraveling cognitive distortions. With or without the help of a professional, figuring out which cognitive distortions you make most frequently and learning how not to do them. Here, we identify and challenge “automatic” thoughts.
- Cognitive restructuring. Once you have identified a rule or assumption that you have been making about the world and your place in it, you can begin to explore the origins, advantages, and disadvantages of this. For example, you might think that in order to be successful in life, you have to run five miles per day, but then you get injured and you cannot run five miles a day anymore. You feel bad about yourself because, besides not getting the endorphins from the regular exercise, you had the belief (that you were previously barely aware of) that running five miles a day made you a “good” person. Time for some cognitive restructuring, meaning it is time to think about what being a “good” person really means to you.
- Behavioral Experiments. In cognitive behavioral therapy behavioral experiments are used to test the validity of the thoughts you are having and their underlying beliefs. For example, if you are afraid to say “no” because you think your friends will not like you if you do, you might do a behavioral experiment wherein you say “no” to someone in your life. You then observe what happens and gather information. Does it result in the person truly liking you less? How can you tell? Are you making assumptions? A good handout for this cognitive behavioral exercise can be found here.
- Exposure and response prevention. This is an excellent cognitive behavioral technique for people with OCD (obsessive compulsive disorder). It involves being around whatever normally elicits a compulsive behavior, but refraining from engaging in the compulsive behavior and then writing about how that makes you feel. Here is the worksheet about it.
- Another form of exposure is called interoceptive exposure. This is exposure to bodily sensations and it is particularly important in treating panic and anxiety. You can find a worksheet about it here.
- Nightmare exposure and rescripting is pretty much what it sounds like. It is a fairly specific technique for people who are having bad dreams. Here is the worksheet.
- Play the script until the end. This is quite a cool technique because a lot of people get crippled at some point in time by fear or anxiety. In this technique, we examine what would happen if the worst case scenario really happens. To me this is a very important technique because it creates sort of a rehearsal in a person’s mind that tells them that no matter what happens and what goes wrong, they will, ultimately, be okay. The handout for this exercise is here.
- Progressive muscle relaxation (PMR). This is hardly unique to CBT, but it is an excellent technique nonetheless. For those who have not heard of it, you relax one muscle group at a time. This is a way to relax your whole body. I am including a link to the worksheet, but the ideal way to do this is if you can find an audio recording of someone guiding you through PMR because then you can just relax, lie on a yoga mat or something like that, and do the exercise very effectively.
- Relaxed breathing. Again, this is not unique to CBT — in fact it has more in common with mindfulness — but it is a great technique once mastered. If you have tried this in the past and it has not worked for you, I encourage you to keep trying. It literally took me years before I even began to understand how to slow down my breath and probably more years before I realized the impact that had on my body. Maybe you already know because you learn faster than me :). It can be frustrating learning to focus on your breath. This is a known fact amongst Buddhist monks and meditation practitioners worldwide. Allow yourself room to “do it wrong” so that you can learn. Here is a worksheet that might help.
So, that is a list of CBT techniques and an overview of what CBT in psychology is. However, remember that CBT is more than a simple list of cognitive behavioral therapy techniques. It is a way of doing therapy. It is using thoughts and behaviours to target emotion. There is a mountain of evidence to suggest that CBT works and works very well for many people in many situations.
What is MBCT – Mindfulness based cognitive therapy – and why do I like it?
Personally, I prefer a variation of CBT called MBCT, which is mindfulness based cognitive therapy. In mindfulness based cognitive therapy, a large part of the focus is on developing self-awareness and on meditation. What I like about this is that I think sometimes people are not 100% conscious of what their thoughts and emotions are.
The mindfulness aspect helps ground people so that they know what underlying thoughts and emotions are causing trouble. It can be very hard to be still and face yourself. It takes a lot of courage, but I think it is a journey worth taking. (If you are interested in MBCT, my favorite book for this is The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness (affiliate link). The book comes with a CD that guides you through progressive muscle relaxation and some other exercises in mindfulness.)
You might also be interested in:
- Recommended Books on CBT
- Books about overcoming depression
- Mental Health Resources
- Free CBT Worksheets for Clients and Therapists