CBT

Knowing what to expect in CBT sessions can help you understand how and why it works. Usually, CBT sessions last around 50 minutes each. During these sessions, a therapist might work with you, your child, or you and your partner on core CBT techniques such as:

• Identifying cognitive distortions. A cognitive distortion is an automatic, negative, or irrational thought pattern that distorts how one sees reality. There are many different cognitive distortions, such as all-or-nothing thinking, discounting the positive, mind-reading, catastrophizing, or overgeneralizing. A therapist might point these out as you work on noticing them yourself. 
• Challenging unhelpful beliefs. After identifying cognitive distortions and unhelpful beliefs, your therapist will help you challenge them. For example, let’s say that you have social anxiety. You want to attend an event but think people will judge you or won’t like you. In CBT, you may challenge that thought with, “I do not have proof of that.” 
• Cognitive reframing. Reframing unhelpful beliefs with more realistic ones. Using the same example, you might reframe beliefs like “people won’t like me” with “I can’t predict what other people are thinking. Other people might be just as nervous to go as I am, and they might feel the same way.” 
• Change maladaptive behaviors. In CBT, a therapist will help you take practical steps to re-engage in specific activities or to break routines that cause continued distress. Let’s say that you’re in cognitive behavioral couples therapy with a partner and are working to increase closeness. In that case, you may work to break a pattern where you retreat and don’t talk to each other after work by asking each other about your day and spending time together instead.
• Coping skills. In addition to cognitive reframing and behavioral activation, you may practice coping skills like mindfulness, progressive muscle relaxation, deep breathing, or taking a walk.  These help to calm the body and the mind. Everyone is different, so a therapist may work with you to find the coping skills that work best for you. 

CBT may also employ techniques like roleplaying. Generally, you can expect to collaborate with your provider and develop a treatment strategy together. What’s an example of how it might differ? Someone in CBT for bipolar disorder might focus on identifying shifts in mood, taking their medication, and following stable routines. On the other hand, CBT for insomnia may focus on changing negative thoughts or behaviors (e.g., poor sleep hygiene) that could play a role in keeping you awake.  Though some parts, like changing negative thought patterns and engaging in behaviors that support your treatment goals, can be similar, the specifics can differ quite a bit.