13 Cognitive Behavioral Therapy Techniques

Cognitive behavioral therapy is one of the most effective models for treating a wide range of psychological problems. In this article, we detail its most effective and interesting techniques.

Written and verified by the psychologist Valeria Sabater.

Last update: 23 October, 2024

The main techniques of cognitive-behavioral therapy (CBT) consist of a set of strategies that are both effective and practical in every psychologist’s daily routine. In fact, thanks to this long-established approach, it’s possible to address everything from depressive disorders, addictions, relationship problems, and the most serious mental disorders. Indeed, it’s a terrific resource.

A study published in Frontiers in Psychiatry defines CBT as the “gold standard of psychotherapy.” This is largely because of the large number of studies that support it. Knowing its mechanisms and the way it operates will allow us a clearer vision of this particular therapy. Let’s find out more.

Cognitive behavioral therapy

In the 1960s, the psychotherapist Aaron Beck developed CBT. From then on, the technique became unstoppable. In fact, it served as the basis for addressing many different psychiatric disorders.

This method, based on conversation and focused on the patient’s ‘problem’ was an advance in comparison to more classical models such as psychoanalysis. CBT is based on the following principles:

• Psychological problems stem from dysfunctional and unhelpful ways of thinking.
• We can all learn new strategies to develop healthier mental and behavioral approaches.
• Suffering is triggered by automatic mental patterns that we’ve learned and reinforced on a daily basis.

It focuses on the following goals:

• Understanding the behavior and motivation of the individual.
• Developing in them a valid sense of self-confidence.
• Providing them with new tools and useful coping strategies.
• Detecting thought distortions and irrational thought patterns.
• Enabling the patient to become their own therapist.
• Unlike psychoanalysis, the past isn’t particularly relevant for CBT. It’s seen as more important to offer the individual tools to manage their suffering and problems in the here and now.

Main techniques of cognitive-behavioral therapy

CBT starts from the basis that the individual’s way of thinking affects their emotions and behavior. Therefore, the focus is placed on intervening in the cognitive mechanisms that build, according to CBT, the basis of psychological disorders. From this premise, a whole series of techniques are developed and applied. They’re as follows:

1. Cognitive restructuring

Cognitive restructuring is a psychological process that allows the patient to identify and change their negative or dysfunctional thought patterns. As such, their negative or distorted automatic reasoning (of which they’re not aware) is challenged. These are the kinds of behaviors that translate into emotional suffering and maladjusted behaviors.

This is one of the most used and effective CBT techniques. An analysis conducted at Stanford University (USA) highlights its usefulness in the treatment of fears.

2. Exposure therapy

The goal of exposure therapy is to help patients face and overcome their fears and anxieties by gradually exposing them to situations or stimuli that cause discomfort.

• In recent years, exposure therapy has taken advantage of the benefits of virtual reality.
• It starts with an analysis for understanding the mechanisms and thoughts that reinforce fears or phobias.
• The goal is to break the cycle of avoidance and allow the patient to manage their anxiety more effectively.
• In each session, the psychologist progressively guides the patient so that they can gradually face their worries and fears.

3. Systematic desensitization

Systematic desensitization is one of the important techniques of CBT. This strategy was developed by the psychologist, Joseph Wolpe. It’s similar to the exposure method, only it starts from a specific premise.

In fact, in systematic desensitization, anxiety and relaxation can’t coexist at the same time. Therefore, a relaxation response must be induced in patients before exposing them to their fears. From this starting point, the psychologist follows the next therapeutic steps:

• Creation of a hierarchy of fears of the patient.
• Training in relaxation techniques.
• Imaginary exposure.
• Live exposure.

A study published in the American Journal of Pharmaceutical Education highlights its effectiveness in treating test anxiety in students.

4. Journal of records and thoughts

In CBT, patients always have ‘homework’. Recording in a journal what they think and what they feel facilitates the therapeutic process. Moreover, it helps them become aware of their mental narratives and how these affect their mood and behavior.

5. Activity programming and behavioral activation

Another CBT technique is behavioral activation and programming of activities. These strategies are essential for patients who are dealing with depression. They’re also useful for those with addictions or who are immersed in self-destructive behavior patterns.

The main objective of this technique is to promote healthier behaviors in the patient. New activities are scheduled that generate changes in their well-being and mental focus.

6. Modeling techniques

Modeling techniques are employed to help individuals develop new skills and behaviors through observation. Seeing someone carry out a healthy and beneficial action is always powerful for the human being. It allows the patient to learn really useful tools for change and well-being. Modeling techniques are as follows:

• Verbal. Through instructions.
• Symbolic. Through videos and movies.
• Live. Seeing someone in person to imitate.
• Self-reinforcement. The person doing the modeling reinforces the correct behaviors of the observer.

7. Stress inoculation

The stress inoculation technique was founded by Donald Meichenbaum in the 1970s. Its aim is to help people cope with stressful situations. A study conducted by the Isfahan University of Medical Sciences (Iran) emphasizes its efficacy in reducing distress in cancer patients. This technique is based on three principles:

• Psychoeducation about stress.
• Acquisition of coping skills.
• Practice and generalization in everyday life.

8. Training in problem-solving

Today, our social and personal scenarios have become increasingly complex. Therefore, enabling problem-solving is a core competence. Cognitive-behavioral therapy pays special attention to this area. The psychotherapist guides the patient in the following steps:

• Detecting everyday challenges and problems.
• Understanding the causes.
• Thinking of different strategies to solve those problems.
• Evaluating the most appropriate actions and decision-making strategies.
• Regulating stress and fear.
• Checking the results.

9. Mastering self-control

Self-control allows us to adopt more thoughtful actions and feel in control of our lives. Few resources are as necessary in the field of mental health as empowering patients in good self-control. Thanks to this psychological competence, the patient achieves the following:

• Reduced impulsivity.
• Better regulated emotions.
• More consistent decisions.
• Promotion of interrelational links.

10. Operant techniques for modifying behaviors

Operant strategies for changing behaviors are essential techniques in CBT. Indeed, in psychotherapeutic settings, it’s essential to establish healthier behaviors and restrict those that are dysfunctional or harmful.

To this end, strategies are carried out that have their origins in behavioral psychology. They’re as follows:

• Punishment.
• Extinction.
• Satiation.
• Time out.
• Overcorrection.
• Differential reinforcement.
• Positive or negative reinforcements.

11. Relaxation and breathing techniques

In recent years, cognitive-behavioral therapy has integrated mindfulness techniques into its methodology. This ancient practice contains some beneficial tools. Indeed, breathing, relaxation, and mindfulness are adequate resources for alleviating many types of symptoms.

An investigation published in the Indian Journal of Psychological Medicine states that CBT that applies mindfulness is effective in patients dealing with anxiety disorders.

12. The upward arrow technique

With the upward arrow technique, the cognitive-behavioral psychologist detects the root of the patient’s dysfunctional thoughts. They pose a series of questions with which they infer the triggering cause. In turn, the patient becomes aware of the mechanisms that are building their discomfort and irrational cognitive approach.

13. Goal Setting Technique

CBT aims to train the patient in the clarification and establishment of goals. After all, humans need motivators in their daily routine to progress, feel useful, and stay activated. To train the individual in this type of tool, the following series of guidelines are followed:

• Clarify their dreams and passions.
• Define their objectives.
• Set SMART goals (specific, measurable, achievable, relevant, and with a time limit).
• Break these goals down into smaller steps.
• Think about the steps and mechanisms of action.
• Stay motivated.
• Follow up and evaluate the results.

The advantages and limitations of CBT

An article entitled Education and Inspiration for General Practice alludes to the main advantage of cognitive-behavioral therapy techniques. These are strategies that have a lasting and positive effect on patients. However, when it comes to their limitations, it should be noted that these resources only seek to address current problems.

This means that CBT doesn’t address the patient’s past and the root of the problem isn’t always resolved. However, the patient is empowered so that, on their own, they can take greater control of their lives by taking care of their mental approach. This is a terrific starting point for safeguarding their psychological well-being.