Cognitive behavioural therapy (CBT)

What is CBT?

Cognitive behavioural therapy (CBT) can help if you are depressed or anxious because it helps change unrealistic, negative ways of thinking. These ways of thinking are very common in people with depression. Negative ways of thinking can include:

  • overgeneralising (‘everything always goes wrong for me’)
  • blaming yourself for things that aren’t your fault (‘My co-worker forgot a deadline because I didn’t remind her’)
  • focussing on the negative and ignoring the positive (‘I should have got all As in my exams, the B just shows I’m not good enough’).

What happens in CBT?

Professor Gavin Andrews, Director of the UNSW School of Psychiatry at St Vincent’s Hospital, and head of the Anxiety and Depression Clinic and Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital, Sydney, answers questions about CBT.

 

The views in these videos are those of Professor Gavin Andrews. This information is not medical advice from NPS and should not be used to treat or diagnose your own or another person's medical condition. Any medical questions should be referred to a qualified healthcare professional.

How do I do CBT?

CBT usually consists of 10 to 20 weekly sessions of 1 hour each. You may also need to do ‘homework’ between sessions, to practise more positive ways of thinking and behaving.

CBT can be done face-to-face with a psychologist or doctor trained in the technique. You can also do CBT online and read self-help books based on the principles of CBT.

How does CBT compare with antidepressants?

For mild depression, CBT is more effective than antidepressants. CBT and antidepressant therapy are about as effective as each other for treating moderate depression. However, after stopping treatment, the effects of CBT last longer than the effects of antidepressants. If you have severe depression, antidepressants are more effective than CBT, but CBT can be helpful once you start to feel better with antidepressant treatment.

How does CBT compare with other kinds of psychotherapy?

Only a few studies have compared CBT with interpersonal therapy (IPT), but the results of these showed they were about as effective as each other for treating depression.

There have not been enough studies to say how effective CBT is compared with other kinds of psychotherapy.

How does CBT compare with counselling?

Counselling is a broad term covering a range of approaches. It aims to support you to find resolution, personal growth and self-healing.

It’s difficult to say if counselling is effective for depression, because there haven’t been enough trials of it. In contrast, trials of CBT and IPT have shown convincing evidence of benefit. However, counselling may be a useful option for people with mild depression who do not want to have CBT or IPT or take an antidepressant.

Is there a benefit in combining CBT and antidepressants?

If you have moderate to severe depression, having CBT as well as taking an antidepressant gives an added benefit.

Read more about CBT.

For more information

Reference
  • National Collaborating Centre for Mental Health. Depression: the NICE guideline on the treatment and management of depression in adults (updated edition). London: National Institute for Health and Clinical Excellence, 2010. www.nice.org.uk/nicemedia/live/12329/45896/45896.pdf (accessed 9 February 2012).