Cognitive behavioral therapy (often referred to just as “CBT”) is an evidence-based form of psychotherapy. Evidence-based means that CBT is a therapy that has been scientifically shown, through rigorous studies like this one or that one, to be an effective treatment for multiple mental health conditions. CBT has also been shown to be helpful for individuals with chronic illness, for managing both certain physical and psychological symptoms of their disease. But what actually is CBT? 

The Cognitive Triad 

The core component of CBT is that thoughts, feelings, and behaviors all interact with one another. For example, you may have received an invitation to go to a celebratory dinner with some close friends. You may begin to think “if I go to dinner, I’ll have pain and I’ll have to leave.” This may make you feel anxious, sad, frustrated, and may increase pain sensation. These thoughts and these feelings may then affect your behavior, making you less likely to go to dinner with your friends! CBT treatment often contains the following steps: 

Step 1: Understanding the relationship between thoughts, feelings, and behavior 

CBT first aims to educate people about the interactions between their thoughts, feelings, and behaviors. Can you think of an example in your own life where your thoughts influenced your feelings, which then changed your behavior? 

Step 2: Changing your thoughts 

CBT then often tries to help people change how they are thinking about a situation, something called cognitive restructuring. Changing how you think about a situation can help how you feel and can change how you behave! Let’s think of the example above. CBT may help you transform that thought in to “If I have pain during dinner, I will be able to handle it. It is more important to me that I see my friends!” This may make you feel comforted, confident, and excited. The behavior would be that you attend your dinner! 

Step 3: Changing your behavior 

CBT also oftentimes addresses behavior change itself, often called exposures. A CBT therapist may help you do things that may seem scary or uncomfortable. Doing these things can help you change your thoughts! For example, if you go to the dinner, you may experience fun and joy with your friends! This helps your brain re-structure how it thinks about a situation, and next time a dinner invitation comes up, your thoughts may sound more like “I went last time, and it was so worth it!” 

What does a CBT session look like? 

CBT sessions often follow a similar structure. CBT is meant to be a short-term, skills-based, and goal-oriented form of therapy. This means that the goal of CBT is ultimately for you to learn to “be your own therapist!” You will learn the skills needed to help you meet your specific goals, whether that be reducing anxiety, increasing social activity, dealing with physical symptoms – your goals are personal to you!  

Because CBT is skills-based and you are learning to be your own therapist, CBT does involve record keeping and homework! This is so that you have practice using your skills outside of session, and record what works and what needs changing.  

CBT for Chronic Medical Conditions 

As mentioned above, CBT is often used as a treatment for individuals with chronic medical conditions. CBT can be used to target both physical symptoms and psychological symptoms in individuals with chronic illness. For example, CBT has been shown to be effective to help treat pain, pain-related disability, and pain-related interference. CBT can also be used to treat insomnia, and enhance medication adherence and depression related to chronic illness.  

CBT for IBD and IBS 

CBT is extremely commonly used as a treatment for IBS. CBT as a treatment for IBS has been shown to be an effective treatment in improving bowel symptoms as well as symptoms such as psychological distress and quality of life. CBT is also often used as a part of treatment for IBD. Although not yet shown to be as useful for treating the physical symptoms for IBD, CBT has been shown to be useful for improving quality of life in patients with IBD with poorer mental health. 

Final thoughts 

CBT is one of the most evidence-based psychotherapies in use! There have been many, many rigorous studies showing that CBT is an effective treatment across individuals with a wide variety of mental and physical health concerns. If you think CBT might be useful for you, reach out to your provider or a member of your Care Team to discuss!