What's it like to be in CBT?

If you imagine therapy as a place to lie on a couch and talk endlessly about your problems, then you may be surprised by CBT. Mental health pioneers like Aaron Beck and Albert Ellis had something very different in mind when they developed what has come to be known as cognitive-behavioral therapy.

First, CBT is a partnership between client and therapist. They work together throughout therapy to help the client achieve change. The therapist is not an all-knowing guru who imparts wisdom on the client, but more like a collaborator in the process of gathering data. The data is then used to help the client move forward toward their goals.

Second, CBT is an active therapy. The therapist routinely assigns homework to help the client learn more about themselves and to try new behaviors. Homework fits with CBT’s goal of having the client become their own therapist, since the client is practicing CBT on themselves each time they do an assignment. Homework can also be used to gather that all-important data mentioned above.

Third, CBT is solution-focused. Even if someone is depressed and is always thinking negatively, some of their thoughts may be 100 percent accurate. In these cases, the therapist helps the client to learn problem-solving skills. These skills can lead the client toward new behaviors, which in turn might help them to see things differently than they normally would.

Fourth, CBT is time-limited. This means that instead of taking the years required by some types of psychoanalysis, CBT is usually much briefer. The length of therapy is driven by the client’s progress toward specific goals. Eight to twelve sessions is often all it takes to help people achieve the changes they seek.

Finally, CBT is present- and future-oriented. This stands in contrast to a focus on the client’s past or childhood. The past can certainly be considered in CBT, but usually as a way of informing the client’s current way of thinking or acting. The idea is to make changes in the present, with an eye toward future goals.