Cognitive-Behavioral Therapy for Depression and Anxiety

There are many different approaches to psychotherapy. Some therapists identify with a particular approach or orientation while others draw from a variety of different approaches. Cognitive-behavioral therapy (CBT) is one specific orientation of psychotherapy that seeks to help people change how they think.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy is based on cognitive theory and was developed by Aaron Beck for anxiety and depression. CBT is a blend of cognitive and behavioral therapies that ​help patients tune into their internal dialogue in order to change maladaptive thinking patterns.

Beck developed specific procedures to help challenge a depressive client's assumptions and beliefs and help patients learn how to change their thinking to be more realistic and thus lead to feeling better. There is also an emphasis on problem-solving and changing behaviors and clients are encouraged to take an active role in their therapy.

Other Types of Cognitive-Behavioral Therapy

One type of CBT is rational emotive behavior therapy (REBT), which was developed by Albert Ellis. Ellis considers strong emotions to result from an interaction between events in the environment and our beliefs and expectations. Some of these beliefs can be too strong or rigid.

For example, maintaining a belief that everyone should like you. With REBT, you would learn to change that belief so that it is less extreme and less likely to interfere with your life. Your belief could then change to wanting people to like you but realizing that not everyone will.

Another form of CBT is dialectical behavior therapy (DBT), which was developed by Marsha Linehan primarily to be used for patients with borderline personality disorder (BPD). DBT emphasizes working on accepting thoughts and feelings instead of trying to fight them. The goal is to get patients to accept their thoughts and feelings so that they can eventually change them.

Exposure and response prevention therapy (ERP) is yet another type of CBT that is usually used for obsessive-compulsive disorder (OCD). In this therapy, patients are exposed to the situations or objects that cause them the most fear (obsessions) but are not able to engage in the behaviors that help relieve the anxiety they feel (compulsions).

For example, if you are afraid of germs, during ERP, your therapist might have you touch money and then not wash your hands for a specific amount of time. Practicing this over and over helps you gain confidence in dealing with the accompanying anxiety and can greatly help relieve symptoms of OCD with repeated exposure. 

Does CBT Work for Depression?

It has been difficult to research the effectiveness of psychotherapy since the term can refer to so many different activities. Cognitive-behavioral therapy, however, lends itself well to research and has been scientifically proven to be effective in treating symptoms of depression and anxiety.

It tends to be short- to moderate-term, in contrast to some other orientations because of its focus on the present, as well as on problem-solving. Its mission to educate the patient to learn to become their own therapist also makes it a long-term treatment.

Medications or Psychotherapy?

Depression and anxiety can be treated with medications, psychotherapy or both. Some research has shown that the combination of medications and therapy can be particularly effective. 

Insurance companies sometimes encourage family doctors to prescribe medications rather than refer to a mental health professional for psychotherapy. There are times when this may be appropriate, but there are other times when psychotherapy is clearly indicated.

If you are taking an antidepressant or an anxiety medication and you believe that part of the problem is not being addressed, consider seeking help from a mental health professional.