What is Cognitive Behavioural Therapy: A Complete Guide to CBT Treatment

Key Takeaways

• Cognitive behavioural therapy (CBT) is a treatment-based, structured, evidence-based talk therapy that focuses on changing negative thought patterns and behaviours to improve mental health and emotional wellbeing.

• CBT is one of the most common and best-studied forms of psychotherapy.

• CBT effectively treats depression, anxiety disorders, post traumatic stress disorder, obsessive compulsive disorder, eating disorders, and many mental health conditions through practical coping skills.

• CBT is also used to treat a wide range of conditions, including chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), and insomnia.

• Treatment typically involves 5-20 therapy sessions where you and your therapist work together collaboratively to identify unhelpful thoughts and develop rational thinking patterns. Some people may notice improvement after only a few sessions, especially for milder issues.

• CBT is available through NHS services for free access, privately through accredited CBT therapists, or through self help resources, with various delivery methods including face to face CBT, online, and group therapy options.

• The therapy combines cognitive therapy techniques (changing thought patterns) with behaviour therapy strategies (modifying actions and responses) for comprehensive psychological treatment.

What is Cognitive Behavioural Therapy?

Cognitive behavioural therapy represents one of the most extensively researched and effective psychological therapies available today. Developed by psychiatrist Aaron Beck in the 1960s, CBT is a structured, goal-oriented, treatment-based form of talk therapy that focuses on the powerful connections between thoughts, emotions, and behaviours. As a treatment-based approach, CBT is systematic and evidence-based, using specific techniques and protocols to address psychological issues.

Unlike other therapies that explore past experiences in detail, cognitive behavioural therapy takes a present-focused, problem-solving approach. The core principle behind CBT is straightforward: our thoughts directly influence how we feel emotionally and how we behave in everyday life. When we develop unhelpful thought patterns or engage in negative behaviours, these can create cycles that maintain mental health problems and emotional challenges. CBT is guided by several core principles, including its structured, goal-oriented nature and its focus on helping clients reframe negative thoughts to improve mental health.

CBT differs from other talking therapies through its collaborative nature. Rather than the therapist acting as an expert who interprets your experiences, cognitive behavioural therapy cbt involves working together as partners to identify problems, set goals, and develop practical solutions. This evidence based treatment has been endorsed by the national institute for health and care excellence and is considered a first-line psychological treatment for numerous mental health conditions.

The structured approach of CBT means each session follows a clear format with specific objectives. Your CBT therapist will help you understand how your thoughts, physical feelings, and behaviours interact, then teach you techniques to break negative cycles and develop healthier patterns.

How CBT Works

The foundation of cognitive behavioural therapy rests on understanding how thoughts, emotions, and behaviours influence each other in a continuous cycle. When you encounter a stressful situation, your automatic thoughts about that situation determine your emotional response, which then influences your behaviour. This behaviour can reinforce the original thoughts, creating either helpful or unhelpful patterns.

For example, if you think “I’m going to embarrass myself” before giving a presentation, you’ll likely feel anxious and may avoid the situation entirely. This avoidance behaviour reinforces the belief that presentations are dangerous, maintaining the cycle of social anxiety.

CBT helps break these cycles through systematic techniques that target both thinking patterns and behavioural responses. Distorted thinking patterns, such as catastrophizing—where you imagine the worst possible outcome or exaggerate the severity of a situation—are common targets in therapy.

During sessions, CBT therapists guide you through exercises to recognise when you’re engaging in distorted thinking, challenge these thoughts with evidence, and gradually change behaviours that maintain problems. Therapists often use a question-and-answer format to help clients gain new perspectives during CBT sessions.

The therapy emphasises practical coping skills you can use in everyday life. Rather than simply talking about problems, CBT provides specific tools and strategies you can apply immediately to manage negative emotions and improve your emotional health.

Cognitive Component

The cognitive therapy aspect of CBT focuses on identifying and modifying unhelpful thought patterns called cognitive distortions. These are systematic errors in thinking that skew how you interpret experiences, often in overly negative or unrealistic ways.

Common cognitive distortions include:

• All-or-nothing thinking: Viewing situations in extreme categories (“If I’m not perfect, I’m a complete failure”)

• Catastrophising: Expecting the worst-case scenario in every situation

• Mind-reading: Assuming you know what others think without evidence

• Overgeneralisation: Drawing broad negative conclusions from single events

• Emotional reasoning: Believing that negative feelings reflect reality (“I feel scared, so it must be dangerous”)

CBT techniques help you recognise these distorted thoughts through tools like thought records, where you track situations, emotions, and the specific thoughts that arise. Your therapist helps you examine evidence for and against these thoughts, consider alternative explanations, and develop more balanced, realistic thinking patterns.

This process isn’t about positive thinking or ignoring real problems. Instead, cognitive therapy teaches rational thinking based on evidence and probability rather than automatic negative assumptions. Over time, this leads to more accurate perceptions and reduced emotional distress.

Behavioural Component

Behaviour therapy principles in CBT focus on changing actions and responses that maintain mental health problems. Many people with anxiety disorders, depression, or other conditions engage in behaviours that provide short-term relief but worsen problems long-term.

Exposure therapy is a key behavioural technique, particularly effective for treating anxiety and phobias. Rather than avoiding feared situations, you gradually face them in a controlled way, learning that your fears are often unfounded or manageable. This process helps reduce avoidance behaviours that maintain anxiety over time.

Activity scheduling and behavioural activation are essential for depression treatment. When feeling low, people often withdraw from enjoyable or meaningful activities, which worsens mood. CBT helps you schedule pleasant and mastery-based activities, even when motivation is low, breaking the cycle of inactivity and depression.

Other behavioural strategies include relaxation techniques for managing physical symptoms of anxiety, assertiveness training for improving relationships, and problem-solving skills for handling life challenges more effectively.

What Conditions CBT Treats

Cognitive behavioural therapy has demonstrated effectiveness across a remarkably wide range of mental health conditions. Research has shown CBT as an evidence based treatment for both common and more complex psychological problems.

Primary mental health conditions treated with CBT include:

• Depression: CBT targets negative thought patterns, inactivity, and hopelessness through cognitive restructuring and behavioural activation. It has been shown to be as effective as medication for treating less severe forms of depression.

• Anxiety disorders: Including generalised anxiety, panic disorder, social anxiety, and specific phobias through exposure work and cognitive techniques. CBT is effective for treating anxiety disorders in both adults and children, and is considered effective for managing anxiety and depression in children and adolescents.

• Post traumatic stress disorder: Trauma-focused CBT helps process traumatic memories and reduce avoidance behaviours. Studies have shown that CBT is effective in reducing symptoms of PTSD.

• Obsessive compulsive disorder: CBT uses exposure and response prevention to break cycles of obsessions and compulsions

• Eating disorders: Addressing distorted beliefs about food, weight, and body image alongside behavioural changes

CBT also proves effective for bipolar disorder (as an adjunct to medication), personality disorders, substance use disorders, and chronic fatigue syndrome (CFS). While CBT has been considered as a treatment for CFS, its effectiveness is debated and results are inconclusive, with studies such as the PACE trial highlighting controversy and limitations.

The therapy has been adapted for various physical health problems including chronic pain, tinnitus, irritable bowel syndrome (IBS), and insomnia. CBT is effective for managing psychosomatic symptoms in IBS and for treating sleep disturbances such as insomnia, with evidence from systematic reviews and clinical trials supporting its use.

CBT helps relieve symptoms associated with mental health conditions, chronic pain, and stress-related issues, reducing or alleviating pain, stress, anxiety, and PTSD, and thereby improving patients' overall well-being. In addition to symptom reduction, CBT has been shown to improve general functioning, mood, and social outcomes, which are important indicators of treatment efficacy.

Many mental health problems share common underlying processes like negative thinking patterns, avoidance behaviours, and poor coping skills. This makes CBT’s core principles applicable across many mental health conditions, though specific techniques are tailored to each person’s particular challenges.

The therapy works effectively across all age groups, from children and adolescents to older adults, with age-appropriate modifications to techniques and materials.

Types of CBT

Cognitive behavioural therapy can be delivered in several formats and in different ways, such as in-person, online, or by phone, to meet different needs, preferences, and circumstances. The most effective approach depends on your specific mental health condition, personal preferences, and practical considerations.

Individual CBT sessions remain the gold standard, involving weekly 45-60 minute sessions with an accredited CBT therapist. This format allows for personalised treatment plans, detailed exploration of your specific issues, and close monitoring of progress.

Group therapy brings together several people with similar problems to learn CBT skills together. Group sessions can be particularly effective for social anxiety, depression, and substance use disorders, providing peer support and opportunities to practise new behaviours in a social context.

Computerised CBT (CCBT) and online therapy options have expanded access significantly. These digital platforms provide structured CBT programmes with interactive exercises, homework assignments, and progress tracking. The quality of content in these digital mental health solutions is crucial for user engagement, effective guidance, and personalisation. Clients are often asked to practice skills learned in therapy between sessions to reinforce their learning. While lacking face-to-face interaction, online CBT can be as effective as traditional therapy for many mental health conditions.

Specialised CBT approaches include:

• Dialectical Behaviour Therapy (DBT): Combines CBT with mindfulness and emotion regulation skills

• Acceptance and Commitment Therapy (ACT): Focuses on accepting difficult thoughts and feelings while pursuing valued goals

• Mindfulness-Based Cognitive Therapy (MBCT): Integrates mindfulness meditation with cognitive techniques

Brief CBT condenses treatment into a few sessions (typically 4-8), focusing intensively on core skills for specific problems. Some people may notice improvement after only a few sessions, especially for milder issues, while more complex cases may require longer treatment. This approach works well in primary care settings or when resources are limited.

Preparing for Therapy

Getting ready for cognitive behavioral therapy (CBT) is an important step toward improving your mental health and emotional wellbeing. Whether you’re seeking help for anxiety disorders, post traumatic stress disorder, obsessive compulsive disorder, eating disorders, or other mental health conditions, preparing in advance can help you make the most of your therapy sessions.

The first step is finding the right CBT therapist, which can often be a time-consuming process. Look for an accredited CBT therapist or licensed mental health professional with experience in treating your specific mental health problems. It’s important to choose a therapist who addresses your particular concerns, such as depression, anxiety, or eating disorders, to ensure you receive appropriate treatment.

You can ask your GP, a friend, or family for personal recommendations, or search online directories and through local and state psychological associations for qualified professionals in your area. Most therapists' websites list the conditions and problems they treat, making it easier to find someone who matches your needs. You can also be referred to a therapist by your primary healthcare provider. Many therapists offer a free initial consultation, giving you the chance to discuss your needs and see if their approach feels like a good fit. Selecting the right kind of therapy that aligns with your goals and circumstances is also crucial for optimizing your outcomes.

Before starting therapy, it can be helpful to keep a diary or journal of your thoughts, feelings, and behaviors. This self-reflection can reveal patterns related to negative emotions or unhelpful behavior, and help you gain insight into the challenges you want to address. Writing down your goals for therapy—such as managing stress, improving coping skills, or changing specific behavioral patterns—can also clarify what you hope to achieve.

CBT aims to equip you with practical tools to handle stressful situations and manage negative thoughts. During CBT sessions, you’ll work collaboratively with your therapist to develop new strategies for dealing with everyday life and emotional challenges. Group therapy is another option, offering support and shared learning with others facing similar mental health conditions.

Understanding the core principles of cognitive behavioral therapy cbt—such as the link between thoughts, feelings, and behaviors—can help you approach therapy with an open mind. CBT is a short term treatment, typically lasting several weeks or months, and requires active participation both during and between sessions. Being committed to practising new coping skills and applying what you learn in real-life situations will help you get the best results.

If you’re unsure whether CBT is right for you, remember that other talking therapies and treatment strategies are available. Your mental health professional can help you explore different options and find the approach that best suits your needs. By taking these steps to prepare, you’re setting yourself up for a more effective and empowering therapy experience—one that can lead to lasting improvements in your emotional health and overall quality of life.

What to Expect in CBT Sessions

Understanding what happens in CBT sessions can help reduce anxiety about starting therapy and prepare you for active participation in your treatment.

Initial assessment typically takes 1-2 sessions where your CBT therapist conducts a thorough evaluation of your mental health problems, symptoms, history, and goals. This phase may include an interview involving psychological testing and self-monitoring to tailor the therapy plan to your needs. You’ll learn about the cognitive-behavioural model and how it applies to your specific situation. Together, you’ll establish clear, measurable treatment goals.

A typical CBT session follows a structured format:

1. Brief mood check and homework review: Discussing your week and any assignments completed

2. Agenda setting: Collaboratively deciding what to focus on during the session

3. Main work: Using specific CBT techniques to address target problems

4. Homework assignment: Planning practise exercises for the coming week

5. Session feedback: Reviewing what was helpful and any concerns

Therapy often includes writing down your own thoughts, feelings, or individual situations in a journal over a certain period of time.

The therapeutic relationship in CBT is collaborative rather than hierarchical. Your therapist acts as a guide and teacher, but you’re an active participant in identifying problems, setting goals, and developing solutions. This partnership approach helps build confidence in your ability to manage mental health problems independently.

Progress tracking occurs throughout treatment using mood diaries, thought records, and standardised questionnaires. Regular review of progress helps adjust treatment strategies and maintain motivation.

Most people attend weekly sessions, though frequency may vary based on severity and individual needs. Sessions CBT typically last 45-60 minutes, providing sufficient time for meaningful work while maintaining focus and structure.

Group Therapy

Group therapy is a unique and supportive way to experience cognitive behavioral therapy (CBT) alongside others who share similar challenges. In this format, a therapist guides a small group—generally between 5 and 15 participants—through structured sessions that focus on understanding and changing unhelpful thoughts and behaviors. CBT helps individuals recognize how their thinking patterns influence their emotions and actions, and in a group setting, you have the added benefit of learning from the experiences and insights of others.

Participating in group therapy can be especially helpful for those who find social situations difficult. The group provides a safe, structured environment to practise new social skills, build confidence, and receive encouragement from both the therapist and fellow group members. This collaborative approach not only fosters a sense of community but also allows participants to see that they are not alone in their struggles.

Therapists leading group CBT sessions ensure that everyone has the opportunity to contribute and benefit from the therapy. The shared experience can make it easier to open up, gain new perspectives, and develop practical coping strategies. Whether you’re dealing with anxiety, depression, or other mental health concerns, group therapy offers a supportive space to work towards positive change together.

Self-Help and Therapy

Self-help plays a key role in cognitive behavioral therapy (CBT), empowering individuals to take an active part in their own recovery. CBT helps people identify and challenge unhelpful thoughts and behaviors, and self-help strategies can reinforce these changes outside of therapy sessions. If you’re interested in starting CBT or want to supplement your therapy, there is a wide list of self-help resources available, including books, online courses, and support groups.

Beginning CBT can feel difficult at first, especially when facing long-standing patterns or emotional challenges. However, with the right strategies and support, you can learn to manage symptoms and improve your wellbeing. Techniques such as journaling, mindfulness exercises, and relaxation practices are commonly used to help manage stress, anxiety, and other mental health concerns. These self-help methods can be particularly helpful for preventing relapse in conditions like eating disorders, supporting long-term recovery and resilience.

By combining self-help with professional therapy, you can enhance the effectiveness of CBT and find ways to manage your mental health more independently. Whether you’re working with a therapist or exploring self-help options on your own, the key is to stay motivated, practise new skills regularly, and seek support when needed. Remember, progress may take time, but every step you take brings you closer to your goals.

Mindfulness and Therapy

Mindfulness is increasingly recognized as a valuable addition to cognitive behavioral therapy (CBT), offering powerful techniques to help manage stress and anxiety. CBT helps individuals understand the connection between their thoughts, feelings, and behaviors, while mindfulness encourages a non-judgmental awareness of the present moment. By integrating mindfulness into therapy, you can learn to observe your thoughts and emotions without immediately reacting to them, which is especially helpful for managing anxiety and preventing panic disorder.

Therapists often incorporate mindfulness exercises—such as deep breathing, guided meditation, and body scans—into CBT treatment plans. These techniques can help you stay grounded during difficult moments and reduce the impact of unhelpful thoughts. Mindfulness is generally considered a helpful adjunct to CBT and can also enhance the effectiveness of other talking therapies, such as acceptance and commitment therapy (ACT).

Practising mindfulness regularly can make it easier to manage emotional challenges, improve focus, and build resilience. Whether you’re new to mindfulness or looking to deepen your practice, combining these techniques with cognitive behavioral therapy cbt can provide a comprehensive approach to improving your mental health.

Technology and Therapy

Advances in technology have made cognitive behavioral therapy (CBT) more accessible than ever before. Today, CBT can be delivered through a variety of digital platforms, including online video sessions, phone calls, and mobile apps. This flexibility is particularly helpful for individuals who may have difficulty attending in-person therapy due to location, mobility, or time constraints.

The National Institute for Health and Care Excellence (NICE) has endorsed online CBT as an effective treatment for anxiety and depression, recognizing its value in expanding access to evidence-based care. Many online CBT services are produced by reputable organizations and offer interactive tools, educational videos, and secure messaging systems to support your progress. These digital options allow you to engage with therapy at your own pace and convenience, while still benefiting from professional guidance.

When considering online CBT, it’s important to choose platforms that are based on proven cognitive behavioral therapy cbt principles and are endorsed by health and care excellence bodies. Whether you access therapy via phone, video, or app, technology can play a key role in helping you manage anxiety and other mental health challenges effectively.

How to Access CBT

Several pathways exist for accessing cognitive behavioural therapy, ensuring that effective psychological treatment is available regardless of your circumstances or financial situation.

NHS Services

The NHS provides free access to CBT for adults through several routes. For many mental health conditions, you can self-refer directly to your local psychological wellbeing service without needing a GP referral. This applies to depression, anxiety disorders, panic disorder, social anxiety, and post traumatic stress disorder. For more information about NHS access and therapy options in Glasgow, consult Brain Botanics Counselling.

Self-referral is typically available online through your local NHS trust’s website or by calling their mental health services directly. The process usually involves completing a brief questionnaire about your symptoms and circumstances.

Certain conditions require GP referral, including eating disorders, bipolar disorder, personality disorders, and severe depression with psychotic symptoms. Your GP will assess your situation and make an appropriate referral to specialised NHS services.

No formal diagnosis is required to access many CBT treatments through the NHS. Services focus on your current difficulties and symptoms rather than requiring specific diagnostic labels before treatment can begin.

Waiting times vary significantly across different areas of the UK, ranging from a few weeks to several months. Some regions offer same-day telephone assessments or rapid access clinics for urgent cases.

Private Treatment

Private CBT offers several advantages including shorter waiting times, choice of therapist, and more flexible scheduling. Accredited CBT therapists can be found through professional registers including the British Association for Behavioural and Cognitive Psychotherapies (BABCP).

Private therapy costs typically range from £60-£150 per session, depending on location and therapist experience. Some private health insurance policies cover CBT treatment, though coverage varies significantly between providers and policies.

Many employers offer Employee Assistance Programmes that include free CBT sessions as part of workplace mental health support. These services often provide immediate telephone consultations and referrals to local therapists.

Alternative Access Routes

Universities typically provide counselling services for students, often including CBT-trained counsellors. These services are usually free and understand the specific pressures of academic life.

Charity organisations and community mental health groups sometimes offer CBT, particularly for specific populations or conditions. Organisations like Mind, Anxiety UK, and condition-specific charities often provide low-cost or free therapeutic support.

Self help resources include CBT workbooks, mobile apps, and online programmes that teach core techniques independently. While not a substitute for professional treatment in severe cases, anxiety help through guided self help can be effective for mild to moderate mental health problems.

Specialised pathways exist for young people under 18 through Child and Adolescent Mental Health Services (CAMHS), school counselling services, and youth-focused charities.

Cost of Therapy

The cost of cognitive behavioral therapy (CBT) can vary widely depending on several factors, including the therapist’s qualifications, location, and the type of therapy you choose. Generally, CBT is considered a cost-effective treatment option compared to other forms of psychotherapy, especially given its strong evidence base and structured approach.

In the UK, CBT is available for free through the NHS, allowing individuals to access treatment without financial barriers. You can discuss options with your GP or explore online referral services to find free therapy sessions. For those seeking private therapy, session fees typically range from £50 to £200, depending on the therapist and region. Some therapists offer a limited number of free or reduced-cost sessions for individuals facing financial difficulties, so it’s always worth discussing your situation and exploring available options.

Health and care excellence organizations, such as the British Association for Behavioural and Cognitive Psychotherapies (BABCP), provide information on accredited therapists and treatment options to help you make informed decisions. Group therapy can also be a more affordable alternative to individual sessions, offering effective support in a shared setting. No matter your circumstances, there are ways to find and access the right CBT treatment for your needs.

Effectiveness and Limitations

Cognitive behavioural therapy ranks among the most thoroughly researched psychological treatments, with extensive evidence supporting its effectiveness across numerous mental health conditions. Understanding both its strengths and limitations helps set realistic expectations for treatment outcomes.

Research evidence consistently demonstrates CBT’s effectiveness through hundreds of randomised controlled trials and systematic reviews, many of which are published in peer-reviewed journals. Meta-analyses show medium to large effect sizes compared to no treatment, with outcomes often comparable to psychiatric medications for conditions like depression and anxiety disorders. Studies frequently track progress over a year or more to assess long-term effectiveness.

The national institute for health and care excellence (NICE) repeatedly recommends CBT as a first-line psychological treatment for depression, anxiety disorders, post traumatic stress disorder, obsessive compulsive disorder, and eating disorders. This endorsement reflects the robust scientific evidence supporting CBT treatments.

There is a range of views regarding CBT’s effectiveness and underlying assumptions. While many support its structured, evidence-based approach, some critics argue that CBT may not address deeper underlying issues or may not be suitable for everyone.

Factors influencing success include:

• Active participation in sessions and homework completion

• Strong therapeutic relationship with your CBT therapist

• Severity and complexity of mental health problems

• Presence of multiple conditions or social stressors

• Personal motivation and readiness for change

Potential limitations include temporary emotional distress during early sessions as you confront avoided thoughts and situations. Some people find the structured approach too rigid or prefer more exploratory therapeutic approaches focusing on past experiences.

CBT requires significant effort and commitment, including regular homework assignments and practise of new skills in everyday life. People experiencing severe depression may initially struggle with the active nature of treatment, though this often improves as mood lifts.

Dropout rates can be higher than some other therapies, particularly when exposure work is involved. However, research shows that people who complete CBT treatment often maintain gains better than those receiving medication alone.

The clinical practice of CBT continues evolving, with ongoing research into optimal treatment length, combination with other treatments, and adaptations for different populations and cultural contexts.

Frequently Asked Questions

How long does CBT take to work?

Most people begin noticing improvements within 4-6 weeks of starting CBT, though this varies based on the specific mental health condition and individual circumstances. Depression and anxiety often respond within 8-12 sessions, while more complex conditions like obsessive compulsive disorder or post traumatic stress disorder may require 15-20 sessions or longer. Factors affecting treatment duration include symptom severity, presence of multiple conditions, life stressors, and how actively you engage with homework assignments and practise new skills between sessions.

Can CBT be combined with medication?

Yes, cognitive behavioural therapy often works excellently alongside psychiatric medications for enhanced effectiveness. Many people with depression, anxiety disorders, or bipolar disorder benefit from combining CBT with antidepressants or other medications. The combination can be more effective than either treatment alone, particularly for severe symptoms. CBT helps develop long-term coping skills that remain even after medication is discontinued, potentially reducing relapse risk. Always discuss medication decisions with your GP or psychiatrist, as they can advise on the best combination approach for your specific situation.

What’s the difference between CBT and other talking therapies?

Unlike other forms of counselling that may explore childhood experiences or focus on insight and understanding, CBT is highly structured and skills-focused. While therapies like psychodynamic counselling examine past relationships and unconscious patterns, CBT concentrates on current problems and practical solutions. CBT sessions follow clear agendas, include homework assignments, and teach specific techniques you can apply immediately. The approach is more directive than person-centred counselling, with the therapist actively teaching strategies rather than simply providing a supportive listening environment.

Do I need to talk about my past experiences in CBT?

CBT primarily focuses on current difficulties and present-moment challenges rather than extensively exploring childhood or past experiences. However, understanding how past experiences shaped your current thinking patterns or beliefs can be relevant when these directly impact your current mental health problems. For example, past trauma might be addressed if it contributes to ongoing post traumatic stress disorder symptoms. The emphasis remains on how past experiences influence your current thoughts and behaviours, and what you can do now to create positive change.

What if CBT doesn’t work for me?

Not everyone responds to CBT, and this doesn’t represent personal failure or indicate that no help is available. If you haven’t seen improvement after adequate treatment (usually 12-16 sessions), several options exist. Your therapist might suggest modifications to the approach, longer treatment duration, or addressing any barriers to progress. Alternative psychological treatments like psychodynamic therapy, interpersonal therapy, or newer approaches like acceptance and commitment therapy might be more suitable. Sometimes combining CBT with medication or addressing underlying factors like sleep problems or substance use improves outcomes. The key is working with your mental health professional to find the most effective treatment strategy for your individual needs.