What Is Cognitive Behavioral Therapy (CBT)? A Practical Overview

Written By Julianna Young

If you’ve ever noticed yourself stuck in a cycle of negative thinking or reacting to a situation in a way that doesn’t align with how you want to show up in the world then you’re not alone. Our thoughts, emotions, and behaviors are deeply connected and this connection can both bring up difficult experiences as well as provide us an avenue to work on living more connected, compassionate, and healthy lives. That’s where Cognitive Behavioral Therapy (CBT) comes in.

CBT is widely used and an evidence-based approach to therapy that helps people understand and change unhelpful thought patterns and behaviors. What we love about it is that it’s practical, fast to start, goal-oriented, and focused on giving you the tools to manage challenges more effectively. Whether you’re struggling with anxiety, depression, stress, or even everyday problems, CBT can help reshape how you internally and externally respond to things.

A quick note, I wanted to use the typical language of “negative thinking” but the rest of the blog will use the term “challenging thoughts” or “challenging thinking” because it is a more compassionate and accurate way to view the thoughts.  It also aligns with some of the other approaches such as IFS that we can utilize.

How Does CBT Work?

At its core, CBT believes that our thoughts influence our feelings which in turn influence our physical or somatic and behavioral responses.  When our systems bring up irrational, distorted, or generally unhelpful thoughts this can lead to distress.  This distress can be both internal and show up as anxiety, depression, etc. or it can be external and show up as distressing or problematic behaviors.   CBT helps break this cycle by pushing back against challenging thought patterns and replacing them with more balanced, realistic ones.

A therapist trained in CBT will typically help clients:

  • Identify challenging thought patterns.  Examples of this could include beliefs like “I’m a failure” or “Nothing ever goes right for me”, or irrational thoughts in the moment like “That person doesn’t like me because they aren’t listening to me”

  • Challenge these thoughts.  By looking at the rational vs. irrational evidence in a particular line of thinking we can work on changing the thoughts. 

  • Replace them with healthier, more constructive thoughts. By finding replacement thoughts, e.g. “I am successful” instead of “I am a failure” we can internally respond differently.

  • Develop coping strategies.  These coping strategies can help us manage the anxiety, sadness, or whatever else that comes up.

CBT is a structured, straight forward, and sometimes time-limited therapy which means it often only goes on for a set amount of sessions.  Our goal is meaningful change in a short time period.  The skills learned in CBT can be used for a lifetime.

Examples of CBT in Action

To make this concept more concrete, let’s look at a few real-life examples.  Below are three examples that highlight CBT and give a glimpse in to how it can be beneficial.

Example 1: Working With Anxiety

Situation: You have to give a presentation at work, and you’re feeling extremely anxious.
Irrational/Automatic Thought: "I’m going to mess up, and everyone will think I’m incompetent."
CBT Approach:

  • Your therapist helps you challenge this thought.  This can involve questions like “What evidence do you have that you’ll mess up?” or “Have you successfully spoken in front of others before?”. 

  • You work on replacing the thoughts with a more balanced one: "I might feel nervous, but I’ve prepared well, and I can do my best."

  • You practice calming techniques, such as deep breathing or visualization, to manage your anxiety before the presentation.

Example 2: Managing Depression

Situation: You’re feeling low and unmotivated, and you spend the day in bed.
Irrational/Automatic Thought: "There’s no point in getting up. Nothing will change."
CBT Approach:

  • Your therapist helps you recognize this as a self-defeating thought that’s reinforcing your low mood.  We can explore the nuance of some all or nothing thinking with “nothing will change” or “no point”.  This is in contract to “something will change” or “there’s at least some point”.

  • You experiment with behavioral activation—choosing one small action (like taking a shower or going for a short walk) to break the cycle of inactivity.

  • You track your mood before and after, noticing how small actions can create positive changes.

Example 3: Reducing Self-Criticism

Situation: You make a mistake at work.
Automatic Thought: "I’m so stupid. I always mess things up."
CBT Approach:

  • You examine the pattern of all-or-nothing thinking which means one mistake doesn’t define your entire competence or value at work.

  • You practice self-compassion by talking to yourself the way you would a friend.  Examples can be “we all make mistakes” or “people have short memories and your coworkers probably won’t remember this in a few days”.

  • You reframe the thought: "I made a mistake, but I can learn from it and do better next time."

Why CBT Works

CBT is one of the most researched and effective forms of therapy for a wide range of mental health or wellness concerns. Here’s why it works so well:

  • It’s practical and solution-focused – You learn specific skills that you can use in daily life.

  • It challenges unhelpful thought patterns – Instead of being trapped in challenging cycles, you develop healthier ways of thinking.

  • It encourages active participation – Therapy isn’t just about talking; it’s about practicing new strategies.  We can practice this in session and use real-world examples from your life. 

  • It empowers you to become your own therapist – Over time, you build resilience and learn to manage challenges independently.

How CBT and EMDR Can Complement Each Other

At EMDR Therapy Nashville we do have a focus on EMDR, however we can also independently use CBT.  That said, I feel it’s good to highlight how they can work together to deepen the benefits.  Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) are both effective, evidence-based treatments, but they work in different ways. While CBT focuses on identifying and restructuring unhelpful thought patterns, EMDR is designed to help process and heal from past trauma. When used together, these approaches can complement each other and create a well-rounded path to healing.

How They Work Together

  • CBT provides structure and coping strategies – CBT helps clients recognize distorted thinking patterns, develop healthier responses, and practice new behaviors. This can be particularly helpful when managing ongoing anxiety, depression, or challenging self-beliefs.  This can also be helpful as we process trauma with EMDR and old trauma-based thought patterns can come up.  For example if we’re working on “I am worthless” with EMDR then we can plan out responses to that belief as we do EMDR so you feel more confident and are able to handle any processing that could occur between sessions.

  • EMDR helps process deeper emotional wounds – EMDR is particularly effective for past traumas that still trigger emotional distress. By using bilateral stimulation (such as eye movements), EMDR helps the brain reprocess traumatic memories so they feel less overwhelming in the present.  EMDR helps reprocess and create new neural pathways with more compassionate and healthier beliefs.  CBT is great for more surface level coping that overlays new thoughts on old patterns.

  • When combined, CBT can provide the rational framework for understanding challenging thought patterns, while EMDR works on a deeper, emotional and physiological level to heal trauma.

Example of CBT and EMDR Working Together

Imagine someone who struggles with self-worth due to childhood bullying.

  • CBT Approach: They work on identifying challenging thoughts like "I'm not good enough" and replacing them with healthier beliefs. An example would be “I am good enough despite how people may have treated me growing up.” They also practice positive behaviors, like assertiveness or self-compassion.

  • EMDR Approach: They revisit the original bullying experiences in EMDR sessions which allows their brain to fully process the trauma and reduce the emotional charge it still holds.  This usually changes the underlying beliefs and eventually decreases the triggers.  This reduces the frequency and strength at which the belief or thoughts around “I am not good enough” even come in.

By using both approaches, the person not only understands and challenges their current challenging thinking (CBT) but also resolves the deeper emotional pain that may still be affecting them (EMDR).

When to Use CBT and EMDR Together

  • If you’re dealing with both present-day anxiety and past trauma – CBT can help you manage daily stress, while EMDR can help process the root causes.

  • If your challenging thoughts feel deeply emotional and hard to shift – EMDR can help reduce the emotional intensity of painful memories, making it easier to adopt new beliefs through CBT.

  • If traditional talk therapy hasn’t fully resolved distressing experiences – Some memories are stored in a way that logic alone can’t fix, and EMDR can help unlock those experiences for deeper healing.

  • If the overwhelm when the triggers comes up is too strong for us to think through, we can utilize CBT short term and reprocess the memories so the trigger is either gone or not nearly as strong.

Using CBT and EMDR together allows for a comprehensive approach—CBT helps with logical restructuring, while EMDR works on healing emotions and past experiences.

Does CBT Work? Research Information

Cognitive Behavioral Therapy (CBT) is one of the most extensively researched forms of psychotherapy.  Numerous studies supporting its effectiveness across a range of mental health or emotional wellness avenues.  This matches the experience we have using CBT with clients at EMDR Therapy Nashville. Below is an overview of key research findings:

1. CBT for Depression

CBT has been shown to significantly reduce symptoms of depression including long after the sessions end.

2. CBT for Anxiety Disorders

CBT is effective in treating various anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder.

  • A meta-analysis published in World Psychiatry concluded that CBT is effective in reducing symptoms of anxiety, with moderate to large effect sizes when compared to control conditions. https://onlinelibrary.wiley.com/doi/10.1002/wps.21069

  • The Cochrane Database of Systematic Reviews reported that CBT delivered in primary care settings is more effective than usual care for anxiety disorders.

3. CBT for Post-Traumatic Stress Disorder (PTSD)

CBT, particularly TF CBT (trauma focused CBT), is recommended for individuals with PTSD.

4. CBT for Insomnia

CBT for insomnia (CBT-I) is recognized as a first-line treatment for chronic sleep difficulties.

5. CBT for Irritable Bowel Syndrome (IBS)

CBT has been adapted to help manage symptoms of IBS, demonstrating significant improvements in gastrointestinal symptoms and quality of life.

These findings underscore CBT's versatility and effectiveness as a therapeutic approach for various mental health and medical conditions.

Is CBT Right for You?

CBT can be helpful for many people, whether you’re dealing with anxiety, depression, stress, confidence, interpersonal relationships, or just want to improve your thought patterns. If you find yourself struggling with challenging thoughts or habits that are holding you back, CBT could be a great tool to explore.

A trained therapist like those at EMDR Therapy Nashville can guide you through the process, tailoring CBT techniques to your unique situation. The good news? The skills you develop in CBT don’t just help in therapy sessions—they can benefit you for life.

If you’re interested in learning more about CBT or want to explore whether it’s right for you, reaching out to a therapist is a great first step. You don’t have to stay stuck in unhelpful patterns—change is possible.

Would you like to learn more? Feel free to contact our office to schedule a consultation.

Julianna Young https://www.theseoanswser.com
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