Tab 3 · Cognitive Behavioral Therapy
CBT Session
A structured, evidence-based approach focused on identifying and modifying unhelpful thoughts and behaviors.
Definition
Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy that teaches patients to recognize the link between thoughts, feelings, and behaviors, and to change patterns that maintain distress.
Purpose
To reduce symptoms by replacing distorted thinking with balanced, evidence-based perspectives and by building behavioral skills that improve functioning.
When It Is Used
Effective for depression, anxiety disorders, OCD, PTSD, eating disorders, insomnia, and as an adjunct in many other conditions.
Core Concepts
- Thoughts influence feelings and behaviors.
- Cognitive distortions maintain emotional distress.
- Behavioral change strategies can shift mood and motivation.
Cognitive
Identify automatic thoughts and underlying beliefs.
Behavioral
Use action and exposure to break avoidance cycles.
Skill-Building
Structured homework consolidates change between sessions.
Mock CBT Session Transcript
An excerpt between Dr. Nabilsi and Mr. S.
Last week you mentioned the presentation. Walk me through the moment you felt the wave of anxiety.
Right before I went up. I thought, 'Everyone is going to see I have no idea what I'm doing.'
That's a powerful automatic thought. On a 0–100 scale, how strongly did you believe it?
Maybe 90.
Let's gather evidence. What facts support the thought, and what facts contradict it?
I had practiced four times. My teacher told me I was prepared. But it still felt true.
What's a more balanced thought we could try out next time?
Something like, 'I'm nervous, but I've prepared and I'll get through it.'
Great. For this week, let's track three situations using a thought record.
Automatic Thoughts Identified
- “Everyone will see I'm a fraud.”
- “If I make a mistake, it will be a disaster.”
- “I have to be perfect or I've failed.”
Cognitive Distortions Challenged
- Mind reading
- Catastrophizing
- All-or-nothing thinking
Activities Used
- Thought record (situation → thought → feeling → evidence)
- Socratic questioning
- Behavioral experiment planning
Homework Assigned
- Daily thought records (3 situations / day)
- Journaling — one balanced reframe per evening
- Behavioral activation — one valued activity scheduled this week
- Cognitive restructuring practice using the worksheet provided
Reflection
Was the session productive? Yes — the patient identified a clear automatic thought, recognized two distortions, and produced a balanced alternative.
What changed? Belief in the original thought dropped from 90 to 55 by session end after evidence review.
What goals were set? Complete three thought records this week and run one behavioral experiment before the next session.
Strengths
- Strong empirical support across many disorders.
- Short-term, structured, and measurable.
- Equips patients with lifelong coping skills.
Limitations
- Requires active patient engagement and homework completion.
- May feel rigid for patients seeking deeper exploration of past experiences.