CBT and Depression

By Jaime Grainger – MFT, Intern

verified by Psychology Today

Every year about 7% of the population will experience depression. Depression can often include feelings of worthlessness or guilt, experiencing hypersomnia or insomnia, fatigue, poor concentration, having a hard time making decisions, decreased motivation, and suicidal thoughts. While these symptoms can leave one feeling helpless there is help and available treatment methods.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is an empirically supported treatment method that focuses on how one’s daily thoughts affect and contribute to certain feelings and behaviors. This treatment method is often utilized short term and focuses on specific problems such as relationship distress, health concerns, and other intrusive thought patterns that one may be struggling with.

CBT is also known for helping one develop more balanced ways of thinking and coping.  It involves a mix of talk therapy and hands-on exercises such as worksheets, journaling, etc.

Types of CBT:

There are many types of CBT that can be utilized during therapy. As a brief overview, these can include:

  • Rational Emotive Behavior Therapy (REBT): Involves identifying underlying irrational beliefs, challenging these beliefs, and learning to recognize and change these thought patterns in the present and future.
  • Cognitive TherapyThis form of therapy is centered on identifying and changing inaccurate or distorted thinking patterns, emotional responses, and behavior.
  • Dialectical Behavior Therapy: This type of cognitive therapy addresses thinking patterns that lead to impulsive behaviors and incorporates strategies such as emotional regulation, mindfulness, distress tolerance, and interpersonal effectiveness as coping methods.

CBT’s efficacy in helping with depression:

In various studies, CBT has been proven to be a beneficial approach to the treatment of depression. This was predominantly seen in Ellen Driessen and Steve Hollon’s (2010) study, which involved looking into the efficacy of CBT in the treatment of depression and the preventative role it can play in symptom relapse.

The researchers expanded upon several large studies that sought to test the benefits CBT can have on treating depression. They explain that during trials clients were given one of the following: a placebo pill, CBT, psychotherapy, or antidepressant medications. In looking at the results it was found that the majority of participants best benefitted from the utilization of CBT in treating depression and preventing future depressive symptoms.

It was further found that the reason CBT proved to be reliable in treating depression is due to the fact that it strongly aides in challenging inaccurate belief patterns that can contribute to the maintenance of depression.

Lastly, in other studies expanded upon by Driessen and Hollon (2010) it was found that CBT also helped clients by preventing depressive relapses and was seen to be as beneficial as medications for those suffering from a form of severe depression.

What to expect in therapy:

Cognitive Behavioral therapy approaches often involve a collaboration between the therapist and the client. Therapy sessions focus on how feelings, thoughts, and behaviors are contributing to negative moods. During sessions, the therapist will also often work with the client to gain insight around problematic thought processes and help the client identify which thoughts have become the most disturbing to the client’s life.

Identifying trigger situations is typically the first step, preceded by identifying what distorted or irrational thought happens during these situations, and what emotional response it leads to.  Strategies involve evaluating the thought for evidence to support the thought or evidence to disprove it. Last we look at what a realistic alternative go-to thought moving forward might be.

Being that a large part of CBT involves challenging irrational beliefs, during session one also confronts beliefs that are unhelpful and are sustaining a problem. This is often done with a therapist and supported via worksheets outside of therapy. During sessions, the therapist may also assist the client by challenging thought processes through direct or indirect ways.

  1. Direct = openly discussing with the client why a belief may prove to be irrational.
  2. Indirect = Utilizing questions in order to uncover why a belief may be irrational or contributing to a problem that is constantly had within the client’s life.

Feel interested but want to know more? Feel free to check out the video posted below for a visual perspective on how this may be utilized within therapy.

Any of this sound familiar? Interesting? Like a good fit for you? If so CBT may be a good therapeutic approach to consider.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Driessen, E. & Hollon, S. 2010. (3): 537–555. doi: 10.1016/j.psc.2010.04.00

Gans, S. (2019, August 31). Retrieved from https://www.verywellmind.com/what-is-cognitive-behavior-therapy-2795747

Gehart, D. (2010). Mastering Competencies in Family Therapy.


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