By: Regina Perez, MA Intern

Using Self-Directed CBT at Home
Cognitive behavioral therapy (CBT) is a popular and proven technique to treat anxiety and depression. The beauty of CBT is that you don’t have to meet with a therapist to use it—self-help CBT is a great way to practice CBT at home and build new neural pathways.
CBT is a short-term treatment aimed at developing skills to help alter emotional responses that are harmful to your well-being. Your therapist will help you change the thoughts and behaviors that trigger or worsen your anxiety and depression. Because thoughts come before feelings, and feelings lead to actions, changing your thoughts can reduce or eliminate your negative emotions and unhealthy behaviors.
What Should I Expect From CBT?
The focus in CBT-oriented sessions is on understanding what is happening inside you when emotional problems arise and helping you do the same. This is about increasing your own awareness of how you think and what you do when you are stressed, anxious, depressed, or in pain. What topics does your brain focus on? Can you tell that you are going down a rabbit hole of worry? How do you talk to yourself when you’re depressed and feeling like you can’t get out of bed?
Awareness is the front door to change, and by being aware of your reactions, you now can begin to change them—both the thoughts and the behaviors.
That being said, the change is not immediate. If you do use self-help CBT to change your thoughts and/or behaviors, you should expect that your feelings will stay the same for a while. For example, you may feel guilty you didn’t volunteer for that committee at work even though you said to yourself that you really don’t have the time. This is because emotions lag behind thoughts and behaviors.
In order for CBT to truly work, you’ll need to repeat these new thoughts and behaviors many times before your brain can build new circuits. You also need to deliberately pat yourself on the back, in spite of how you feel, for breaking old thought and behavioral patterns. This all takes practice!
So, what can we do outside of therapy to quiet our inner critic? How can we reframe negative thoughts that affect our mood? That’s where self-directed CBT comes into play.



How Do I Use CBT at Home?
1. Locate the problem and brainstorm solutions: Journaling and talking with your therapist can help you discover the root of your depression. Once you have an idea, write down in a simple sentence exactly what’s bothering you and think of ways to improve the problem. Writing down a list of things you can do to improve a situation can help ease depressive feelings. For example, if you’re battling loneliness, action steps to try might include joining a local club or group based on your interests or calling a friend.
2. Identify the negative thought and challenge it: Begin by identifying feelings and negative thoughts that frequently come to mind. Start to question those thoughts by analyzing the beliefs behind it.
Next, test and challenge the negative thoughts by separating the thoughts from reality. Ask yourself, “Is this thought really true?”
Finally, begin to change the negative thoughts into a realistic, positive replacement. Remember these positive self-statements and repeat them back to yourself when you notice the little voice in your head creeping in to slay a positive thought. In time, you’ll create new associations, replacing the negative thoughts with positive ones.
3. Find new opportunities to think positive thoughts: People who enter a room and immediately think, “I hate that wall color,” might instead train themselves to locate five things in the room that they feel positively about as quickly as possible. Set your phone to remind you a few times a day to reframe your thoughts into something positive. You can also buddy up with someone else working on the same technique. That way, you and your buddy can get excited over having positive thoughts and experiences to share with each other throughout the day.
4. Finish each day by visualizing its best parts: At the end of each day, practice gratitude by writing down the things in your life you’re most thankful for. Recording positive thoughts, and even sharing those thoughts online, can help you form new associations in your mind or create new pathways Someone who’s created a new pathway of thinking might go from waking up in the morning thinking, “Ugh, another workday” to “What a beautiful day it is.”
5. Learn to accept disappointment as a normal part of life: Disappointing situations are a part of life, and your response can affect how quickly you can move forward. A better approach might be to allow yourself to feel disappointed and remember that some things are out of your control. Work on what is within your control: Write down what happened, what you learned from the experience, and what you can do differently next time, watching out for overly negative thoughts. This can help you move on and feel better about your future.



Self-Help CBT in a Nutshell
Cognitive
- Learning to identify your thought patterns.
- Discovering how your thoughts affect your feelings and behaviors.
- Determining if your thoughts are accurate or rational.
- Replacing biased thoughts with more realistic ones.
Behavioral
- Scheduling activities for yourself that bring you enjoyment and a sense of accomplishment.
- Recognizing how your actions influence your thoughts and emotions.
- Planning ways to make the best use of your time.
- Breaking down big, daunting tasks into smaller, more manageable ones.
- Facing your fears gradually and systematically so they diminish.
Practice CBT At Home… Or Anywhere!
As you’ve probably noticed, these approaches seem doable. This is what makes CBT so effective. It isn’t so much the novelty of the interventions but the systematic approach and emphasis on practice.
You can begin to practice these skills whenever those troubling thoughts and emotions begin to flood you. CBT is about learning to control your brain rather than your brain controlling you. It’s about you learning to run your life.
Implementing these self-help CBT techniques can lower your anxiety, improve your mood, and provide you with skills that you can use as often as you need them.