Cognitive-Behavioral Therapies
Jessica Chang, MHC-LP
Individual therapy is a collaborative process between therapist and client, regardless of therapeutic orientation and modality. However, the therapist’s therapeutic orientation and the client’s preference in therapeutic modality can be a determining factor in facilitating collaboration and treatment that feels effective for the client. Depending on the flexibility of the therapist and client on these topics, even with strong rapport, the efficacy of the therapeutic space may be compromised.
Therapy is a commitment. It is important for therapists and clients to be honest with the type of therapeutic modalities they are willing to invest in and work with. For clients, this means having a sense of what works, and maybe more importantly does not work, for you. This can be a tedious and frustrating process that is subject to change throughout different seasons in life, but resonating with the treatment process can strengthen the therapeutic relationship, increase clients’ feelings of growth, and positively impact motivation in therapy. It can be helpful to start with gaining an understanding of what therapeutic modalities are available. To help with this process, the following article outlines a few of the more common forms of cognitive-behavioral therapy (yes, there are different kinds!). If you are interested in learning more about psychodynamic therapy, you may refer to this previous article.
Cognitive-behavioral therapy
Cognitive-behavioral therapy combines cognitive, or insight-based, therapy with behavioral therapy, which focuses on changing one’s behaviors. This modality is problem-focused and action-oriented while also maintaining connection with current automatic thoughts and thought-patterns that influence behaviors (as opposed to exploring previous experiences and roots of present concerns, i.e. psychodynamic therapy).
Cognitive Behavioral Therapy (CBT)
CBT focuses on the connection between thoughts, feelings, and behaviors. It aims to help individuals change negative thought patterns that contribute to negative emotions and maladaptive behaviors by identifying negative thoughts and situations that cause them. By changing behavior patterns that reinforce negative thoughts and feelings and building new thinking and behavioral patterns, CBT can help clients achieve a better quality of life.
CBT is a collaborative process between the therapist and client that involves setting specific goals, developing strategies to achieve them, and monitoring progress over time. Therapists may challenge a client’s thinking and beliefs to help build problem-solving skills and promote healthier coping strategies and adaptive behaviors.
CBT is a widely practiced and evidence-based approach to therapy that has been shown to be most effective for treatment of:
Anger issues
Anxiety
Bulimia
Depression
Somatic symptom disorder
Stress
Substance abuse and relapse prevention
Dialectical Behavior Therapy (DBT)
DBT is another form of cognitive-behavioral therapy, utilizing both cognitive and behavioral techniques to help clients learn to manage their emotions, cope with distress, and improve interpersonal relationships. DBT emphasizes the balance between acceptance and change, recognizing the dialectical tension between self acceptance and the need for personal growth and behavioral change. This modality focuses on accepting and tolerating distressing experiences in the past, present, and future.
Therapists who practice DBT help clients to learn and experience the benefits of mindfulness practices, acceptance, change, and effective coping skills. This helps individuals manage intense emotions, improve interpersonal relationships, and build a higher quality life. DBT therapists assist clients in gaining insights into past behavior and learning to accept and deal with the consequences of previous actions. DBT has four core components: 1) emotional regulation, 2) distress tolerance, 3) core mindfulness, and 4) interpersonal effectiveness (to improve your relationships with others and yourself).
DBT has been shown to be effective for treating:
Anxiety
Binge eating disorder and bulimia
Borderline personality disorder
Depression
Post-traumatic stress disorder
Self-harm and suicidal behavior
Substance use disorder
Rational Emotive Behavior Therapy (REBT)
REBT is another type of cognitive-behavioral therapy. It aims to help clients challenge unhelpful thoughts in order to avoid negative emotions or behaviors. In REBT, it is a person’s beliefs and interpretations about activating events and not the events themselves that lead to emotional distress and maladaptive behaviors. REBT focuses on identifying destructive thoughts and feelings in the present to actively challenge those thoughts and replace them with more rational, realistic ones. This results in new ways of thinking and prevention of maladaptive behaviors and negative emotions.
REBT therapists may teach clients to dispute their irrational beliefs by challenging their accuracy, usefulness, and logical consistency. In REBT, irrational beliefs are extreme, illogical, and rigid, while rational beliefs are logical, flexible, and non-extreme. Through working together using various REBT interventions, therapists can help clients replace irrational beliefs with rational ones. The goal is to hopefully change your unhelpful thoughts, emotions, and behaviors before you experience an adverse outcome due to your beliefs.
Research has shown REBT to be effective for treating:
Anger, guilt, and shame
Anxiety
Depression
Disruptive behavior in children
Obsessive-compulsive disorder
Psychotic symptoms
Social anxiety disorder
Social and other phobias
Conclusion
Cognitive-behavioral therapy can be helpful in a variety of ways through many different forms of treatment. This is a non-exhaustive description of a few cognitive-behavioral therapy modalities that can be used as a baseline in determining if cognitive-behavioral therapy is for you. It can be quite insightful for your own treatment to get a sense of individual therapists and how they may conduct sessions, their therapeutic orientation, and their flexibility in incorporating different treatment modalities into practice. For more information on what different modalities may look like in practice and how it may impact your treatment, consider speaking with your current therapist or scheduling a phone consultation (which are typically free!) to begin your therapy journey or to find a new therapist who feels in alignment with you.
References
3 Types of Behavior Therapy. Red Oak Recovery. (2022).
Brice, S. (2025). Rational Emotive Behavior Therapy (REBT) for Addiction Treatment. AmericanAddictionCenters.
Dialectical Behavior Therapy (DBT). Cleveland Clinic. (2022).
Fletcher, J. (2022). What to know about rational emotive behavioral therapy. MedicalNewsToday.