Introduction to Cognitive Therapy

What is cognitive therapy?
Cognitive therapy is a step-by-step method for changing your thinking. It is thinking about your thinking. Cognitive therapy has been scientifically proven to help with many of life’s challenges including anxiety, depression, and addiction.[1, 2]

External factors influence your life to some degree, but the greatest impact on your quality of life is your own thinking. It is how you interpret external factors. That is the biggest preventable cause of unhappiness in your life. Cognitive therapy helps you identify your negative thinking and replace it with healthier thinking.

Cognitive therapy helps to change the wiring of your brain. When you challenge your thinking, you create new neural pathways. A neural pathway is like a pathway in a forest, the more you use it, the clearer the pathway becomes, and the easier it is to use next time. The more you do cognitive therapy, you create new neural pathways and healthy thinking which begin to replace your old negative thinking. You begin to change the way you automatically respond to the world.[3-5]

What is negative thinking?
Any thinking that leads to negative consequences is negative thinking. Negative thinking is usually rigid, absolute, and not supported by the facts. For example, if you have low self-esteem, you may believe that you are somehow flawed, and you will tend to ignore facts that don’t support your belief.

Absolute and rigid means that you tend to take an all-or-nothing approach in your thinking and that you are resistant to change. For example, you may think that you’re a failure at everything, and you may be resistant to hearing encouraging advice from your friends.

What causes negative thinking?
Negative thinking is learned thinking. You weren’t born thinking this way. You learned to think this way by watching the people around you. You learned how to think and respond to situations through imitation. You then turned that way of thinking into a habit through repetition.

If you learned to see the world in a negative and absolute way, you will probably be negative and absolute as an adult. What you have learned you can unlearn and learn something new in its place. You can learn new coping skills and change your life.

The basic tool of cognitive therapy is the thought review. A thought review is ten questions that lead you step-by-step through the process of changing your thinking. A thought review gives you a chance to reflect on your thinking after the fact, when you’re not reacting out of fear or anger, and come up with a better way of handling a situation.

How can you get the most out of cognitive therapy?
Once you have learned how to do a thought review, you become mindful of your negative thinking during the day so that you can stop yourself from slipping into old habits. Practice challenging your negative thinking and looking for healthier alternatives.

Your thinking is not fixed. It can be changed. Once you realize that fact and get into the habit of challenging your thinking, you will begin to change your life.

What is behavioral therapy? CBT is really two forms of therapy: cognitive and behavioral therapy. Behavioral therapy is sometimes used initially with individuals who are too anxious or too depressed to even acknowledge that their thinking is part of the problem.

Behavioral therapy encourages you to try simple tasks, which gradually improve your self-esteem. Once you see that you can positively change your thinking, you may be more willing to acknowledge the role your negative thinking plays in how you feel. But in most cases, individuals are encouraged to start directly with cognitive therapy rather than behavioral therapy.

History of Cognitive Therapy

In the 1950s, American psychologist Albert Ellis introduced Rational Therapy in which people were taught the A-B-C approach for dealing with uncomfortable situations. The A-B-C approach states that when a person is confronted with an adversity A, their beliefs B, will influence the way they respond to that adversity and lead to emotional and behavioral consequences C.

If the beliefs B, are rigid, absolute, and unrealistic, the consequences C, will likely be self-defeating and destructive. If the beliefs B, are flexible and constructive, the consequences C, will likely be self-helping and constructive. People can change their lives and their consequences by D, disputing and challenging their beliefs.

Rational therapy was partly developed as a reaction to psychoanalysis, in which it was assumed that understanding your negative beliefs was the most important part of self-change.

In the 1960s, American psychiatrist Aaron T. Beck introduced Cognitive Therapy partly based on the ideas of Albert Ellis, and used it as a treatment for depression. Beck developed the idea of the thought record, in which individuals could challenge their thinking through writing their thoughts down and look for healthier ways of thinking. He also developed self-reporting measures for anxiety and depression including the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI).


1. Hofmann, S.G., et al., The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res, 2012. 36(5): p. 427-440.
2. Driessen, E. and S.D. Hollon, Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. Psychiatr Clin North Am, 2010. 33(3): p. 537-55.
3. Brooks, S.J. and D.J. Stein, A systematic review of the neural bases of psychotherapy for anxiety and related disorders. Dialogues Clin Neurosci, 2015. 17(3): p. 261-79.
4. Porto, P.R., et al., Does cognitive behavioral therapy change the brain? A systematic review of neuroimaging in anxiety disorders. J Neuropsychiatry Clin Neurosci, 2009. 21(2): p. 114-25.
5. Paquette, V., et al., "Change the mind and you change the brain": effects of cognitive-behavioral therapy on the neural correlates of spider phobia. Neuroimage, 2003. 18(2): p. 401-9.

Last Modified: February 19, 2017

Information included: Learn cognitive behavioral therapy and cbt techniques. Understand negative thinking and how it relates to anxiety and depression. Find thought review and thought record examples on how to overcome negative and distorted thinking. Also learn about the history of cognitive therapy, rational therapy and Albert Ellis and Aaron T. Beck.