Counselling vs Therapy vs Psychotherapy: What’s the Difference?
Counselling, therapy and psychotherapy overlap, but they are not identical. What each involves, who provides it in the UK and how to choose what suits you.
CBT Explained: What to Expect From Cognitive Behavioural Therapy
Cognitive behavioural therapy explained: how CBT works, what sessions involve, homework and techniques, what it helps with, how long it takes and its limits.
Key takeaways
- CBT focuses on how thoughts, feelings and behaviours connect, and on practical change now.
- It is structured, time-limited and includes practice between sessions.
- NICE recommends CBT for many conditions, including anxiety disorders and depression.
On this page
Cognitive behavioural therapy (CBT) is one of the most widely used and researched talking therapies in the UK. It’s practical and structured, and many people like that it gives them tools they can use straight away.
How CBT works
CBT is based on the idea that thoughts, feelings, physical sensations and behaviours are connected, and that unhelpful patterns can keep problems going. For example: “I’ll embarrass myself” (thought) → anxiety (feeling) → avoiding the party (behaviour) → the fear never gets tested.
CBT helps you notice these patterns and try different responses. The aim isn’t to “think positive”, but to see situations more accurately and act in ways that help.
What sessions are like
- Structured: each session usually has an agenda.
- Focused on the present: it looks mainly at current problems rather than the past.
- Collaborative: you and your therapist set goals together.
- Practice between sessions: exercises to try in daily life.
A typical 50–60-minute session starts with a check-in and a look at how your practice went, then works through one or two topics and ends by agreeing what to try next. Some therapists use short questionnaires each week to track progress.
A typical course
- Assessment: you talk about what’s troubling you, how it affects your life and what you want to change.
- Formulation: together you map the cycle of thoughts, feelings, sensations and behaviours that keeps the problem going.
- Active work: most sessions tackle a specific problem with a technique, then plan a real-life step.
- Relapse prevention: towards the end you write a plan for setbacks, so you can keep using the skills on your own.
A course often runs between six and twenty sessions.
Common techniques
| Technique | What it involves |
|---|---|
| Thought records | Writing down situations, thoughts and feelings to spot patterns |
| Cognitive restructuring | Questioning unhelpful thoughts and finding balanced alternatives |
| Behavioural experiments | Testing predictions in real life |
| Graded exposure | Facing feared situations step by step |
| Behavioural activation | Scheduling rewarding activities to lift low mood |
Types of CBT
| Type | Often used for |
|---|---|
| Guided self-help | Milder anxiety and low mood, working through CBT materials with a practitioner’s support |
| High-intensity CBT | Moderate to severe difficulties, with a qualified CBT therapist |
| CBT for insomnia (CBT-I) | Long-term sleep problems |
| Trauma-focused CBT | Post-traumatic stress disorder (PTSD) |
| CBT with exposure and response prevention | Obsessive-compulsive disorder (OCD) |
What CBT can help with
NICE recommends CBT for a range of difficulties, including anxiety disorders, depression, OCD, panic and some sleep problems. See also counselling for anxiety.
Is CBT right for you?
CBT may suit you if you want practical tools and clear goals, are willing to practise between sessions and are dealing with a specific problem such as panic, worry or low mood. It can feel less suitable if you want to explore your past in depth, or if life is so chaotic right now that regular practice isn’t realistic. A good therapist will talk this through with you at assessment.
Limitations
CBT requires active participation and practice, and not everyone finds its structured style suits them. Some people prefer an exploratory approach such as person-centred therapy. Our overview of counselling vs therapy vs psychotherapy compares approaches.
Accessing CBT
CBT is widely available through NHS Talking Therapies and privately. Accredited CBT therapists are often registered with BABCP, which keeps a register you can search. The title “CBT therapist” isn’t protected in the UK, so check training and registration before you book; see how to find a counsellor in the UK.
CBT is also the main recommended therapy for panic disorder; see panic attacks: what helps. For trauma, EMDR is another NICE-recommended option.
Frequently asked questions
How long does CBT take to work?
Many people notice changes within several sessions, especially if they practise between sessions. A full course often takes a few months.
Is CBT available on the NHS?
Yes, through NHS Talking Therapies and other NHS services.
Does CBT ignore the past?
Not entirely. It focuses on the present, but your therapist may look at how earlier experiences shaped the beliefs you hold now.
Can I do CBT on my own?
Guided self-help and CBT-based books and apps can help, particularly for mild difficulties. For moderate or severe problems, a therapist is usually recommended.
Sources
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