Cognitive behavioral therapy (CBT) is the most widely used evidence-based treatment for depression and anxiety.

In CBT, the focus is on thoughts, and how they directly affect emotions, and behaviors. If you are having a lot of negative thoughts, you are likely to have a lot of negative feelings.

During cognitive behavioral treatment, you and your therapist will work together to identify problem areas in cognitions and behavior while collaborating actively on treatment plans to meet your goals. CBT requires active participation from the individual, both in sessions and in-between sessions. Behavioral experiments are often utilized and assigned in-between sessions to test thoughts and challenge, for example, avoidant behaviors. CBT is designed to empower the individual through in-session and in-between session exercises.

Things you can expect when doing cognitive behavioral therapy (CBT):

You and your therapist will become collaborators
In CBT, you and your therapist will work together as a team. The therapist and you will discuss what you would like to change in your life, how to best accomplish these changes, and how to go about actually achieving these changes. You and your therapist will also collaboratively decide on what kind of change would be healthy and realistic. As you work to reach your goals, your therapist will guide you, hold you accountable, and support you and your work.

Focus is primarily on the present
In contrast to traditional therapy, CBT focuses on the problems you are encountering in your life today. Occasionally, discussion of earlier trauma, childhood, previous patterns of behaviors, and interpersonal relationships will be warranted to uncover core beliefs about self.

There is an emphasis on problem-solving
CBT is practical. If one of your goals is to reduce depressive feelings, you and your therapist may agree that engaging in more activities is likely to help. Challenging some of the avoidant behaviors that are often present in depression, can help introduce positive experiences into your daily life. In this case, you may spend some of the session talking about potential activities and how you can overcome potential barriers to engaging in those activities. Thus, one of the primary features of CBT is that the focus is on concretely helping you to reach your goals.

I am a doctoral-level licensed psychologist in North Carolina; I have expertise in various evidence-based treatments for adults and am committed to providing scientifically validated interventions. I work with a diverse population, including trauma, insomnia, mood disorders, anxiety, and relationship problems. I take my work and clinical specializations seriously and continue to devote a considerable amount of time and effort to advance my training and professional development. For your convenience, my services are provided via telehealth.

Dr. Sara Michelson
Licensed Psychologist Chapel Hill N.C.

Patterns of thought will be addressed
Cognitive-behavioral therapy addresses negative and unhealthy thought patterns. Our thoughts contribute greatly to our mood, our level of emotional distress, and other emotions. Your therapist may teach you different ways to think about situations that are problematic for you.

You will learn new skills
CBT typically helps individuals address anxiety, depression, relationship problems, etc. by teaching new skills and ways of coping. For example, someone with social anxiety may work to improve the skill of tolerating being in anxiety-inducing social situations. Someone who is prone to extreme worry may work on the skill of talking themselves through their anxiety. Someone with depression may try to improve their ability to engage in behavioral activation. Research has shown that improvements of these skills, can help to alleviate significantly psychological distress.

What are some of the strategies used in CBT?

In CBT, the focus is on thoughts and behavior. Some of the strategies used include:
• Identifying problematic thoughts and thought patterns that are keeping you stuck
• Changing your relationship to the problematic thoughts by accepting their presence and challenging their accuracy
• Developing balanced alternative views to initial interpretations of events
• Learning new problem-solving and emotion regulation skills
• Building motivation and ability to engage in productive and meaningful behavior through exercises

In terms of the current pandemic, CBT lends itself well to telehealth and is a good way to examine some of the anxieties and feelings of frustration that we all are likely to currently be experiencing.