FAQs

CBT is an evidence-based psychological treatment that is proven to be effective in the treatment of a variety of problems including anxiety, depression, relationship concerns, substance use problems, mental illness and eating disorders.

CBT’s core principles include viewing psychological problems as a result of unhelpful thinking patterns and learned behavior. The cognitive aspect of treatment involves identifying unhelpful thinking patterns and restructuring thoughts into more adaptive thinking. The behavioral aspects include strategies to change behavior and improve coping skills.

Clients can expect to learn new skills that can be practiced in everyday life to help challenge and change their negative thinking and problematic behavior and emotions.

The CBT therapist can help the client explore and monitor their thoughts so they can learn how their thoughts drive their emotions and behavior.  Clients learn to identify various types of distortions in thinking that contribute to depression and anxiety in order to replace negative thoughts with more constructive thoughts. Changing negative thoughts to more accurate and balanced thinking can help reduce symptoms of anxiety and depression and improve mood and outlook on life.

During your first appointment, the CBT therapist will work collaboratively with you to understand what your goals are for treatment.  The CBT therapist will explain how CBT can be applied to specific problems and how learning new skills in therapy can also be practiced outside of therapy to help you make changes.

CBT is a structured, time-limited, problem focused treatment that normally lasts between 8 – 20 sessions for the treatment of anxiety and depression.  Some individuals experience improvement in symptoms in as little as 4-6 sessions. The duration of treatment can vary depending on complexity and severity of the problem.

CBT treatment for OCD involves a combination of cognitive restructuring with Exposure and Response Prevention (ERP). This consists of providing psychoeducation to the client about communication problems between the front part of the brain and the deeper parts. In OCD, the brain provides false information and sends a “danger” signal, which elicits the obsession or compulsion as a protective response. The only way to change how the brain functions is to practice doing something different.  By slowly introducing the person with OCD with the situations or objects that trigger their compulsions and obsessions and teaching the client to delay their response to the trigger, clients can gain a sense of control.  Through the exposure, clients learn that the messages they are receiving that are contributing to the obsession and compulsion are incorrect. ERP can assist clients to better cope with their anxiety understanding that they are experiencing sensations which are not dangerous, which allows them to challenge the accuracy of their thoughts contributing to OCD. It is important to note that the treatment of OCD is paced in accordance with the client’s goals.

CBT is different from other therapies as it is highly structured and focuses on problem solving. Instead of therapies where clients speak freely for extended periods, CBT allows the therapist to more quickly help clients to identify maladaptive thinking contributing to their problems and set goals. One of the main benefits of CBT is that clients learn skills to become their own therapists and identity connections between their thoughts and behavior, which can be used beyond the therapy room and throughout their lifetime.  CBT is also present oriented in addressing current problems rather than other therapies that focus on exploring an individual’s past.

CBT is effective in managing stress as it allows individuals to examine thoughts and behaviors that contribute to stress. CBT can help change negative ways of thinking and faulty beliefs that contribute to anxiety-provoking situations.

For children, CBT can involve play therapy activities such as arts, crafts, role playing or puppets, that can assist children in staying engaged while exploring solutions to problems.

CBT can be useful to teenagers in increasing their awareness of how they can modify unhelpful thinking patterns. CBT can help teens better manage social situations, increase emotional regulation and reduce anxiety, fears and phobias.

Tips for finding the right CBT therapist include:

• Ensure you feel comfortable with the therapist and that they understand your needs
• A CBT therapist should be open to answering questions about CBT and have specialized training
• Consider what mode of therapy would work best for you (in person, virtual, telephone)
• Consider other factors such as gender, race, and cultural background
• Learn about the psychotherapy fees and different options that may work for you for the duration and frequency of sessions

There are several benefits to virtual CBT such as receiving services from the comfort of your home, avoiding travel time, having greater flexibility in scheduling, and the availability of appointments outside of regular business hours. Virtual therapy is also more accessible for people in remote communities. Some people also chose virtual therapy when they feel intimidated by in-person interactions.

In-person CBT can allow for a more personal connection and quicker development of trust and rapport between the client and the therapist.  In-person therapy may be better suited for clients who experience severe mental illness or have more intensive treatment requirements.

As humans, feeling anxious is normal from time to time. Some signs that one may need to seek therapy for anxiety include symptoms of feeling overwhelmed, irritability, restlessness, struggle to maintain or build relationships, heart palpitations, and fatigue. If you notice that any one of these signs is getting in the way of your basic lifestyle, it is important to reach out and talk to a professional for help and guidance.

CBT, also known as Cognitive-Behavioural Therapy, is the best treatment of choice for social anxiety. CBT is an evidence-based therapy that explicitly targets anxiety disorders, such as social anxiety disorder, panic disorder, generalized anxiety disorder, and agoraphobia. Social anxiety is a disorder that is built upon social situations, such as negative evaluation, offending others, or embarrassment. Using CBT to treat social anxiety will increase one’s understanding of anxiety, promote balanced thinking, reduce anxious thoughts, boost coping skills, reduce avoidance, and more.

Generalized anxiety disorder, also known as GAD, is a type of anxiety that carries symptoms of excessive anxiety and worry about a number of activities and events, having difficulty controlling anxiety, and additional symptoms of restlessness, fatigue, irritability, difficulty concentrating muscle tension, and sleep disruption. If any of these symptoms are persistent for months, if not years, it is best to seek help for therapy and talk to your doctor/psychiatrist. Symptoms may often fluctuate over time and worsen over certain times of stress.

• Anxiety is the body’s reaction to any actual or perceived danger. It is a natural feeling that every human feels from time to time. If your anxious symptoms are getting in the way of your day-to-day life, creating difficulty to manage or focus on tasks, it is vital to use coping strategies to take control of the situation.
• Some of the best strategies for managing anxiety include deep breathing, exercise, grounding techniques, mindfulness, and connecting with others. Breathing practices can help slow your heart rate, which should help you calm down. Exercise can also help calm your mind and boost your mood, such as walking or doing yoga. Grounding techniques involve being aware of the present to disrupt future oriented anxious thinking. Mindfulness is a form of relaxation that allows you to stay engaged with your actions and bring your attention back to where you are. Some forms of mindfulness include meditation and body scan.
• In some cases, anxiety can make one isolate themselves from the world and people around them. Connecting with others for support can help one feel less alone. For example, try contacting friends, family, or a therapist.

• A panic attack is often characterized by recurrent feelings of extreme anxiety or uneasiness that are associated with a range of physical symptoms such as dizziness, trembling, palpitations, and chest pain, feeling unreal, and feelings of impending doom. Additional signs of a panic attack include irrational thinking and a fear of going mad or losing control, this triggers what is called a secondary fear, a catastrophic misinterpretation of your symptoms that reinforce the fear cycle.
• Oftentimes, once one has had a panic attack, you will fear that you’ll have another one. This may result in avoiding situations where they have occurred in the past.
• Panic attacks can be challenging to manage on your own and may become worse without treatment. Cognitive-behavioural therapy (CBT) is the most recommended form of treatment for those struggling with panic attacks or diagnosed with panic disorder. CBT consists of assorted therapeutic strategies and interventions, including psychoeducation, muscle relaxation, cognitive restructuring, interoceptive exposure, and in vivo exposure. CBT treatment traditionally lasts anywhere between 8-12 weeks. With great involvement in one’s treatment, CBT can allow one to develop the best coping strategies to use on their own once terminated from treatment.

Burnout, chronic stress, and emotional exhaustion can come in different forms and to all individuals undergoing work-related, personal, social, physical, or mental stress. Burnout is often associated with compassion fatigue and moral stress. Oftentimes, burnout occurs when work stress is combined with additional stressors that exceed the ability to cope, further resulting in mental and physical distress. The results of poor coping with burnout and chronic stress can lead to worsened symptoms as well as addiction, depression, and more. Stress and burnout have become increasingly common around the world. Treatment for chronic stress and burnout involves multi-faceted approaches such as CBT strategies, lifestyle adjustments, mindfulness, emotion-regulation practices, and a strong support system. Making that first step to seek help and support is crucial to getting on the right path to further alleviate and address such factors and symptoms of stress and burnout.

Post-traumatic stress disorder (PTSD) is a condition that is caused by experiencing, being part of, or witnessing an extremely stressful or terrifying event. Signs of PTSD include flashbacks, constant hypervigilance, severe anxiety, nightmares, and uncontrollable thoughts about the event. CBT can help with PTSD to aid clients in reducing symptoms and improving overall functioning. Psychoeducation is shared to facilitate relaxation and provide greater understanding for the patient. Further, CBT allows clients to re-evaluate distorted thinking patterns, such as the expectation of catastrophic outcomes. CBT also provides exposure for the client to reduce avoidant behaviours, return to a sense of control and self-confidence, and provide predictability.

Effective CBT can help improve relationships with family, friends, peers, and/or acquaintances. CBT is intended to help couples, families, or individuals evaluate their thinking, correct their communication, and focus on the important aspects of their relationships. CBT can also help with any misunderstandings that may potentially arise. The first step is to recognize what is primarily important to yourself and the relationship. What are your values? What are the other individuals’ values? How can you foster collaboration? What are some alternatives to resolving conflicts that have arisen or may potentially arise? All questions one or the relationship can work on to get to the end goal of working all matters out and being on the same page. CBT can help you identify, evaluate, and modify those helpful and unhelpful thought processes and behaviours to eventually manage any day-to-day or heightened problems one may be having.

Self-esteem is known as one’s overall perception and assessment of one’s worth as a person. This can include feelings, attitudes, and beliefs about themselves. Self-esteem plays a crucial role in one’s well-being and functioning. It can affect our confidence, the ability to handle pressured situations, and happiness. There is a variety of causes of low self-esteem, including negative self-talk, social comparisons, depression, anxiety, and childhood experiences. CBT can help those individuals who struggle with low self-esteem and negative talk by changing disruptive thinking patterns and ineffective behavioural patterns that may be keeping us stuck in the dysfunctional loop. Some specific interventions that CBT can implement for these individuals include cognitive restructuring, systematic exposure, problem-solving skills, and mindfulness training. CBT is a very versatile approach and carries essential tools to challenge negative beliefs about one’s identity. If you are struggling with these issues, it is appropriate to seek help to avoid worsening your symptoms.

CBT is one of the most effective ways of managing anger. CBT is known for addressing any unhelpful thoughts and behaviours that are disrupting one’s lifestyle and for cases of anger, heightening anger. CBT can help one manage and initiate healthier responses and reactions to any triggers that often cause such intense emotions. CBT for anger often includes providing psychoeducation to clients to further understand the great cause of their anger and how, as a team, we can address it. Cognitive restructuring is another excellent source of CBT, which allows one to question and alter their immediate thought processes. Instead of responding with anger, CBT helps to replace those responses with a calmer and more controlled behaviour/emotion. In addition, behavioural strategies such as deep breathing, grounding techniques, and progressive muscle relaxation are practical tools to calm those physical responses. CBT also involves assertiveness training, exposure training, and self-reflection. Combining all CBT resources allows one to develop skills and strategies for dealing with, managing, and lowering anger levels.

• Fear is a feeling that is rooted in our body’s way of telling us that there may be an impending threat to our well-being or safety. While fear can be helpful in some cases, there are other times that fear is less helpful. Fears such as rejection may prevent one from seeking opportunities that could be valuable for the future self.
• Phobias are rooted in anxiety and are known for unwarranted fear of a specific situation or object. Individuals with specific phobias will often do anything they can to avoid being in a scenario with their fear. The initial causes for phobias and fears may come from past experiences that have haunted us to the present. This being said, CBT is a common source of treatment for fears and phobias. CBT urges you to face your fears through exposure treatment. Exposure treatment has been shown to be effective in patients with extreme phobias to social anxiety. In conjunction, CBT also tackles your thoughts and cognitive distortions related to your fear or phobia via cognitive restructuring.

CBT helps individuals recognize and manage their thoughts, feelings, and behaviors related to the loss. CBT helps individuals manage grief by addressing negative thought patterns that can exacerbate feelings of sadness and hopelessness. By reframing these thoughts, individuals can achieve a more balanced perspective, leading to reduced distress and improved coping.

Furthermore, this type of therapy helps individuals navigate grief by:

1. Normalizing Reactions: Educating individuals about the normalcy of grief reactions and reducing feelings of isolation.
2. Identifying Triggers: Recognizing specific triggers that intensify grief and developing strategies to manage them.
3. Enhancing Coping Skills: Building a toolkit of coping strategies to handle grief-related stressors effectively.
4. Promoting Self-Compassion: Encouraging self-compassion and reducing self-blame often associated with loss.
5. Facilitating Meaning-Making: Helping individuals find meaning and purpose in their grief journey, which can foster acceptance and growth.

1. Reid Wilson offers a variety of self-help guides, educational videos, programs, online courses, and treatment options for a variety of anxiety problems: https://anxieties.com/
2. Think CBT provides an abundance of therapy worksheets and exercises that you can work on to supplement to your therapy sessions.
   Free CBT Worksheets | Cognitive Behavioural Therapy Exercises | the Think CBT Workbook
3. The Beck Institute offers a wide variety of resources including this worksheet packet:
   Worksheet-Packet-2020-Web (1).pdf
4. Check out this CBT anxiety skills workbook!
   The-Anxiety-Skills-Workbook.pdf
5. DBT Self Help | Self-serve resources for the DBT community offers self help resources for mindfulness, distress tolerance, emotional regulation
6. The Mindful Method YouTube channel has great video resources to provide you with practical tools and strategies that you can apply to your daily life to help you better manage your thoughts, emotions, and behaviors
   (Master the Mind) Intro to Cognitive Behavioral Therapy – CBT
7. ACT Mindfully with Russ Harris Internationally-acclaimed ACT trainer, author of the world’s best-selling ACT book, The Happiness Trap: Russ’s ACT-based self-help book, an international best-seller, with over one million copies sold.
   Acceptance and Commitment Therapy | ACT Mindfully

His YouTube channel also has some highly useful ACT videos to help you maximise your human potential for a rich, full and meaningful life; to cultivate health, vitality and well-being through mindful values-based living.

Dr. Russ Harris – Acceptance Commitment Therapy – YouTube

CBT is often combined with other forms of psychotherapy including Acceptance and commitment therapy (ACT), Dialectical behavior Therapy (DBT), Emotion Focused Therapy (EFT), Solution Focused Brief Therapy (SFBT), Mindfulness Based Cognitive Therapy (MBCT), Somatic Psychotherapy and others. Our therapists use a person-centred holistic approach to create a specialized treatment combining psychotherapy methods to adapt to your unique experience and complex needs.

CBT is often combined with Exposure and Response Prevention to treat anxiety, panic and OCD symptoms. Exposure and response prevention (ERP) involves the client and therapist practicing confronting thoughts, images, objects, situations, or sensations that induce anxiety and trigger compulsive behaviours in a safe environment. The goal of CBT and ERP in this context is to overcome avoidance of feared stimuli that ultimately reinforce and perpetuate anxiety and OCD symptoms. By facing fears in a safe and supportive environment, the overactive amygdala in the brain learns that the stimuli (i.e. the distressing thought, image, object, situation, or sensation) are not as dangerous as once perceived, reducing subsequent distress.

CBT can be combined with pharmaceutical interventions such as SSRI (selective serotonin reuptake inhibitors) or SNRI (serotonin and norepinephrine reuptake inhibitors) in the initial phases of therapy to reduce the severity of symptoms. Once clients start to make progress in therapy, many clients choose to taper off their SSRI or SNRI medications under the supervision of their psychiatrist or doctor.

Psychotherapists can assist with medication management and help you work through cognitive and emotional changes that occur during medication reduction. By developing coping skills and tools, our therapists will guide you through increasing your distress tolerance (your capacity to handle symptoms of stress, or anxiety) while simultaneously helping you improve your well being through evidence based behavioral activation strategies that help increase positive reinforcement and minimize symptoms of depression. Both CBT and medication are effective at treating depression. However, CBT alone has shown to be superior at improving overall functioning and has fewer side effects than medications, making it a favourable long-term solution.

Mindfulness, which focuses on the present and teaches us to acknowledge thoughts non-judgmentally, is beneficial to clients when implemented as part of a self-care plan and can prevent relapse. Mindfulness and CBT complement one another since mindfulness changes how we approach negative thoughts, and CBT challenges negative automatic thoughts and proposes that thoughts and behaviours influence the way we feel. Mindfulness is often used alongside CBT once symptoms start to improve. Mindfulness meditation allows the client to notice and accept thoughts with compassion without wanting to change them or avoid them. Other mindfulness techniques, such as grounding, allow the client to get out of their head and reduce worrying about the future by redirecting attention to focus on the body in the present. Engaging in mindfulness has been shown to reduce decrease anxiety and depression and increase resilience and overall well-being.

However, it is important to note that mindfulness is not helpful when used as a distraction to avoid uncomfortable feelings.

Emotional regulation entails recognizing, understanding, and accepting one’s emotions while controlling impulsive reactions enabling individuals to navigate challenges without becoming overwhelmed or overly reactive.

Emotion regulation is critical for mental well-being because it allows individuals to handle stress, form healthy relationships, and make thoughtful decisions, even in challenging situations. Individuals with anxiety, ADHD, depression, mood disorders or neurodivergence may struggle with heightened sensitivity to emotional triggers, leading to overwhelming responses that can disrupt their daily lives and find it particularly difficult to manage emotions effectively.

Psychotherapy can be an effective tool for improving emotion regulation skills, as it provides individuals with a safe space to explore and understand their emotions under the guidance of a trained professional. Through various therapeutic approaches, individuals can develop healthy coping mechanisms and learn how to recognize patterns in their emotional responses.

Psychotherapy also helps individuals identify the root causes of their emotional challenges. For example, a therapist might help a client uncover unresolved trauma that contributes to heightened emotional reactivity. By working through past experiences, clients can begin to heal and reduce the emotional weight those experiences carry in their current lives. With time, individuals often report feeling more in control of their emotions, which can lead to improved relationships, increased self-confidence, and a more positive outlook on life.

Cognitive Behavioral Therapy (CBT) encourages clients to reframe negative thoughts, which can, in turn, lead to more balanced emotional responses. Dialectical Behavior Therapy (DBT) teaches skills like mindfulness, distress tolerance, and interpersonal effectiveness, all of which are integral to regulating emotions. Emotion-focused therapy (EFT) focus on helping individuals understand, regulate, and transform their emotions by exploring and processing emotional experiences, individuals can increase self-awareness, develop healthier coping strategies, and form more fulfilling relationships

Keeping a notebook is not only helpful for completing in session exercises and homework tasks. Notebooks can also help you and your therapist track and highlight successes that sustain motivation and subsequent successes.

Be honest with your therapist when it comes to setting up behavioural experiments, exposures, and other homework tasks. If an exercise does not catch your interest or is too overwhelming, you are less likely to complete it and more prone to setbacks. Your therapist wants you to succeed and can help break tasks down into more manageable pieces to ensure you succeed.

Write down a list of things you value as well as easy, medium, hard, and impossible goals that you want to achieve, but your symptoms get in the way of. Reviewing these values and goals (and stating with conviction that you can achieve them!) can provide extra motivation and justification during more challenging times encountered during therapy.

Be sure to reward yourself whenever you succeed. Make a list of small, medium, and large rewards that you can look forward to receiving.

Lastly, enlist the support of trusted friends, partners, or family members. These supports can help you identify triggers and unhelpful coping strategies as well as provide encouragement.

Your therapist will help you stay on track, keep you accountable and motivate you to stay committed to your mental health journey!