CBT for Depression: How It Works, Examples, & Effectiveness
Cognitive behavioral therapy (CBT) is one of the most thoroughly researched psychotherapies for treating depression. In fact, research shows it's just as effective as antidepressants and more effective than your average treatment. So, what exactly is CBT? How does it work? And, who can benefit from CBT for depression?
CBT aims to reduce negative or unhelpful thoughts and behaviors common in those with depression through practical problem-solving and homework assignments. Those seeking CBT for depression will typically attend 12-20 weekly sessions, but many will experience improvements after just a few sessions.
What Is Cognitive Behavioral Therapy (CBT)?
Cognitive behavioral therapy, or CBT, is one of the most scientifically supported treatments for depression. The foundation of CBT is the connection between thoughts, emotions, and behaviors. The goal is to help you learn about your thought patterns and apply coping mechanisms that challenge negative thoughts, harmful behaviors (especially self-destructive ones), and negative attitudes.1 CBT’s core focus is on helping you take what you learn in sessions and apply those skills to your everyday life.
What Types of Depression Can CBT Treat?
Cognitive behavioral therapy (CBT) is a treatment style that can be used to treat and lessen the severity of a variety of mental health disorders. Research has shown that CBT can be effective for depressive disorders and episodes that may be impacting your life, especially in the mild to moderate range of symptoms.
CBT can be effective in treating these types of depression:
Major depressive disorder
Persistent depressive disorder (PDD)
Seasonal affective disorder
The depressive episodes of bipolar disorder
Schizoaffective disorder, depressive type
How Does CBT Help With Depression?
CBT combines cognitive and behavioral approaches to reduce depression. Therapists may challenge depressive thinking patterns that lead to inaction or self-harming behaviors by targeting both thoughts and actions. By changing how a person feels, CBT posits that each can influence the other.
Cognitive Methods to Change Depressive Thinking Patterns
Cognitive behavioral therapy teaches you to challenge and rationalize your negative thoughts, which eventually reduce their power over you. By understanding your thought patterns and emotions behind them, therapists can present a more realistic perspective of the situation to help you overcome depressive thoughts. A common depressive thought pattern is “mind reading,” where you believe you know what others are thinking. By challenging this and other depressive thoughts, it helps build a healthier pattern of thinking and self-talk.
Behavioral Methods to Improve Energy & Motivation
Behavioral methods are highly effective in treating depression, which can cause a lack of motivation or low energy. One such behavioral method rewards people for engaging in tasks like putting away dishes or two. Adding a reward makes people more likely to repeat the behavior in the future, which alters brain chemistry. Cognitive behavioral therapy employs several other behavioral methods to reduce the power of not engaging in behaviors as well.
7 Common CBT Techniques for Depression
Common CBT techniques used for depression include cognitive restructuring, thought journaling, and mindful meditation. Many of these techniques are used together to show the connections between thoughts, emotions, and behaviors.
Here are seven common CBT techniques for depression:
1. Cognitive Restructuring
Cognitive restructuring helps you learn about potential cognitive distortions and unhealthy thought patterns that could be increasing depressive emotions or suicidal thoughts. This can reduce cognitive errors, help you form healthier patterns, and practice ways to rationalize distortions.
2. Activity Scheduling
Activity scheduling is a behavioral therapy technique in which you reward yourself for scheduling low-level activities that encourage positive regard and self-care. By scheduling these activities and rewards, you learn to motivate yourself to complete necessary tasks even when you are feeling low. It also increases the chances of continuing to complete these tasks after you end your formal therapy sessions.
3. Thought Journaling
Journaling about your emotions, thoughts, and behaviors can help you identify potential triggers and discover how your thoughts influenced your behavior. This can increase self-awareness and allow you to learn coping techniques to use in the future.
4. ABC Analysis
Similar to journaling, this skill is solely focused on breaking down the behaviors that are related to depression, like snapping at people or sleeping all day.
The ABC model uses the following structure:
The “Activating” event
Your “Beliefs” about that event
The “Consequences” of the event, including your feelings and behaviors surrounding the event.
In analyzing Your triggers and consequences, you can explore the “consequential” behaviors and look to find common causes in your depressive triggers.
This technique encourages you to look at your thoughts more objectively, as they are not always grounded in reality. It should help you see that even though you may have a negative opinion of yourself, this doesn't make it true.
6. Successive Approximation or “Breaking It Down”
Breaking down large tasks into smaller goals will help you feel less overwhelmed. By practicing successive approximation, you will be more likely to complete your goals and be better able to cope with large tasks in the future.
7. Mindful Meditation
By practicing meditation for depression, you'll learn to reduce negative thoughts and stay present in the moment. Meditation can help you recognize and understand your negative thought patterns, and then let go of them.
What Is the Effectiveness of CBT for Depression?
Cognitive behavioral therapy (CBT) has been certified and monitored by the Beck Institute since its inception in 1993. The Beck Institute continues to provide training in CBT to mental health professionals and continuously monitors research on the efficacy of CBT as a treatment for various ailments.
Outside of this, many other research studies have proven the effectiveness of CBT for depression:
Studies show that the behavioral activation techniques used in CBT are useful in the treatment of those with severe depression.
When compared to antidepressant medication, CBT alone may be effective in continued recovery for depression.
Cognitive therapy shares efficacy with medication in treating moderate to severe major depressive disorder, although this can be impacted by the level of the therapist’s experience with CT/CBT.
CBT was found to be an effective intervention in lowering depressive symptoms and depressive relapse rates, especially in comparison with a control group.
A study on bipolar disorder—which includes depressive episodes and symptoms found that the group with CBT treatment had fewer bipolar episodes, shorter bipolar episodes, and less hospitalization admissions. In addition, this group’s depressed mood and mania symptoms were noted to be significantly lower.
Cognitive behavioral therapy can help alleviate depressive symptoms in many ways. In accessing CBT, whether through a therapist or by practicing at-home skills, you can start feeling a bit better and getting back to the things that are most important to you.