Rewiring the Mind


Chapter 16: Therapy and Treatment

Learning Outcomes

  • Describe the basic principles of cognitive-behavioral therapy (CBT)
  • Identify how CBT helps individuals recognize and change negative thought patterns
  • Apply psychological reasoning to real-world therapeutic scenarios

Key Terms

cognitive-behavioral therapy (CBT)
a form of psychotherapy that aims to change cognitive distortions and self-defeating behaviors
exposure therapy
counterconditioning technique in which a therapist seeks to treat a client's fear or anxiety by presenting the feared object or situation with the idea that the person will eventually get used to it

Cody's CBT Journey

Cody, an 18-year-old freshman, had always been a perfectionist. He pushed himself hard in school, sports, and social life. But when college began, the pressure became overwhelming. Cody started experiencing panic attacks before exams. He also started making excuses for why he couldn't go to parties and other social events, convinced he'd embarrass himself. "I feel like I'm failing at everything," he told the campus therapist.

A person sitting on a bed looking down at their hands

After an initial assessment, Cody was diagnosed with generalized anxiety disorder. His therapist recommended cognitive-behavioral therapy (CBT), explaining that it could help him identify and challenge the negative thoughts fueling his anxiety.

In their first few sessions, Cody learned how thoughts, feelings, and behaviors are interconnected. He began tracking his anxious thoughts in a journal. One entry read: "If I don't get an A, I'll disappoint everyone." His therapist helped him reframe this: "One grade doesn't define me. I'm learning and growing."

As therapy progressed, Cody practiced exposure therapy, gradually facing situations he feared, like speaking up in class or attending study groups. He also learned relaxation strategies and problem-solving skills. Slowly, his confidence grew.

Cody realized that his anxiety wasn't just about stress; it was about deeply rooted beliefs he hadn't questioned. CBT gave him tools to challenge those beliefs and build healthier ones. "It's like I'm rewiring my brain," he said. "I still get anxious, but now I know how to handle it."

Explore the Concept

Check out this video to learn how CBT helps people recognize and change negative thought patterns and why it's widely used to treat anxiety and depression.

1. On Your Own

Which statements reflect the current scientific understanding of CBT? Select the two that apply.

Behind the Therapy

Cognitive-behavioral therapy (CBT) is based on the idea that our thoughts influence our emotions and behaviors. By identifying and challenging distorted thinking, individuals can reduce emotional distress and improve coping strategies. Research shows CBT is effective for a wide range of conditions, including anxiety, depression, posttraumatic stress disorder (PTSD), and insomnia.

An illustration of a tangle of knots that gradually loosens to a checkmark

Unlike medication, CBT teaches skills that can be used long after therapy ends. It's structured, goal-oriented, and often involves homework assignments. While not a cure-all, CBT empowers individuals to take an active role in their mental health.

2. On Your Own

What is the role of CBT in mental health treatment? Select the best answer.

The Healing Process

Cody continued CBT for several months. He still faced challenges—anxiety before presentations, moments of self-doubt—but he now had tools to manage them. He joined a peer support group and began journaling regularly.

A person writing in a notebook

"I used to think I had to be perfect," Cody shared. "Now I know it's okay to struggle. CBT didn't erase my anxiety, but it gave me a way to understand it and work through it."

His journey wasn't linear, but it was transformative. With time, support, and practice, Cody began to feel more confident, more resilient, and more in control of his thoughts.

Reflect & Respond

Answer the following questions to reflect on key ideas from the case study. Remember to print your work before leaving this page!

  1. How can CBT help individuals take control of their mental health?
  2. What are the benefits of learning to challenge negative thought patterns?
  3. How does this approach differ from medication-based treatments?
  4. What role did journaling and exposure therapy play in Cody's progress?
  5. Why is it important to understand the connection between thoughts, feelings, and behaviors in managing mental health?

References

Jeong, H. S., Lee, J. H., Kim, H. E., & Kim, J.-J. (2021). Appropriate number of treatment sessions in virtual reality-based individual cognitive behavioral therapy for social anxiety disorder. Journal of Clinical Medicine, 10(5), Article 915. https://doi.org/10.3390/jcm10050915
This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0).

Sprouts. (2021, September 15). Cognitive behavioral therapy (CBT) [Video]. YouTube. https://youtu.be/Jz55Uk9EH6U?si=s8frlK7Gyv7bIlmL

Photo Credits

dark_blade on Adobe Stock. "African American man sitting on bed with sad face. ai generated."

blankstock on Adobe Stock. "Tangle of thoughts, psychological stress and easy problem solving. Psychology solution concept. Confused purpose, trouble solution and think easy. Psychology path, stress reduction. Vector."

laperuz on Adobe Stock. "Young Black man writing in notebook during soft natural light."