CBT Counseling: Cognitive Behavioral Therapy

CBT counseling or Cognitive-behavioral therapy is a form of psychotherapy based on the cognitive model claiming “the way individuals perceive a situation is more closely connected to their reaction that the situation itself.” The goal is to boost happiness by modifying negative thoughts, emotions, and behaviors. Unlike other forms of therapy that focus on a patients’ past, CBT counseling encourages problem-solving to change destructive thought patterns and behaviors.

CBT counseling uses a unique array of both cognitive and behavioral techniques, which vary from case to case. As we previously mentioned, the goal of CBT counseling is to create a tool belt of problem-solving skills. CBT borrows from many different therapeutic modules including dialectical behavior therapy, acceptance/commitment therapy, Gestalt therapy, compassion-focused therapy, mindfulness, motivational interviewing, positive psychology, interpersonal psychotherapy, and psychodynamic psychotherapy.

The History of CBT Counseling 

Psychiatrist Aaron Beck, M.D. developed cognitive-behavioral therapy in the 1960s. He began perceiving that a number of his patients were having internal dialogues during their sessions – internal dialogues that they weren’t too keen on sharing. Beck realized his clients were using negative thoughts in a downward spiral – often without any prompt. This “eureka” moment led Beck to find that the link between thoughts and feelings is crucial.

He created the term “automatic thoughts” in order to better describe the emotion-filled thoughts that seem to pop up out of the blue almost automatically in a certain situation. Beck continued to find that although his clients weren’t always fully aware of their negative thought cycles, they could learn to at least verbalize them. By identifying these troubling thoughts his clients were better able to understand and overcome their difficulties.

Beck originally called this practice “cognitive therapy” because of the direct correlation on thinking. The behavioral title was added as the style of therapy grew to employ behavioral techniques as well. At the end of the day, CBT theorizes that it isn’t certain events or situations that actually upset us, but rather the meaning we individuals give to that event or situation. If our thoughts revolve around too much negativity, we may be blinded from the truth – meaning that if we continue to hold onto the same negative thought patterns, we may be unable to overcome those difficulties or learn anything new.

Why We Use  CBT Counseling 

CBT counseling is often the preferred choice of therapy because it can most quickly help a client identify and cope with his/her specific challenges. It tends to require fewer sessions than other kinds of therapy and can be used to treat a wide array of issues such as:

  • Manage mental illness symptoms
  • Prevent a relapse of mental illness symptoms
  • Treat a mental illness when medications aren’t a good option
  • Learn coping techniques for stressful life situations
  • Identify ways to manage emotions
  • Resolve relationship conflicts
  • Learn effective communication skills
  • Cope with grief or loss
  • Overcome emotional trauma related to abuse or violence
  • Cope with a medical illness]
  • Manage chronic physical symptoms

The Steps of CBT Counseling

Every one of us is unique in cultivating our own life experiences. We know that one size does not fit all in therapy, however, CBT typically includes but isn’t limited to the following steps:

Step One

The first step of CBT is identifying the difficult situations and challenges in your life. Before you can approach solving the problems, you have to figure out what those problems even are. They can be a plethora of issues like a medical condition, divorce, grief, anger, or other symptoms of mental illness. As you and your therapist identify those issues you’ll begin to set which ones (and their associated goals) that you want to focus on.

Step Two

Once your issues are identified, you’ll be able to start becoming self-aware of your thoughts, emotions, and beliefs revolving around that issue. This is when you will most likely hear the cliché line of “How does that make you feel?” While it may feel a little cheesy the first time, your therapist wants to encourage communication and openness. Also by hearing out loud the negative self-talk you often give yourself, you may start thinking about it all differently. Your therapist may also ask you to start journaling your thoughts, so you can see on paper how you interpret a situation and also how you view yourself.

Step Three

Negativity identification. This is to help you recognize patterns of negative thinking or associated behavior that may be contributing to your woes. You may be asked to pay attention and note your emotional, physical, and behavioral responses in different situations. This will help you recognize your triggers outside of your sessions and help you be more mindful of solutions when you find yourself in those stressful and unpleasant situations.

Step Four

Now that those negative thought patterns are identified, it’s time to reshape them. Mental illness and other situations may try to warp your reality. Often your therapist will ask you whether your thoughts or views of a situation are based on fact or inaccurate perception of what is going on. This is a really difficult step and will take time. You may have spent a lifetime wrapped up in negative ways of thinking about both your life and yourself. However, with a strong support system, practice, mindfulness, and cultivation of self-love, in time, these new thinking/behavioral patterns will become a habit.

Getting the Most out of CBT Counseling

We want to be careful and disclaim that CBT counseling won’t be successful for everyone. However, there are a number of steps you can take to get the most out of your sessions:

CBT Counseling: One

Before you even have your first session, go into it remembering that therapy is a team effort. It is the most successful when you are an active part of the process. Also remember therapy is a two-way street. If you feel you aren’t connecting to your therapist that in no way defines you or your ability to cope. Sometimes it takes multiple sessions with a few different therapists to figure out whom you gel the most with. And there is no shame in that. Just like romantic relationships, sometimes you have to interact with a few different people in order to figure out your likes and dislikes in a therapist. Once you find a therapist that suits you, you two can set and achieve your goals together

CBT Counseling: Two

One of the hardest parts of therapy is letting your guard down and actively asking for help. It is crucial to be honest and open not only with your therapist but also with yourself. The success of your sessions will boil down to your willingness to share and openness to try coping skills.

CBT Counseling: Three

It is of the utmost importance you stick to your treatment plan. If you are on medication, please take it. Do your best not to skip therapy sessions – and if you feel you must (due to illness or another outside factor) you can always have a phone conversation with your therapist. We know there are times you will feel down or unmotivated. These are the times you truly should go to therapy as you can use those emotions and thoughts as talking points and start approaching solutions to them. The more sessions you skip, the more your progress will be disrupted.

CBT Counseling: Four

Try to remain realistic about the process and your results. Rome wasn’t built in a day, and neither will your coping skills. Working on such traumatizing and emotional issues will be painful. It will require hard work. Often times you will feel drained and maybe even worse than you did initially. It may take several sessions to get over the pain and start to change your thinking. And that is perfectly normal! As they say, “It’s always darkest before the dawn.”

CBT Counseling: Five

Do your homework. This correlates with the consistency we mentioned earlier. If your therapist asks you to read, journal, or do other activities outside of your sessions, please do your best to follow through. The homework is often meant to help you apply the things you cover in your sessions and help you begin to create new, more positive habits.

If you live outside of the South Hills of Pittsburgh, to find a therapist near you, click here.

How Can We Help You? 

Negative thoughts and behaviors can and do happen. But when we find ourselves in that negative state of mind, we may be basing our thoughts and reactions based on that negative view of the situation – often making the issue seem far much worse than it is. The goal of CBT is to help encourage problem-solving and coping skills to correct those misinterpretations. CBT can help with a number of issues and mental health disorders such as sleep disorders, depression, bipolar disorders, anxiety disorders, phobias, OCD, eating disorders, substance abuse disorders, schizophrenia, and PTSD. Cristina Panaccione and Associates Counsels have locations in the South Hills of Pittsburgh and Robinson Township in the Western suburbs. We are currently accepting a limited number of new patients, so check out our services pages to learn more about how we can help you navigate your personal roadblocks.

* This information has not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. Please contact a medical professional for advice.


When was the last time someone listened to you?  Really listened and provided active feedback.

To get started let our intake coordinator connect you with our therapist who is your best fit for your needs

Cristina Panaccione Contact Form