Cognitive Behaviour Therapy

Our rating
Adolescents 1 smiley: This treatment is useful. It is supported by scientific evidence as effective, but the evidence is not as strong.
Adults 3 smileys: This treatment is very useful. It is strongly supported as effective by scientific evidence.
Older adults 3 smileys: This treatment is very useful. It is strongly supported as effective by scientific evidence.

What is it?

Cognitive behaviour therapy (CBT) has two components: cognitive therapy and behaviour therapy. Cognitive therapy teaches people how to overcome distorted, negative thinking patterns linked with depression. Behaviour therapy teaches skills and ways to change behaviour. For example the therapist might get people to do more things that give them pleasure, help them to solve problems in their life, or teach them better social skills.

How does it work?

People who are depressed have distorted thinking patterns. They see themselves and their situation more negatively than others see it. These thinking patterns can make their depressed mood worse. In cognitive behaviour therapy, distorted thinking is challenged by the therapist who teaches the person how to overcome their negative thinking patterns in everyday life.

CBT can be delivered in different ways. For example a therapist can work with a single person or groups of people. People can also work by themselves with books or on a computer.

Is it effective?

There is a lot of scientific evidence on CBT for the treatment of depression in adults and older adults. More scientific studies on CBT for the treatment of depression in adolescents is needed.

Across all age groups CBT has been shown to be effective in the treatment of depression. People who had CBT reported lower depressive symptoms compared to people who did not have CBT. CBT and antidepressants reduced people’s depressive symptoms better than only antidepressants or only CBT. Studies have shown CBT is about as effective as other psychological interventions in treating depression.

One study in older adults found CBT had a small positive result in treating people with major depression.

Are there any disadvantages?

CBT may involve seeing a therapist weekly for several months which can be expensive. In Australia Medicare provides rebates for visits to trained therapists (see below).

CBT may not be suitable for severely depressed people because they may have difficulties concentrating and learning the new thinking skills.

Where do you get it?

CBT is provided by therapists such as clinical psychologists, psychologists or counsellors who have been specially trained to provide this therapy (see Psychologists and other therapists). In Australia, Medicare provides rebates for visits to some therapists under the Better Access to Mental Health Care scheme. CBT may also be covered by some private health insurance funds. It is available from therapists employed in hospitals or government-funded clinics. Self-help books on CBT can be bought in most bookshops and many online programs are available for free.

You can learn more about cognitive behaviour therapy techniques in moodgym and e-couch, our free online programs. 

Recommendation

CBT appears to be an effective treatment for depression and is recommended as a first choice of treatment.

Key references

  • Barth J, Munder T, Gerger H, Gerger H, Nuesch E, Trelle S,Hansjorg Z, Juni P, Cuijpers P. Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis. PLOS Medicine 2013; 10: e1001454.
  • Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer  A, Dobson KS. A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry 2013; 58: 376-385.
  • Cuijpers P, Hollon SD, van Straten A, Bockting C, Berking M, Andersson G. Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013; 3: e002542.
  • Dubicka B, Elvins R, Roberts C, Chick G, Wilkinson P, Goodyer IM. Combined treatment with cognitive–behavioural therapy in adolescent depression: meta-analysis. British Journal of Psychiatry 2010; 197: 433–440.
  • Gould RL, Coulson MC, Howard RJ. Cognitive behavioral therapy for depression in older people: A meta-analysis and meta-regression of randomized controlled trials. Journal of the American Geriatrics Society 2012; 60: 1817–1830.
  • Hetrick SE, Cox GR, Merry SN. Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit? Journal of Psychology Research and Behavior Management 2011; 4: 97-112.
  • Ma D, Zhang Z, Zhang X, Li L. Comparative efficacy, acceptability, and safety of medicinal, cognitive-behavioral therapy, and placebo treatments for acute major depressive disorder in children and adolescents: a multiple-treatments meta-analysis. Current Medical Research and Opinion 2014; 30: 971-995.
  • Pinquart M, Duberstein PR, Lyness JM. Effects of psychotherapy and other behavioral interventions in clinically depressed older adults: A meta-analysis. Aging and Mental Health 2007; 11: 645–657.
  • Simon SS, Cordás TA, Bottino CM. Cognitive Behavioral Therapies in older adults with depression and cognitive deficits: a systematic review. International Journal of Geriatric Psychiatry 2015; 30: 223-33.
  • Watanabe N, Hunot V, Omori IM, Churchill R, Furukawa TA. Psychotherapy for depression among children and adolescents: a systematic review. Acta Psychiatrica Scandinavica 2007; 116: 84–95.
  • Weisz JR, McCarty CA, Valeri SM. Effects of psychotherapy for depression in children and adolescents: a meta-analysis. Psychological Bulletin 2006; 132: 132-49.
  • Wilson K, Mottram PG, Vassilas C. Psychotherapeutic treatments for older depressed people. Cochrane Database Systematic Review. 2008; 1.

Last reviewed and updated: 1 December 2016