Cognitive behavioral therapy (CBT) is a structured form of talk therapy that focuses on helping people see the connections between their thoughts, emotions, and behaviors. A therapist utilizing CBT can help clients identify the negative or problematic core beliefs that could lead to patterns of unhealthy or unwanted behaviors. Then, the work focuses on changing these beliefs and shifting negative behaviors to improve mood.

CBT can be used to treat a variety of mental health concerns, including depression, anxiety, substance use disorders, relationship problems, and stressful life situations.

Is CBT for Depression Effective?

Hundreds of scientific studies have proven that CBT can be incredibly effective in treating depression, and that combining CBT treatment with medication leads to better outcomes than medication on its own. Further, the relapse rate of those who went through CBT was lower than those who only took medication.¹

Benefits of CBT for Depression

CBT is one of the first-line therapies for depression because of its many advantages, including the way it helps people modify the beliefs or patterns that may be contributing to depression, leading to long-term change.

Here are some of the benefits of CBT for depression:¹

• CBT can be used on its own or in conjunction with other therapy modalities
• CBT changes the underlying beliefs that may have contributed to depression, reducing the change of recurrence
• CBT can be used to address a wide variety of problems for people of all ages, from individual habits to relationship concerns
• CBT increases the likelihood that someone will stick to other recommended treatments as well, including medication

Potential Drawbacks of CBT for Depression

CBT has very few risks or drawbacks. However, for some people, starting therapy can bring up negative feelings that they may have been avoiding, or they may get upset during therapy appointments. Therapists are trained to help people work through these feelings, as well as teach new skills for processing negative emotions as they arise.

Others may find that CBT can help with surface-level problems but does little to address some of their deeper wounds or traumas. In these cases, other forms of trauma-focused therapy may be a better fit. Additionally, people with severe depressive symptoms or suicidality will likely need more intensive treatments than CBT on its own to manage symptoms.

If you are feeling suicidal or experiencing a mental health crisis, please reach out for immediate support by contacting your local emergency services, visiting your local emergency room, or calling/texting the National Crisis Hotline at 988.

Common CBT Techniques Used to Treat Depression

There are dozens of CBT techniques that a therapist might employ depending on your specific symptoms and needs, but much of CBT involves taking a deeper look at the connections between your thoughts, emotions, and actions.

Here are just a few examples of techniques you might encounter when you start CBT for depression:

Cognitive Restructuring

The heart of CBT involves identifying and challenging the negative core beliefs that could be contributing to some of the depressive symptoms. CBT therapists call these negative beliefs “cognitive distortions,” which could include all-or-nothing thinking, overgeneralizing, or catastrophizing. Spending time “restructuring” by replacing the cognitive distortions with statements built on truth can help people form healthier thought patterns.

This is often done using the “ABCDE” model:²

• Activating event: What event caused the negative belief to show up
• Belief: The full negative statement triggered by the event
• Consequence: The feelings you have related to the activating event and negative belief
• Disputing the belief: What evidence do you have that the belief is true? What evidence do you have that it’s false?
• Effective new belief: This is the new, replacement thought for when the negative belief pops up

Behavioral Activation

Depression often leads to low motivation and loss of interest in activities that you used to enjoy. A therapist can help you identify these activities and help you come up with tactics to re-engage, even when you don’t feel like it. This could be starting small, such as taking a walk around the block before starting work, and working your way up to larger goals, like going to a weekly yoga or art class.

Part of this exercise could also include tracking your mood before and after completing the activity, helping you realize that engaging in life again really does help you feel better, building positive momentum.

Structured Problem-Solving

Problems of any shape and size can feel overwhelming, especially when depression is causing low mood and lack of motivation. Problem solving strategies involve breaking something down into the smallest, most manageable tasks possible, then starting to tackle those things one-by-one.

CBT therapists might use the acronym SOLVE:

• Select & identify the problem: Boil the problem down to a clear statement
• Generate Options: Consider all the ways you could start to approach the problem
• Rate the Likely outcome of each option: Think through any potential issues or barriers that may arise after attempting that solution
• Choose the Very best option: After weighing them out, then you must actually follow through on the option you chose
• Evaluate how well it worked: Consider whether the problem is resolved, and if not, what else needs to change

Thought Journaling

Journaling gives you a space to get all your thoughts out onto a page, where you can then identify thought patterns and core beliefs. Your therapist might give you specific journaling prompts to help you start to untangle some of the thoughts and feelings you have around your depression or other life situations. They might ask you to gather evidence for and against a certain negative core belief or cognitive distortion, or do a quick entry with how you’re feeling every morning and evening.

What to Expect During a CBT Session for Depression

Cognitive behavioral therapy gives clients a space to talk openly with a skilled mental health professional about the issues they’re facing. A CBT therapist will offer non-judgmental attention and affirmation, then help you identify shifts you can make to start rewiring some of your thought patterns.

Some of the work may feel difficult, but it’s important to remember that sticking with therapy will help you feel better in the long run and get out of the ruts caused by your depression.

Here’s what you can expect during a CBT session:³

• Your therapist will gain a deeper understanding of the issues you’re facing, symptoms you’re noticing, and any other concerns you have. Then, you’ll work together to identify the goals you have for therapy.
• Your therapist may ask several questions to learn more about your current thought patterns, helping you better identify and understand your negative core beliefs. You’ll likely spend some time determining how these beliefs impact your day-to-day feelings and behaviors.
• Your therapist will help you find ways to start changing your thoughts and actions to boost positive emotions. You may work through specific exercises together, such as the ABCDE or SOLVE techniques mentioned above, to really understand these patterns and start making shifts in your thinking.
• You’ll likely be assigned some homework, like filling out more ABCDE worksheets at home, answering some journaling prompts, or doing one “behavioral activation” activity per day between therapy sessions.

How to Get the Most Out of CBT for Depression

CBT has been proven to help people with depression feel better, but it’s important that you put in some effort to really see those changes take place. While parts of your therapy journey might feel difficult, it’s important to stick with it.

Here are a few ways to get the most out of your CBT sessions:⁴

• Remember that you and your therapist are on the same team: Your therapist wants to help you feel better and work through the thought patterns that are keeping you stuck. Even when this feels challenging, having trust and rapport with your therapist is proven to be one of the key factors in therapy being successful (so if you don’t feel this connection, you may want to try someone else).
• Be as honest as possible: Be sure to share what’s working and what isn’t as you go through the process so your therapist can tailor sessions to what will be most helpful for you. You won’t hurt your therapist’s feelings if you give them feedback about what wasn’t helpful; in fact, that’s one of the key ways you can build trust and ensure you’re getting the most out of your time together.
• Follow your treatment plan: Depression can make it incredibly difficult to stay motivated, but sticking with your plan is the best way to start feeling better. This means going to therapy and doing your homework, even when you don’t feel like it.
• Be patient: You may feel worse when you first start therapy, as it’s bringing up negative emotions that you may have been burying. Stay open to the process and remember that you won’t feel better overnight, but look for any small wins you can hold onto as you build upward momentum.

CBT as Part of a Larger Treatment Plan

CBT is a common, effective type of therapy, but many therapists pull CBT techniques into a more “eclectic” treatment plan that uses several modalities. A therapist may utilize strategies from CBT like activity scheduling and behavioral activation, while also incorporating ideas from acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), or interpersonal therapy (IPT).

Your therapist will work with you to determine which modalities and strategies are most helpful for your situation.

How Long Can I Expect CBT for Depression to Last?

CBT typically takes place over a limited number of sessions, though the exact number will depend on your needs and the intensity of symptoms you’re experiencing. A typical range is between five and 20 appointments, but you can talk to your therapist about what you’re experiencing and decide together what makes the most sense for you.

Northeast Health Services Depression Treatment in Massachusetts

If you’re looking for depression treatment in Massachusetts, our team of empathetic mental health professionals are here for you. Our clinics offer therapy, medication management, and other evidence-based treatments for depression that can all work to target your symptoms of depression and help you start to feel better.

Fill out a brief form or call 508.794.8711 to learn more about how we can help. If you’re already a client, find your office location and contact them directly.

 

Footnotes:

1. Gautam, M., Tripathi, A., Deshmukh, D., & Gaur, M. (2020). Cognitive Behavioral Therapy for Depression. Indian journal of psychiatry, 62(Suppl 2), S223–S229. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_772_19
2. Serafini G, Costanza A, Aguglia A, Amerio A, Placenti V, Magnani L, Escelsior A, Sher L, Amore M. (2023). Overall goal of Cognitive-Behavioral Therapy in Major Psychiatric Disorders and Suicidality: A Narrative Review. Med Clin North Am. 107(1):143-167. https://pubmed.ncbi.nlm.nih.gov/36402496/
3. Cognitive Behavioral Therapy (CBT). (2022). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/21208-cognitive-behavioral-therapy-cbt
4. Cognitive Behavioral Therapy. (2025). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610