Cognitive behavioural therapy (CBT)
Your thoughts shape how you feel. And how you feel shapes what you do. CBT helps you break that chain, in a practical and proven way.
What is cognitive behavioural therapy?
Cognitive behavioural therapy combines two perspectives: cognitive therapy, which focuses on your thoughts, and behavioural therapy, which focuses on your behaviour. Together they form one of the most researched and most firmly proven forms of therapy in the world.
The starting point is simple: your thoughts, feelings and behaviour influence each other continuously. Negative thoughts bring up unpleasant feelings, which lead to avoidant behaviour, which then confirms the negative thoughts. CBT breaks that spiral.
Scientific basis: CBT is the most researched psychological treatment worldwide. More than 2,000 clinical studies confirm its effectiveness. International guidelines from the WHO, NICE and the Dutch Trimbos Institute regard CBT as the first-choice treatment for anxiety disorders, depression and a large number of other complaints. Research shows that in the long term CBT is even more effective than medication alone.
Two parts, one approach
The cognitive part: thoughts
In certain situations, thoughts shoot through your head automatically. "I am going to make a fool of myself." "I will never manage this." Those thoughts feel like facts, but they are not. CBT teaches you to recognise them, examine them and replace them with helpful, realistic thoughts.
The behavioural part: what you do
Unwanted behaviour is learned, and can therefore also be unlearned. With anxiety you avoid situations, which keeps the anxiety in place. CBT confronts you step by step with what you avoid, so you discover it is more bearable than you thought.
How does CBT work in practice? From event to consequence
A widely used tool in CBT, known in Dutch as the 5G scheme, shows how one situation sets off a whole chain of reactions:
Event
What happens
Thoughts
What you think
Feelings
What you feel
Behaviour
What you do
Consequence
What comes out of it
Example
You have plenty of ideas during a brainstorm. But you say nothing, because you think: "My ideas are not good enough anyway." That feeling makes you uncertain, so you stay quiet. The consequence: the others miss your input, and you confirm to yourself that you have nothing to contribute.
In CBT you examine that thought. Is it true? How do you know? You practise with a different thought: "My ideas are worth sharing." And you challenge yourself to share three ideas in the next session. What actually happens then?
Which complaints does CBT work for?
CBT is one of the most broadly applicable forms of therapy there is. It is effective for:
CBT is usually given one to one, but it can also be used in couples therapy or in a group. A course of treatment takes 8 to 20 sessions on average, depending on the complaint.
What can you expect?
CBT is an active therapy. You work not only during the sessions, but also practise at home. That homework is essential: it helps you build new thoughts and behaviours into your daily life.
Together with your provider you map out which thought and behaviour patterns keep your complaints in place.
You learn to recognise those patterns, examine them and replace them step by step with helpful alternatives.
You practise actively, outside the sessions too, with behavioural experiments and exercises.
You build skills you can keep using after the treatment, which helps prevent relapse.
Related complaints
Related treatments
Frequently asked questions
Getting started with CBT
Ready to break your patterns?
Book an intake with a provider who has CBT expertise. During that conversation you will look together at whether CBT is the right approach for your situation.
CBT may be reimbursed from Dutch basic health insurance with a referral from your GP.
Sources: Butler et al. (2006), Clinical Psychology Review · NICE Guidelines Depression & Anxiety 2023 · Trimbos Institute multidisciplinary guidelines