Cognitive Behavioral Therapy (CBT) is an effective and accessible method for supporting your mental health. CBT helps you notice thought patterns that are negative or harmful to you so that you can change the way you respond to them. This clinically-reviewed blog explains what CBT is and how it can help you get relief from symptoms of anxiety and depression. For folks who cope with mental health issues, CBT can be a helpful tool. It is recognized as one of the most evidence-based and effective therapeutic treatments available to patients. 


What is CBT?

Cognitive Behavioral Therapy (CBT) is a type of therapy that works to reduce symptoms of depressionanxiety, and other mental health issues, such as substance use disorder (SUD), post-traumatic stress disorder (PTSD), relationship challenges, stressful life situations, and many other clinical conditions. 

CBT can be used on its own, with a professional therapist or counselor, with other treatment modalities, and/or with medication. Research shows that CBT has similar effects to medication used for depression. It is effective when used on its own, but research has indicated that combining prescribed medications with CBT is often better.

How does CBT work?

There are four basic steps to using CBT to support your mental wellness. If you’re interested in trying CBT on your own, this blog offers some self-directed exercises

  1. Identify what is bothering you. First, figure out what conditions, situations, relationships, or experiences are troubling you. These issues might be outside your control, such as a mental health disorder or family member. They may also include issues such as a medical condition, relationship change, loss of a loved one, addiction, or intense emotional struggles. Choose which issue is the most important to you, and which one you would like to work on first.

  2. Notice how you’re thinking about your issues. After you’ve identified what is bothering you, write down or talk about your feelings and thoughts about them. This might look like making notes in a journal, sharing your feelings with your therapist, talking to your support group, or talking with your friend. Pay attention to not only how you interpret a specific situation, but also how you talk to yourself about it.  Notice your beliefs about yourself, other people, and your experiences. 

  3. Are your thoughts helping you or hurting you? Review how your body, emotions, and behavior changes when you are in a challenging situation. For example, your shoulders may feel tight every time you have to interact with a particular family member. Or you may notice that you say negative things to yourself every time you scroll through a friend’s social media. These patterns might actually be making your issue worse! Notice where you feel your stress and what actions—conscious or unconscious—you might be taking in response to it.

Change thought patterns that don’t serve you. This is the biggest challenge many of us take on. Working with a group, individual counselor or therapist, or friend will support you as you take on this step.  Accept that your way of thinking or behaving may not have been the best, although it was the best you could do at the time. Review your thought patterns, especially your thoughts toward yourself and your life. How can you redirect your thinking to be healthier and more loving? With practice, you can grow toward better thought patterns that feel nourishing and good to you.

How do I use CBT?

Working with a therapist, counselor, Plume Support Group, or caring friend may be helpful to getting the most from your CBT. While CBT can be effective as an individual practice, you can gain more perspective by sharing what you’re learning about yourself with someone you trust. 

We strongly recommend working with a trained licensed therapist when deciding to move forward with engaging in CBT to help manage symptoms of mental illness. We recognize that for many people, therapy may not be accessible—but you may be able to connect with a support group through your local clinic, LGBTQ center, or hospital or choose to use CBT self-directed resources.

Here are some free and low cost self-directed CBT resources you can find at the library, on your phone, or online. Each of these resources is self-directed and low-cost (or free)! 

  • Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety – This helpful workbook will support you as you practice using CBT for specific issues of depression and anxiety.

  • What’s Up? A Mental Health App – This free app includes in-app purchase ads. What’s Up? uses CBT along with acceptance and commitment therapy (ACT) to help redirect negative thoughts and feelings.

  • Free CBT worksheets – Therapist Aid provides free CBT worksheets that provide psychoeducation on the topic of CBT and worksheets designed to help individuals identify and defuse unhelpful thoughts associated with anxiety and depression. Many therapists use these worksheets, so they’re a great resource to bring to therapy if you have someone you’re working with.

If you have symptoms of mental illness, or if your mental health issues are interfering with your daily life, please seek support beyond self-guided CBT.

What is Transgender-Affirmative CBT (TA-CBT)?

To support our community, there is a special modality called transgender-affirmative CBT (TA-CBT). This type of behavioral therapy is an evidence-informed intervention developed to address the specific mental health needs of gender-diverse, gender non-conforming, trans, and/or nonbinary people. Finding a gender-affirming therapist is the first step to ensuring that your therapist is familiar with TA-CBT or would be an appropriate clinician to use TA-CBT with you. If you want to know if your therapist can help you with TA-CBT, you should ask!

TA-CBT works by helping people develop adaptive coping skills. It reduces distress that trans people may struggle with as part of their gender identity.Some of these stressors may include experiencing transphobia, discrimination, and microaggressions; navigating challenging healthcare situations; coming out to friends, family, and in the workplace; and more.