Cognitive behavioural therapy: breaking the cycle

The most common alternative to pharmacological treatment offered to patients with depression and anxiety by the NHS is cognitive behavioural therapy, or ‘CBT’. This guide details how it works.

Source: Wayne Mclean /

Download the full print version of the infographic here

How does CBT work?

  • CBT is based on the concept that thoughts, feelings, physical symptoms and behaviours are interconnected.
  • CBT challenges people to identify unhelpful thoughts and evaluate evidence for and against them.
  • This process allows problems to be addressed more realistically, and emotions to be proportional.
  • Making a change in one of these areas can break the cycle and result in more helpful thinking patterns and behaviours. 
  • A course of CBT can be up to 20 sessions, usually once per week or fortnight, with each session lasting 30–60 minutes.


*The Improving Access to Psychological Therapies service includes a range of talking therapies, such as guided and non-guided self-help, CBT, counselling, psychoeducational peer support and mindfulness




Sources: National Institute for Health and Care Excellence, NHS, NHS Digital, Royal College of Psychiatrists,

Editorial adviser: Amanda C de C Williams, clinical psychologist and reader in clinical health psychology at University College London

Graphic: Wayne McLean

Last updated
The Pharmaceutical Journal, PJ, February 2020, Vol 304, No 7934;304(7934):DOI:10.1211/PJ.2020.20207745

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