Types of Therapy
Cognitive Behavioral Therapy (CBT): How It Works
What Is CBT Therapy, and How Do You Find a CBT Therapist You Can Afford?
CBT therapy (cognitive behavioral therapy) helps you notice automatic thoughts that are inaccurate or harmful, question them, and change the behavior patterns that keep you stuck. NIMH calls it the "gold standard" psychotherapy for anxiety disorders and an evidence-based therapy for depression. SAMHSA lists 11,636 mental health facilities that offer CBT (October 2026), so most clinics in the finder provide it, including many with a sliding fee.
Cognitive behavioral therapy, usually shortened to CBT, is the therapy mental health facilities list more than any other. SAMHSA lists 11,636 of its 12,467 mental health facilities as offering it (October 2026). If you’ve been told to “try CBT,” this guide explains what happens in it, what it’s used for, and how to get it without paying more than you can manage.
How CBT Therapy Works
NIMH describes CBT in one sentence: it helps you become aware of automatic ways of thinking that are inaccurate or harmful, question those thoughts, understand how they affect your feelings and behavior, and change self-defeating patterns.
In practice, that has two halves.
- The cognitive part is about thoughts. You learn to catch a thought such as “I always mess things up,” question it, and see how it shapes your feelings and actions.
- The behavioral part is about actions. You change what you do, such as slowly facing situations you’ve been avoiding, or adding activities that help your mood.
Ask your therapist at the start how sessions will run and what the goals are. NIMH lists tracking emotions and behaviors, building coping and problem-solving skills, and mindfulness and relaxation among the elements therapists commonly use.
What CBT Is Used for
NIMH names CBT for a wide range of conditions, and the version a therapist uses is often tailored to the condition. NIMH says CBT works best when customized to the specific disorder.
| Condition | How CBT is adapted | What NIMH or the VA says |
|---|---|---|
| Generalized anxiety disorder | Questioning worry and changing avoidance | The “gold standard” psychotherapy |
| Panic disorder | Learning to react differently to the body sensations of panic, including interoceptive exposure | Attacks can become less frequent |
| Social anxiety disorder | Exposure plus practicing social skills, sometimes in a group | Group CBT can offer unique benefits |
| OCD | Exposure and response prevention (ERP) | Effectively reduces compulsions, even for people who don’t respond well to medication |
| Depression | Challenging unhelpful thoughts and changing behavior; newer versions add mindfulness or target insomnia | An evidence-based therapy for depression |
| PTSD | Cognitive Processing Therapy, a trauma-focused cognitive therapy | Among the most effective talk therapies; usually about 8 to 16 sessions |
The condition guides go further: anxiety therapy, therapist for depression, therapist for OCD and PTSD therapy.
CBT for Anxiety
NIMH calls CBT the “gold standard” psychotherapy for generalized anxiety disorder, panic disorder and social anxiety disorder, because it has been well studied.
For anxiety, CBT often includes exposure therapy, which NIMH describes as a type of CBT. You spend short periods, with support, facing the things that trigger fear, and keep going until the fear goes down over time. For panic, NIMH says CBT teaches you to react differently to the physical sensations of an attack, such as a racing heart, and the attacks can become less frequent. For social anxiety, CBT also helps you learn and practice social skills.
NIMH says exposure therapy for panic may be paired with relaxation exercises and breathing training.
CBT for Depression
NIMH lists CBT and interpersonal therapy as evidence-based therapies for depression. With CBT, you learn to challenge and change unhelpful thoughts and behaviors to ease depressed and anxious feelings. NIMH notes that newer forms of CBT add mindfulness, or focus on specific symptoms such as insomnia.
For milder depression, NIMH says psychotherapy is often tried first, with medication added if needed. People with moderate or severe depression are usually prescribed medication as part of the first plan. A clinician can help you decide what fits.
Where to Find It: CBT by State
SAMHSA's FindTreatment.gov lists 11,636 mental health facilities with this service (cbt) across 55 states and territories, checked October 2026. Pick a state for its facilities, cities and treatment agency.
CBT for PTSD and Trauma
The VA’s National Center for PTSD names Cognitive Processing Therapy, Prolonged Exposure and EMDR as the most effective talk therapies for PTSD. They usually last about 8 to 16 sessions. All three are trauma-focused, which the VA explains means the work centers on the traumatic event and what it means to you.
In these therapies, you either talk or think through the memory until it becomes less upsetting, or you work on changing unhelpful beliefs about the trauma. Cognitive Processing Therapy teaches you to evaluate and change upsetting thoughts about the trauma. The VA says it usually takes 12 weekly sessions, and almost all VA medical centers offer it in their PTSD programs; the PTSD therapy guide covers where else to find them.
CBT for Children and Teens
CBT is also used with children and teens, often with parents involved. NIMH suggests asking any therapist whether they have experience with your child’s age group and condition, and how parents or caregivers will take part in treatment. For OCD, NIMH notes that children may need extra help from family members and providers to manage symptoms.
Start with your child’s pediatrician, who can rule out medical causes and refer you. If your child has Medicaid, the federal EPSDT benefit covers medically necessary mental health care for children under 21. SAMHSA lists 8,115 facilities that serve children and teens. The child and teen therapist guide has more.
Variations of CBT
NIMH notes that many therapies are variations of an established approach like CBT. Ones you may hear about:
- Exposure therapy, for anxiety disorders and phobias.
- Exposure and response prevention (ERP), for OCD.
- Cognitive Processing Therapy, for PTSD, which the VA lists among the most effective PTSD therapies.
- Acceptance and commitment therapy (ACT), which NIMH describes as taking a different approach than CBT: accepting thoughts without judgment and focusing on meaningful activities. NIMH says research supporting it for generalized and social anxiety is growing.
- Dialectical behavior therapy (DBT), which NIMH says was developed for borderline personality disorder and teaches skills for intense emotions and relationships. See the DBT guide.
There’s no FDA-style approval process for therapies. That’s why NIMH suggests asking any therapist what approach they use and what evidence supports it.
How to Find a CBT Therapist
Because CBT is so common, the hard part is usually finding someone trained in the version you need, at a price you can pay. Take these steps in order:
- Decide how you’ll pay. Medicaid, Medicare, job-based or Marketplace insurance, or none.
- Make a short list. Filter the mental health care finder by CBT, payment and telehealth, or ask your insurer for in-network therapists.
- Ask about training. Ask whether the therapist is trained in CBT for your concern, such as ERP for OCD or exposure for panic.
- Ask about structure. NIMH suggests asking about goals, the expected number of sessions and how progress will be assessed.
- Ask about cost. Fees, insurance and whether there’s a sliding scale.
- Check the license with your state board using the license check guide.
Psychologists, clinical social workers, licensed counselors, marriage and family therapists and psychiatrists can all provide CBT when trained in it. The psychiatrist vs therapist guide explains how the license types differ.
Paying for CBT at Low or No Cost
CBT is billed as psychotherapy, so it’s covered wherever talk therapy is covered.
- Medicaid is the single largest payer for mental health services in the U.S., according to Medicaid.gov. SAMHSA lists 10,558 facilities that accept Medicaid. Details vary by state; see the Medicaid therapy guide.
- Medicare Part B covers individual and group psychotherapy from psychologists, clinical social workers, marriage and family therapists and mental health counselors, among others. After the deductible, you pay 20% of the Medicare-approved amount. See the Medicare therapy guide.
- Marketplace and job-based plans must cover psychotherapy, and parity rules keep copays and visit limits for mental health in line with medical care. The insurance coverage guide explains your rights.
- No insurance. SAMHSA lists 5,770 facilities with a sliding fee or payment help and 1,479 community mental health centers. NIMH also points to university and medical school training clinics and state or county health department programs.
- Group CBT. SAMHSA lists 10,595 facilities offering group therapy, another way to get CBT.
The low-cost care checker shows which of these fit your state and coverage, and the therapy cost guide covers what you’ll pay without insurance.
When CBT Isn’t Enough on Its Own
NIMH says treatment for depression and anxiety typically involves psychotherapy, medication or both. CBT can be used alone, or alongside medication from a prescriber. If you’ve been in therapy for a reasonable time and aren’t improving, NIMH suggests raising it with your therapist and, if needed, trying another professional or approach. The anxiety medication guide explains what FDA has approved.
If you’re having suicidal thoughts or are in crisis, don’t wait for your next session. Call or text 988, or chat at 988lifeline.org, any time. Veterans can dial 988 and press 1. If someone is in immediate danger, call 911. NIMH notes that therapists can help you create a safety plan, and the crisis line finder lists local crisis lines.
Frequently Asked Questions
How Many Sessions of CBT Will I Need?
It depends on the condition and the plan. For PTSD, the VA says trauma-focused talk therapies such as Cognitive Processing Therapy usually last about 8 to 16 sessions. NIMH suggests asking your therapist at the start what time frame or number of sessions they recommend and how progress will be assessed.
Does CBT Work by Video?
NIMH says psychotherapy for depression and anxiety disorders can be effective in person or through telehealth. SAMHSA lists 10,324 facilities offering telehealth (October 2026). See the telehealth therapy guide.
Is CBT Covered by Insurance?
CBT is psychotherapy, so it falls under the same coverage as other talk therapy. Marketplace plans must cover psychotherapy and counseling, Medicare Part B covers individual and group psychotherapy, and Medicaid covers mental health care with details set by each state.
What Is the Difference Between CBT and DBT?
NIMH says DBT, dialectical behavior therapy, was developed specifically for people with borderline personality disorder; it uses mindfulness and teaches skills to control intense emotions, reduce self-destructive behaviors and improve relationships. SAMHSA lists 8,628 facilities offering DBT (October 2026). The DBT guide explains who it's for.
Can I Do CBT Without a Therapist?
NIMH notes that web-based programs and mobile apps can offer information and feedback without a therapist, and that a provider may use digital tools to support therapy. If symptoms are getting in the way of daily life, NIMH suggests talking with a health care provider.
Is CBT Used With Medication?
Often. NIMH says treatment for depression and anxiety disorders typically involves psychotherapy, medication or both, and that even when medication relieves symptoms, psychotherapy can help with specific issues such as self-defeating thinking or irrational fears.
More on Types of Therapy
- DBTWhat DBT is, who it helps and how to find a program
- EMDREMDR for trauma and PTSD and how to find it
- Telehealth TherapyHow telehealth therapy works and what covers it
- Psychiatrist vs TherapistWho prescribes, who provides therapy, and which license to check
- AnxietyThe therapies NIMH describes for anxiety disorders and how to find one near you
- DepressionTherapy for depression, who provides it and how to pay for it
This guide explains mental health care in plain language from official sources. It isn't medical advice; a licensed clinician can assess what care fits your situation.
Sources
- NIMH: Psychotherapies
- NIMH: Depression
- NIMH: Generalized Anxiety Disorder: What You Need to Know
- NIMH: Panic Disorder: What You Need to Know
- NIMH: Social Anxiety Disorder: What You Need to Know
- NIMH: Obsessive-Compulsive Disorder
- NIMH: Borderline Personality Disorder
- VA National Center for PTSD: PTSD Treatment Basics
- VA National Center for PTSD: Cognitive Processing Therapy
- Medicare.gov: Mental Health Care (Outpatient)
- HealthCare.gov: Mental Health and Substance Abuse Coverage
- SAMHSA FindTreatment.gov listing data, checked October 2026