Cognitive behaviour refers to the way our thoughts (cognitions) and actions (behaviours) interact and influence how we feel and function in daily life. It’s the foundation of Cognitive Behaviour Therapy (CBT), which is based on the idea that:

 

• Our thoughts affect how we feel.

• Our feelings influence how we behave.

• Our behaviours can reinforce our thoughts, creating helpful or unhelpful cycles.

 

For example, if someone thinks, “I’m not good enough,” they might feel anxious or sad, which could lead them to avoid social situations.

That avoidance then reinforces the belief, “See? I can’t handle it,” and the cycle continues.

 

CBT helps people identify and challenge unhelpful thoughts, replacing them with more balanced and realistic ones, which in turn can lead to more positive behaviours and emotional outcomes.

 

It’s widely used to support people with depression, anxiety, trauma, and even physical health conditions where mindset plays a role in recovery.

 

 Common Cognitive Symptoms

These relate to how a person thinks, remembers, and processes information:

• Memory loss or forgetfulness

• Difficulty concentrating or making decisions

• Confusion, especially in new environments

• Trouble planning or completing tasks

• Language or speech difficulties

 

 Common Behavioural Symptoms

These are changes in how a person acts or responds to situations:

• Withdrawal from social or daily activities

• Repetitive behaviours or speech

• Irritability or mood swings

• Avoidance or refusal to engage in tasks

• Changes in sleep, appetite, or hygiene

 

 

 

These symptoms can appear in conditions like depression, anxiety, dementia, or trauma-related disorders, and they often overlap. For example, someone with major depression might show both cognitive symptoms (like slowed thinking) and behavioural ones (like staying in bed all day).

 

Cognitive Behaviour Therapy (CBT) is a structured, evidence-based psychological treatment that helps people understand the relationship between their thoughts, feelings, and behaviours. It’s grounded in the idea that “how” we think about situations influences how we feel and what we do, so by changing unhelpful thought patterns, we can change our emotional responses and behaviours too.

 

Here’s a quick breakdown of how CBT works:

Identify unhelpful thoughts – These may include negative self-talk, distorted thinking (such as catastrophizing or black-and-white thinking), or core beliefs formed from past experiences.

Challenge and reframe – You learn to question whether these thoughts are accurate or helpful, and to replace them with more balanced, realistic alternatives.

Practice new behaviours – CBT encourages testing out alternative ways of thinking through real-world behavioural experiments, reinforcing positive change.

 

It’s commonly used to treat anxiety, depression, PTSD, phobias, and even chronic pain or insomnia—and it pairs beautifully with mindfulness and creative therapies.

 

Cognitive Behaviour Therapy (CBT) uses a toolkit of practical techniques to help people shift unhelpful thought patterns and behaviours. Here are some of the most widely used ones:

 

1. Cognitive restructuring (or reframing) – This involves identifying distorted thinking (like catastrophizing or overgeneralizing) and challenging those thoughts to develop more balanced alternatives.

 

2. Behavioural activation – Often used for depression, this technique encourages scheduling enjoyable or meaningful activities to counteract withdrawal and low mood.

 

3. Thought records – Clients track situations, emotions, automatic thoughts, and alternative responses to build awareness and practice reframing in real time.

 

4. Exposure therapy – Gradual, controlled exposure to feared situations or stimuli helps reduce anxiety and avoidance behaviours, especially in phobias or PTSD.

 

5. Problem-solving training – Clients learn structured steps to approach challenges, thereby improving their confidence and reducing feelings of overwhelm.

 

6. Socratic questioning – Therapists use guided questions to help clients examine the evidence for and against their beliefs, promoting insight and cognitive flexibility.

 

7. Behavioural experiments – These are real-life tests of beliefs (e.g., “If I speak up in a meeting, I’ll embarrass myself”) to gather evidence and challenge assumptions.

 

8. Relaxation and mindfulness techniques – These support emotional regulation and help clients stay grounded when working through distressing thoughts.

 

9. Guided discovery – This involves gently questioning clients to help them explore alternative perspectives and uncover underlying beliefs. It’s like allowing someone to become a curious detective of their mind.

 

10. Imagery-based techniques – These include visualising feared situations (imaginal exposure) or using positive imagery to reinforce strengths and coping strategies. Great for clients who respond well to creative or sensory approaches.

 

11. Core belief work – This goes deeper than surface thoughts to address long-standing beliefs like “I’m not good enough” or “I must be in control.” Techniques include belief testing, schema work, and compassionate reframing.

 

12. Values clarification – Clients explore what truly matters to them, which can guide goal-setting and behavioural choices. This is especially helpful in recovery coaching or when motivation is low.

 

13. Role-playing – Practising difficult conversations or new behaviours in a safe space helps build confidence and reduce anxiety.

 

1. Activity scheduling and mastery logs help track progress. They also boost a sense of achievement. This is especially useful for clients with low motivation or self-worth.

 

15. Graded task assignment – Breaking down overwhelming tasks into manageable steps to build momentum and reduce avoidance.

 

1. Acceptance strategies – Traditional CBT focuses on change. Newer methods like ACT (Acceptance and Commitment Therapy) use mindfulness and acceptance. They help clients deal with distressing thoughts in a different way.

 

Cognitive Behaviour Therapy (CBT) is known for its structured, present-focused, and goal-oriented approach. However, it is just one of many therapy types. Each type has its own strengths based on the client’s needs, preferences, and goals.

 

We blend techniques—for example, combining CBT’s thought-challenging with ACT’s values work or DBT’s emotion regulation.

 

Hybrid approaches that combine Cognitive Behaviour Therapy (CBT) with other modalities are becoming increasingly popular, especially for clients with complex or layered needs. These integrative models draw on the strengths of CBT—like structure, goal-setting, and cognitive reframing, while weaving in complementary techniques to deepen emotional insight, enhance flexibility, or support trauma recovery. Here are some compelling examples:

 

1. CBT + Psychodynamic Therapy 

Known as Integrative Cognitive Therapy, this approach blends CBT’s present-focused strategies with psychodynamic exploration of unconscious patterns and early life experiences. It’s especially useful for clients who benefit from both symptom relief and deeper emotional insight.

 

2. CBT + Dialectical Behaviour Therapy (DBT) 

   DBT builds on CBT by adding mindfulness, distress tolerance, and emotion regulation skills. This combo is powerful for clients with emotional dysregulation, such as those with borderline personality disorder or complex trauma.

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3. CBT + Acceptance and Commitment Therapy (ACT) 

   ACT shifts the focus from changing thoughts to accepting them and committing to values-based action. When paired with CBT, it offers a flexible toolkit that balances cognitive change with psychological flexibility.

 

4. CBT + Mindfulness-Based Cognitive Therapy (MBCT) 

   Originally developed to prevent depression relapse, MBCT integrates mindfulness practices with CBT techniques. It’s ideal for clients prone to rumination or chronic stress.

 

5. CBT + Eye Movement Desensitisation and Reprocessing (EMDR) 

   For trauma work, CBT can be paired with EMDR to address both cognitive distortions and somatic memory processing. This hybrid is often used in PTSD treatment plans.

 

6. CBT + Art or Narrative Therapy 

   Especially relevant to your interests, this blend allows clients to externalise thoughts and emotions creatively, while still applying CBT’s structured reflection and reframing. It’s an excellent fit for trauma-informed or neurodivergent clients.

 

7. CBT + Schema Therapy 

   Schema Therapy expands CBT by targeting deeply rooted patterns (schemas) formed in childhood. It’s particularly effective for personality disorders or long-standing relational issues.

 

Here are a few compelling case studies that illustrate how hybrid CBT approaches are applied in real-world setting.

 

CBT + Compassion-Focused Therapy (CFT)

A case study involving an older adult with complex mental and physical health issues combined CBT with CFT to reduce depression and anxiety. The therapist employed a case formulation approach to tailor interventions, blending cognitive restructuring with compassion-based imagery and self-soothing techniques. This helped the client shift from harsh self-criticism to a more nurturing internal dialogue.

 

CBT for Insomnia + ACT for Chronic Pain

In a group treatment model, clients with both insomnia and chronic pain received a hybrid of CBT-I (sleep education, stimulus control) and ACT (mindfulness, values-based action). The result? Significant improvements in sleep efficiency, pain acceptance, and reductions in anxiety and catastrophising. This model showed how blending structured CBT with ACT’s flexibility can address both physical and emotional distress.

 

Self-Regulation CBT (SR-CBT) for Difficult-to-Treat Depression

A client with recurrent, treatment-resistant depression benefited from a high-dose SR-CBT model that integrated first-, second, and third-wave CBT elements. Over a 10-month acute phase and a 15-month maintenance phase, the client experienced improved mood stability and reduced reactivity to setbacks, despite a previous non-response to standard cognitive-behavioral therapy (CBT).

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Cognitive Behavioural Therapy                  

Focus: Identifying and changing unhelpful thoughts and behaviours               

Best For: Anxiety, depression, PTSD, OCD, insomnia, and behaviour change

 

Psychodynamic Therapy 

Focus: Exploring unconscious patterns and past experiences                   

Best For: Long-standing emotional issues, relationship patterns, and self-awareness

 

 

Humanistic Therapy

Focus: Emphasising personal growth, self-acceptance, and authenticity    

Best For: Self-esteem, identity, existential concerns      

                       

Dialectical Behaviour Therapy (DBT)

Focus: Combining CBT with mindfulness and emotional regulation skills

Best For: Borderline personality disorder, emotional dysregulation, self-harm

 

 

Acceptance & Commitment Therapy (ACT)

Focus: Encouraging acceptance of thoughts and commitment to values-based action.

Best For: Chronic pain, anxiety, depression, and life transitions

 

 

Mindfulness-Based Therapies

Focus: Cultivating present-moment awareness and non-judgmental acceptance

Best For: Stress, relapse prevention, anxiety, depression