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Cognitive Behavioural Therapy (CBT): What’s the Evidence?

Mental health problems are serious and widespread. We need therapies that work.

We know that CBT is a leading therapy, which works very well for lots of different problems. These problems include depression, anxiety, insomnia, PTSD, OCD, and many others. CBT is also helpful for some physical health conditions. CBT can be used with individuals, groups and couples, and in many different settings. For more about what CBT is like, you can read our page on What is CBT?

We know that CBT works well because it is based on evidence from research and clinical practice. The science behind it is strong. We want to share knowledge and understanding about CBT, so that more people experiencing mental health problems get the best care. As part of this, we want people to understand the science, so they can see why CBT could be helpful for them or their loved ones.

CBT and Science

  • The field of CBT is committed to using scientific methods to better understand:
  • How to make sense of different mental health problems
  • How best to help with different mental health problems
  • Who CBT works best for and
  • How CBT works.

One of BABCP’s core values is to use an evidence-based approach. This means understanding what evidence is available about an approach, and using what works best. This commitment to science has enabled the field of CBT to progress into many different areas with confidence.

What do we mean by evidence?

When we talk about the evidence base we are mostly referring to research studies which have been carried out and written up in academic journals which are peer-reviewed. This means that the quality of the articles has been checked by other researchers working in similar fields. It is important that research studies have strong, robust designs. This is so that we can be confident that the therapy being tested is very likely to work well for a range of people. It also means we can be confident that any improvement is due to the treatment we are testing, and not something else. If you are interested and want to find out more about different types of research study you could read our therapist’s guide to research.

Studies might explore things like:

  • Does a CBT work for a particular problem?
  • Is CBT cost-effectiveness? (can services afford it?)
  • How does CBT work?
  • How do people feel about the treatment?
  • Who does the treatment work best for?

Why is evidence important?

Just as with any treatment for a problem, it is important to know what works and for whom? It is also important to make sure that a treatment is not harmful. This helps people to make decisions about which type of therapy to have. We have some links and references to some of the evidence for CBT listed below.

An absence of evidence for something doesn’t mean it necessarily doesn’t work, it may just be that those studies have not been done yet.

Sometimes people debate the evidence which is available, and this helps to advance our understanding of what works for whom.

The available evidence for a treatment grows and changes over time. Sometimes recommendations for treatment change in response to this.

It’s important to know that not every therapy works for everyone, and there are alternatives to CBT on offer. Being able to choose what therapy you want to have is also important.

What is the evidence for CBT?

There is wide-ranging research evidence showing the effectiveness of CBT for many different people and problems. It is widely recommended across the world. We are continually learning and developing treatments and approaches.

A useful review and overview of some of this evidence can be found in the following two chapters.

Chapters

For a helpful review of evidence for CBT try Chapter 10 in Layard, R., & Clark, D. M. (2015). Thrive. Princeton University Press.

This book by Corrie and Lane is really useful and the authors and publisher have kindly given access to Chapter 1 Understanding Cognitive Behaviour Therapy

Corrie, S., & Lane, D. A. (2021). First Steps in Cognitive Behaviour Therapy. SAGE Publications Limited. Chapter 1

For more technical information about CBT’s evidence base you are also welcome to read our guide to evidence for therapists which contains references to more academic articles.

How do I find out more about the evidence base for different types of problem?

There are lots of different types of therapy and it can be confusing to know which one to choose. When claims are made that a particular approach is effective, it is important to establish the source of the claims so you can see if these claims are reliable. One helpful and reliable source in the UK is the NICE guidelines.

NICE Guidelines

What are NICE guidelines?

The National Institute for Health and Care Excellence, also known as NICE, regularly reviews the evidence for different problems and publishes guidelines for addressing each problem based on this evidence. NICE Guidelines are used to recommend what treatments get offered in England and Wales. They are also referred to internationally.

In addition, in Scotland the Scottish Matrix (2011) sets out the available evidence base for psychological therapies for common mental health problems, and in Wales the Matrics Cymru has also been developed.

CBT is recommended in many of these guidelines and is a treatment provided by the NHS for many problems. If you want to read about the specific guidelines for a particular problem you are experiencing, you can go to www.nice.org.uk and search for the guidance summary for that problem.

Listen

For more information on specific problems you can also listen to our podcast series, ‘Let’s Talk About CBT’. These have interviews with clinicians and people who have experienced CBT firsthand, and in all of the episodes the clinician gives a brief review of the evidence base for that problem.

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