How CBT Works: Understanding Its Role in Treating Anxiety and Depression

Cognitive Behavioural Therapy (CBT) is one of the most evidence-based and widely practiced psychological treatments for anxiety and depression. Rooted in the principle that our thoughts, emotions, and behaviours are deeply interconnected, CBT helps individuals break unhelpful patterns and develop healthier ways of thinking and responding. At the London Psychologist Clinic, we specialise in delivering CBT with a personalised and clinical approach, helping clients gain clarity, emotional resilience, and long-term wellbeing.

Understanding Anxiety and Depression

Before exploring how CBT works, it’s important to understand the symptoms of the two most common conditions it treats: generalised anxiety disorder (GAD) and clinical depression.

Common symptoms of anxiety may include:

• Persistent worry or a sense of dread

• Physical symptoms such as heart palpitations, dizziness, tension, or gastrointestinal discomfort

• Restlessness or difficulty concentrating

• Avoidance behaviours or compulsive checking

Depression may present with:

• Persistent low mood or feelings of sadness

• Loss of interest or pleasure in previously enjoyed activities (anhedonia)

• Fatigue, disturbed sleep, or changes in appetite

• Feelings of guilt, worthlessness, or hopelessness

• Suicidal thoughts in severe cases

These symptoms often overlap, and many individuals experience both conditions simultaneously. What they share is a pattern of negative, repetitive thinking and behavioural withdrawal, which CBT targets directly.

How CBT Works

CBT is structured, time-limited, and goal-oriented. It focuses on identifying and challenging maladaptive thoughts and behaviours, replacing them with more balanced alternatives.

The therapeutic process typically involves:

• Assessment and formulation: Understanding the client’s experience through a collaborative model that links current problems with underlying thought and behaviour patterns.

• Cognitive restructuring: Identifying distorted thinking styles (e.g., catastrophising, black-and-white thinking, overgeneralisation) and learning to evaluate them more realistically.

• Behavioural experiments: Encouraging clients to test out new behaviours, face avoided situations, and break cycles of fear or hopelessness.

• Skills training: Developing coping mechanisms such as relaxation techniques, problem-solving, assertiveness training, and mindfulness.

Sessions are active and collaborative, often involving homework tasks and practical exercises. The aim is to equip individuals with tools that promote long-term change—not simply symptom relief.

Why CBT Works: Evidence and Outcomes
CBT is extensively supported by clinical research. According to the National Institute for Health and Care Excellence (NICE), CBT is a recommended first-line treatment for both moderate to severe depression and all forms of anxiety disorders, including social anxiety, OCD, PTSD, and panic disorder.

A meta-analysis by Hofmann et al. (2012) found that CBT produced large effect sizes for anxiety disorders and moderate-to-large effects for depression. Moreover, CBT has shown long-lasting outcomes, with lower relapse rates compared to pharmacotherapy alone.

In a study published in The Lancet Psychiatry (2015), adults receiving CBT for depression were significantly less likely to relapse within 12 months compared to those receiving usual care. When combined with medication, CBT offers even greater resilience against future episodes of depression and anxiety.

The Benefits of CBT for Clients
Clients who engage in CBT often report the following outcomes:

Increased insight into their emotional responses

Improved confidence in managing stress and worry

Reduction in avoidance behaviours

Restoration of energy, motivation, and hope

Greater emotional flexibility and problem-solving skills

Unlike some therapies that delve exclusively into the past, CBT also looks forward—teaching people to identify triggers, change habits, and regain agency in their lives.

Is CBT Right for You?

CBT is highly adaptable and can be delivered in individual therapy, group settings, or online formats. It is suitable for adults, adolescents, and—in modified forms—even children. While not every individual responds the same way, its transparent, skill-building approach empowers clients to understand their difficulties and develop lasting change.

Getting Started
At the London Psychologist Clinic, our chartered psychologists offer CBT informed by the latest research and guided by a warm, collaborative ethos. Whether you are dealing with persistent anxiety, low mood, or the effects of life stress, we can help you understand the psychological processes involved—and work with you to overcome them.

To speak with a clinician or book a confidential consultation, please call 07916 293807 or email info@londonpsychologistclinic.co.uk. Evidence-based therapy, tailored to you.

References:

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

NICE Guidelines (2022). Depression in Adults: Treatment and Management.

Kuyken, W. et al. (2015). Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment. The Lancet Psychiatry, 2(6), 475–484.