Who this approach usually helps
- Depression
- Generalised anxiety and constant worry
- Panic attacks
- Social anxiety
- Insomnia
- Stress and the pressure of migration
- Perfectionism and harsh self-criticism
What is CBT?
CBT grew out of the work of psychologists such as Aaron Beck and Albert Ellis in the 1960s and 1970s. Beck noticed that people with depression tend to have quick, automatic negative thoughts about themselves, the world and the future, thoughts that pass through the mind without being examined. Those thoughts shape feelings and behaviour, and together they form a cycle that is hard to leave.
Today CBT is less a single technique than a family of methods built on one shared idea: we cannot always change what happens, but we can learn to see it differently and respond to it differently.
The core idea: thoughts, feelings and behaviour
Imagine you sent a friend a message and hours later there is still no reply. If you think "they must be upset with me", you will probably feel anxious or sad, and you may stop writing to them. If you think "they are probably busy", the same situation feels very different. The situation is the same; the interpretation is not.
In CBT you and your therapist identify these interpretations, treat them as hypotheses and weigh the evidence for and against them. The aim is not "positive thinking" but more realistic, more flexible thinking. The behavioural side matters just as much: activities you have dropped out of fear or low mood are brought back step by step, because real experience often convinces the mind more than any argument.
What does a CBT session look like?
CBT sessions usually have a clear structure. You start by reviewing the past week and your exercises, agree on an agenda together, work on one or two specific issues, and end by choosing a task for the coming week. The therapist is active: asking questions, explaining, and working with you as a team.
Practice between sessions is an essential part of CBT. Someone with social anxiety might fill in a "thought record": the situation, the thought that came up, the feeling and its intensity, and finally a more balanced view. Someone with depression might plan a few small, rewarding activities across the week, known as behavioural activation. The tasks are not meant to be heavy; they bring what you learn in session into your real life.
Who it helps and what the research says
CBT is one of the most researched psychotherapies, and clinical guidelines in many countries recommend it as a main treatment for depression, anxiety disorders (such as generalised anxiety, panic and social anxiety), OCD, insomnia and some consequences of trauma. Specialised versions are also used for eating disorders and chronic pain.
Still, evidence for a method does not mean it works for everyone in every situation. Results depend on many factors: the severity of the problem, your relationship with the therapist, motivation and room to practise, and life circumstances. CBT does not promise a cure, but it gives you tools that stay with you after therapy ends.
How long does it usually take?
CBT is usually short-term and goal-focused. For many common problems, such as mild to moderate depression or anxiety, a course of roughly 8 to 20 sessions is typical, often weekly. More complex or long-standing difficulties may need more time.
Early on you and your therapist set concrete goals and review progress regularly. As things improve, sessions are often spaced out, and the final ones focus on relapse prevention: what you can do if symptoms return.
CBT online and in Farsi
The clear, practice-based structure of CBT suits video sessions very well, and research suggests online CBT can be nearly as effective as in-person sessions for many people. Worksheets and exercises can be shared on screen, and the session happens from your own home.
Speaking your mother tongue matters. Many automatic thoughts arrive in Farsi, carrying proverbs, "shoulds" and things we heard growing up. A therapist who knows the language and culture understands the pressure of migration, family expectations or the shame of asking for help more easily. For online sessions, choose a quiet private place, use headphones and a stable connection, and keep a notebook nearby.
Limits and alternatives
CBT is not the best fit for everyone. If your difficulties seem rooted in deep, long-standing patterns from childhood that keep repeating in relationships, schema therapy, which grew out of CBT, may suit you better. If struggling with your thoughts has worn you out and you want to live alongside them instead, acceptance and commitment therapy (ACT) is a good option. For OCD, the specialised form of CBT called exposure and response prevention (ERP) is recommended.
If you are in acute crisis or having thoughts of harming yourself, please contact local emergency services first. A good therapist will explore with you in the first sessions which approach fits your needs.
