Aviva Psychology Services
Cognitive behavioral therapy (CBT)
A structured, evidence-based approach to changing thought and behavior patterns that fuel anxiety, depression, and emotional distress.
When insight isn't enough
You already know thoughts aren't entirely rational. You have tried reasoning with them, pushing them out of mind, ignoring them, and telling yourself you will get over it.
Sometimes these techniques work temporarily. Then the worry often returns, the self-criticism and hopelessness increase, and it takes more effort to keep the defeating thoughts at bay.
Knowing all of this is not enough. What's usually missing isn't insight. It's a skillset. Cognitive behavioral therapy (CBT) is a structured, evidence-based approach to alter self-defeating thought patterns and make meaningful behavioral changes to improve the quality of your life.
CBT is one of the most studied forms of therapy for anxiety, depression, OCD, and trauma. Our team of psychologists at Aviva Psychology Services have specialty training and expertise in this approach.
What is cognitive behavioural therapy?
Cognitive behavioral therapy (CBT) is an evidence-based treatment focused on the relationship between thoughts, feelings, and behaviors. In short, how we think about a given situation affects the way we feel and how we are likely to respond. When we are under psychological distress, our minds often rely on thoughts that are unrealistic, distorted, and unhelpful. This skewed interpretation can increase our distress and negatively impact the actions we take.
CBT is an active therapy that focuses on increasing awareness of skewed thinking and the impact on your emotions and behaviors. You will learn specific skills to identify and modify unhelpful thought patterns, regulate emotional responses, and change behavioral patterns that maintain psychological distress.
CBT is one of the most extensively researched forms of psychotherapy and is recognized by the
American Psychological Association as a foundational treatment for multiple mental health conditions. CBT has been shown to have the same long-term benefits as medications for depression and to be more effective in relapse prevention.
Who can CBT help?
CBT has decades of research supporting its application across a wide range of symptoms and concerns. At Aviva, our psychologists use CBT to treat:
- Anxiety disorders — including generalized anxiety, panic, and social anxiety
- Depression and persistent low mood
- Obsessive-compulsive disorder and intrusive thoughts
- Health anxiety and chronic worry
- Insomnia and sleep difficulties
- Trauma-related symptoms and PTSD
- Stress tied to work, relationships, or life transitions
- Perinatal anxiety and depression
CBT tends to work well when you want to understand what's keeping an unhelpful thought or behavior pattern in place and when you want to walk away with skills to change them.
How does CBT work in practice?
CBT sessions are collaborative and focused. During your initial sessions, you and your psychologist will explore your symptoms, identify specific goals, and establish a treatment plan. These goals and your treatment plan will inform the work you do going forward.
From there, sessions examine the connection between your thoughts, emotions, and behaviors. Your psychologist will help you identify automatic thoughts and the immediate interpretations that arise in response to varied experiences and situations. Distorted thoughts often operate outside of awareness even though they significantly influence emotional and behavioral responses. Bringing awareness to them is a crucial component to replacing them with more rational and adaptive thought patterns.
A core component of CBT involves treating negative beliefs as hypotheses to be tested rather than as facts. Between sessions, you'll engage in behavioral experiments designed to gather evidence about the accuracy of your interpretations. This might include tracking thought patterns, testing predictions about social situations, or gradually approaching situations you've been avoiding.
Why we use this approach at Aviva Psychology Services
At Aviva Psychology Services, our doctoral-level licensed psychologists are trained in Cognitive Behavioral Therapy because of its strong empirical foundation and demonstrated effectiveness across diverse populations and concerns.
CBT aligns with our commitment to evidence-based practice and values-driven care. The approach supports clients in building psychological flexibility-- the ability to be present with difficult thoughts and emotions while taking action aligned with personal values. Our psychologists integrate CBT with other evidence-based approaches, including Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and relational frameworks to provide comprehensive, individualized care.
We value CBT's transparency. Clients understand what they're working toward, why specific interventions are used, and how progress is measured. This clarity supports collaboration and empowers clients to become active participants in their own treatment.
How are CBT sessions structured?
CBT sessions are structured but not rigid. Your psychologist will typically begin by reviewing any observations or exercises from the previous week, then focus on current concerns or goals. CBT is an active process, involving dialogue and problem solving with your psychologist, rather than one-sided reflection.
You'll work together to identify thought patterns, examine evidence for and against specific beliefs, and develop alternative interpretations when appropriate. Your psychologist will introduce cognitive and behavioral strategies tailored to your specific needs, and together you'll determine how to practice these skills between sessions.
The tone is collaborative and straightforward. You maintain control over what you're ready to work on and how quickly the process moves forward. Many clients appreciate CBT's focus on skill-building and its emphasis on practical application outside of session.
What people get wrong about CBT
If you've read about CBT before, you've probably formed a picture of it. Maybe you think it's positive thinking. Maybe it's worksheets and homework, or a clinical process that skips past how you actually feel.
That's not how we practice it. CBT is about noticing the thoughts that quietly run the show and asking whether they hold up. It's collaborative, it moves at your pace, and it stays rooted in your real life. You and your psychologist figure out what fits.
Benefits of CBT
Increased Awareness
Recognize automatic thoughts, distortions, and their impact on emotions.
Practical Skills
Apply practical cognitive and behavioral strategies in daily life to address stuck points.
Lasting Change
Build tools that continue working after therapy concludes.
CBT has been clinically tested and shown to reduce symptoms of anxiety and depression while improving overall functioning.
Research indicates that CBT produces benefits comparable to psychiatric medication for depression, with lower relapse rates after treatment concludes.
Clients often report improved ability to manage stressors, increased confidence in decision-making, and greater emotional regulation. While outcomes vary by individual, many clients begin noticing shifts in their thought patterns and emotional responses within the first month of treatment.
Is CBT the right fit for you?
CBT may be fitting if you prefer a structured, goal-oriented approach to therapy. It tends to work well for people who are willing to engage in active skill practice between sessions and who value understanding the rationale behind therapeutic interventions.
That said, therapy approaches are not one-size-fits-all. Some people benefit from integrating CBT with other therapeutic frameworks, while others may find that a different modality better matches their needs and preferences. Your psychologist will discuss fit openly during the assessment process and will collaborate with you to determine the most effective approach for your specific situation.
What's next?
Starting therapy can feel overwhelming, but we keep the process simple and supportive. Here’s what to expect:
Request an Appointment
Once you complete this form, we will reach out. If we have a fitting opening, we will schedule a complimentary 15-minute phone consultation to assess fit further together.
Assessment and Planning
During the first 2-4 sessions, we assess your history, symptoms, and goals. Together, you and your psychologist will establish a treatment plan and discuss next steps.
Ongoing Weekly Sessions
Sessions are typically weekly for 55 minutes at a consistent time. You and your psychologist will focus on your treatment needs and goals.
FAQs about anxiety treatment
How does CBT differ from other types of therapy?
CBT is more structured and present-focused than traditional psychodynamic or insight-oriented therapies. It involves specific skill-building and homework between sessions. While some therapies focus primarily on understanding the origins of problems, CBT emphasizes learning new ways to respond to current challenges.
Is CBT available through telehealth?
Yes. Our psychologists provide CBT through secure video sessions for clients located anywhere in Massachusetts. Many clients find that telehealth CBT fits both their therapeutic and logistical needs.
How long does CBT typically take?
CBT is commonly short- to medium-term. Many clients notice improvement within 4 to 20 sessions depending on goals and complexity.
What kind of training do CBT therapists have?
At Aviva Psychology Services, all psychologists hold doctoral degrees (PhD or PsyD) and are licensed in Massachusetts. Our team receives specialized training in CBT through graduate programs, internships, postdoctoral fellowships, and ongoing professional development.
What if I've tried CBT before and it didn't work?
Previous experiences vary. Effectiveness depends on the therapeutic relationship, specific strategies used, and current readiness. These factors are explored during assessment.
Ready to explore Cognitive Behavioral Therapy?
If you’re considering Cognitive Behavioral Therapy (CBT) in Massachusetts, a consultation can help determine whether this approach aligns with your goals. We’ll review your concerns, answer questions, and outline next steps if fitting.
