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What is CBT? How Cognitive Therapy Helps Insomnia | Sleep Reset

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December 6, 2022

How Cognitive Behavioral Therapy Works for Insomnia and Beyond

Medically reviewed by: 

Cognitive behavioral therapy, or CBT, is a psychological treatment that focuses on changing negative thinking and behaviors. It's one of the most popular and effective forms of psychotherapy and can be used to treat a wide variety of conditions, including depression, anxiety, and insomnia.

How cognitive behavioral therapy works can be confusing if you aren’t already practicing it, but the basic principles can be easily understood.

What is CBT?

Cognitive behavioral therapy is a structured form of talk therapy developed in the 1960s. It's based on the idea that our thoughts, feelings, and behaviors are interconnected. Essentially, if we can change how we think about something, we can change how we feel and behave.

What principle underlies cognitive-behavioral therapy? 

CBT is a problem-focused and action-oriented approach to treatment. It's geared toward helping you find solutions to specific problems in your life. It does not focus on exploring your past or understanding why you have the problem.

CBT is usually short-term. You'll work with your therapist to identify your thought process and behavior patterns during as few as five sessions.

The goals of CBT vary depending on the individual. But in general, the purpose of CBT is to help you:

  • Identify and reshape negative thinking patterns
  • Change negative behaviors and beliefs
  • Improve mood
  • Develop coping and problem-solving skills

What is cognitive restructuring?

One of the most common techniques used in CBT is cognitive restructuring. This practice is the process of identifying and challenging negative thoughts.

Cognitive restructuring can help you identify stressful or distressing thoughts and replace them with more productive ones. It can also help you develop more realistic thinking patterns.

For example, say you find out a group of coworkers went to a happy hour and didn’t invite you. This makes you think “no one likes me, I must be terrible at my job.” This could lead you to feel anxious or depressed, stewing on those negative thoughts. Through cognitive restructuring, a therapist may help you reframe those thoughts as “my coworkers enjoy working with me, but we also enjoy separate personal lives.”

How to practice CBT

CBT is traditionally practiced with a mental health counselor in a face-to-face setting. Some CBT techniques can be done at home, using books, apps, and online resources.

For those who are struggling with a specific problem, like social anxiety or insomnia, there are CBT apps that can help. These apps can help you learn how to manage your symptoms with tools like the 3 Cs of CBT, a simple mnemonic for cognitive restructuring that stands for catching, checking, and changing.

Steps in CBT

Here's a closer look at the steps involved in CBT:

Identify the problem

The first step is to identify the problem you want to improve. This problem could be social anxiety or trouble connecting with colleagues. You and your therapist can then determine specific cognitive behavioral therapy goals to pursue.

Observe your thoughts

Once you've articulated a problem, observing your thoughts and trying to identify negative patterns is the next move. Journaling can make this easier. For one week, write down every negative thought you have. 

See if you notice a pattern. For example, if you're a busy executive, you might be plagued with thoughts like: I don't deserve this position. I'm going to make a mistake and get fired

Challenge your negative thoughts

After you have confronted the negative thoughts, you can start to challenge them. Ask questions like: Is this thought based on fact or opinion? How much evidence do I have for this thought? If this thought is true, what's the worst that could happen?

Remembering glowing reviews from past employers could help you realize that you're competent. The same knowledge could fortify you against catastrophizing or imagining the worst. A small mistake likely won't get you fired; if it does, you can find a new position.

Replace your thoughts

You can also try replacing your negative thoughts with less critical reflections. Perhaps your co-workers didn't invite you to lunch because they knew you had an important meeting to prepare.

Your therapist can help you determine which thoughts are true and which are cognitive distortions.

Practicing CBT for insomnia

CBT can be an effective treatment for insomnia. People with insomnia often have racing thoughts, sleep anxiety, and difficulty relaxing.

CBT for insomnia (CBT-I) typically focuses on two areas: 

1. Identifying and changing negative thoughts and beliefs about sleep: Do you lay in bed worrying about when you're going to fall asleep? These anxious thoughts could be contributing to your insomnia.

2.  Establishing healthy sleep habits: There are several practices you can do to promote better sleep, such as avoiding late-night caffeine and alcohol, removing harmful stimuli from the bedroom, and creating a soothing bedtime routine.

If you're concerned about your sleep habits, Sleep Reset can help. The Sleep Reset program uses CBT for insomnia to help you overcome sleep issues.

Take the Sleep Quiz to get personalized recommendations for better rest.