Cognitive Behavioural (CBT) Counselling in Musselburgh

Photo of Rachel Rickman, Psychotherapist, MBACP
Rachel Rickman
Psychotherapist, MBACP
Waitlist for new clients
I am a qualified CBT therapist with experience of people with issues such as anxiety, anger, depression and self esteem.
Hello I’m Rachel and a very warm welcome. As you find yourself here, you may be feeling stuck in life at the moment and perhaps issues or difficulties may be causing you distress or to feel overwhelmed. Perhaps you feel anxious, depressed or have low self esteem? Often through no fault of our own we can get caught up in these difficult cycles. The good news is I can help you get "unstuck" and help you to achieve lasting change in your life. I will help you move towards your goals and lead a more fulfilled life. I am here to support you every step of the way, giving you the space and time to discover yourself.
I am a qualified CBT therapist with experience of people with issues such as anxiety, anger, depression and self esteem.
Hello I’m Rachel and a very warm welcome. As you find yourself here, you may be feeling stuck in life at the moment and perhaps issues or difficulties may be causing you distress or to feel overwhelmed. Perhaps you feel anxious, depressed or have low self esteem? Often through no fault of our own we can get caught up in these difficult cycles. The good news is I can help you get "unstuck" and help you to achieve lasting change in your life. I will help you move towards your goals and lead a more fulfilled life. I am here to support you every step of the way, giving you the space and time to discover yourself.
0131 381 8606 View 0131 381 8606
Photo of Jason Michael Lumb, DCounsPsych
Jason Michael Lumb
Verified Verified
2 Endorsed
I use Cognitive Behavioural Therapy ( CBT) as my core therapy, which can be supported by a counselling approach as therapy progresses
Are you concerned that your use of substances or coping strategies are getting out of control and is causing problems in your life? Or are you worried that you will not be able to cope without them, even though you would like to cut back or stop? Do you feel locked into thinking styles which are starting to dominate your life such as anxiety or depression and don't know what to do? Imagine if you could regain control of your life so you felt happier, and were no longer dependant or worried about your substance use or problematic behaviours? Recovery for you is possible but sometimes we need a bit of help and guidance to get there.
I use Cognitive Behavioural Therapy ( CBT) as my core therapy, which can be supported by a counselling approach as therapy progresses
Are you concerned that your use of substances or coping strategies are getting out of control and is causing problems in your life? Or are you worried that you will not be able to cope without them, even though you would like to cut back or stop? Do you feel locked into thinking styles which are starting to dominate your life such as anxiety or depression and don't know what to do? Imagine if you could regain control of your life so you felt happier, and were no longer dependant or worried about your substance use or problematic behaviours? Recovery for you is possible but sometimes we need a bit of help and guidance to get there.
0131 381 0141 View 0131 381 0141
Photo of Maud Ray, Counsellor, MSc, MBACP
Maud Ray
Counsellor, MSc, MBACP
I am an accomplished International Couple Psychosexual Therapist, (PG Dip) (Tavistock trained), BACP Accredited & COSRT registered, with a BSc (Hons) in Psychology. I have extensive experiencI have a wide range of clinical experience from both the public and private sectors. ​ ​My clients are from all over the world with varied multi-cultural backgrounds, ages, gender, sexuality, and brain configuration. The Psychosexual lens is raw, powerful, unique, no stone is left unturned. We look at your life; the biology, psychology, spirituality, physiology, past , present and future.
I am an accomplished International Couple Psychosexual Therapist, (PG Dip) (Tavistock trained), BACP Accredited & COSRT registered, with a BSc (Hons) in Psychology. I have extensive experiencI have a wide range of clinical experience from both the public and private sectors. ​ ​My clients are from all over the world with varied multi-cultural backgrounds, ages, gender, sexuality, and brain configuration. The Psychosexual lens is raw, powerful, unique, no stone is left unturned. We look at your life; the biology, psychology, spirituality, physiology, past , present and future.
01273 092176 View 01273 092176
Photo of Rose Noonan, Counsellor, MBACP Accred
Rose Noonan
Counsellor, MBACP Accred
Serves Area
Hi thank you for visiting my profile page, you’ve just taken the courageous first step to look for help through counselling. Sometimes we face challenges in our day-to-day lives which can be stressful, frustrating and difficult to manage. Turning to someone you don’t know can be daunting and confusing making you feel vulnerable and scared. However, counselling offers a safe, caring confidential space to explore, and discuss your difficulties. I will listen and support you with empathy and respect. I will work with you in an open, honest and non-judgemental way.
Hi thank you for visiting my profile page, you’ve just taken the courageous first step to look for help through counselling. Sometimes we face challenges in our day-to-day lives which can be stressful, frustrating and difficult to manage. Turning to someone you don’t know can be daunting and confusing making you feel vulnerable and scared. However, counselling offers a safe, caring confidential space to explore, and discuss your difficulties. I will listen and support you with empathy and respect. I will work with you in an open, honest and non-judgemental way.
01875 444490 View 01875 444490
Photo of Maya Tomse, Psychotherapist, MA, MBACP
Maya Tomse
Psychotherapist, MA, MBACP
Online Only
Living with neurodiversity like ADHD, Autism, learning differences, OCD etc. can bring both unique strengths and daily challenges. Anxiety, stress, and relationship struggles are common, leaving many individuals, couples, and families feeling stuck. I understand this deeply—not only through years of professional training but also from my own life in a neurodivergent family. In therapy, I offer a safe, supportive space to explore how neurodivergence shapes communication, intimacy, and family dynamics.
Living with neurodiversity like ADHD, Autism, learning differences, OCD etc. can bring both unique strengths and daily challenges. Anxiety, stress, and relationship struggles are common, leaving many individuals, couples, and families feeling stuck. I understand this deeply—not only through years of professional training but also from my own life in a neurodivergent family. In therapy, I offer a safe, supportive space to explore how neurodivergence shapes communication, intimacy, and family dynamics.
0131 297 6069 View 0131 297 6069
Photo of Melanie Peele, Counsellor, BACP
Melanie Peele
Counsellor, BACP
Online Only
While there is so much joy in getting to know ourselves deeply and authentically, living as a queer and/or transgender person in this world is not always easy. I specialise in gender, sexuality, and relationship diversity. I work with adults and older adolescents who are LGBTQIA+/gender non-conforming, or questioning their identities. I also specialise in trauma recovery, treating healthcare professionals, and working with English speaking immigrants. I work from multiple affirming perspectives, including Health at Every Size, neurodivergence affirming, disability affirming, and fat-positive perspectives.
While there is so much joy in getting to know ourselves deeply and authentically, living as a queer and/or transgender person in this world is not always easy. I specialise in gender, sexuality, and relationship diversity. I work with adults and older adolescents who are LGBTQIA+/gender non-conforming, or questioning their identities. I also specialise in trauma recovery, treating healthcare professionals, and working with English speaking immigrants. I work from multiple affirming perspectives, including Health at Every Size, neurodivergence affirming, disability affirming, and fat-positive perspectives.
0131 381 4596 View 0131 381 4596
Photo of Janis Sinclair, Psychotherapist, PMCOSCA
Janis Sinclair
Psychotherapist, PMCOSCA
2 Endorsed
Serves Area
Are you anxious and finding life overwhelming, suddenly the simplest decisions are impossible - this may be situational, relational or historical; large or small I offer a space to speak freely secure in the knowledge our sessions are confidential. My theory is person centred although I offer Integrative therapy which is a progressive form of psychotherapy that combines different therapeutic tools and approaches to fit the needs of the individual client.
Are you anxious and finding life overwhelming, suddenly the simplest decisions are impossible - this may be situational, relational or historical; large or small I offer a space to speak freely secure in the knowledge our sessions are confidential. My theory is person centred although I offer Integrative therapy which is a progressive form of psychotherapy that combines different therapeutic tools and approaches to fit the needs of the individual client.
01785 338104 View 01785 338104
Photo of Ian Burke - Clinical Forensic Psychology , Psychologist, PsychD
Clinical Forensic Psychology
Psychologist, PsychD
Serves Area
I am trained in a number of therapeutic modalities including Cognitive Behavioural Therapy ( CBT), Acceptance and Commitment Therapy (ACT), Eye Movement Desensitisation and Reprocessing (EMDR), and Sensory Attachment Intervention (SAI).
Clinical Forensic Psychology is a child focused psychology practice specialising in the assessment and treatment of children and young people presenting with emotional and mental health difficulties related to experiences of trauma. In addition, I also provide treatment for children who are struggling with a wide range of emotional and behavioural difficulties. If you think I can help you or your child please get in contact with me for a no obligation discussion. You can find my website at www.clinicalforensic.com
I am trained in a number of therapeutic modalities including Cognitive Behavioural Therapy ( CBT), Acceptance and Commitment Therapy (ACT), Eye Movement Desensitisation and Reprocessing (EMDR), and Sensory Attachment Intervention (SAI).
Clinical Forensic Psychology is a child focused psychology practice specialising in the assessment and treatment of children and young people presenting with emotional and mental health difficulties related to experiences of trauma. In addition, I also provide treatment for children who are struggling with a wide range of emotional and behavioural difficulties. If you think I can help you or your child please get in contact with me for a no obligation discussion. You can find my website at www.clinicalforensic.com
01764 915909 View 01764 915909

More Therapists Nearby

Photo of Claire Feldman - Claire Feldman - Binge Eating Therapist, Psychotherapist, MBACP Accred
Claire Feldman - Binge Eating Therapist
Psychotherapist, MBACP Accred
3 Endorsed
Serves Area
You may feel capable and organised in many areas of life, yet food can feel like the one place things quietly unravel. You might start the day with good intentions, only to find that by evening you're eating in a way that doesn't match what you truly want. Afterwards comes frustration, guilt, or the familiar promise to "start again tomorrow." Struggles with food rarely come down to willpower. For many people — particularly those with ADHD, or those who've always felt wired a little differently — eating becomes entangled with dopamine, emotional regulation, and the exhaustion of masking.
You may feel capable and organised in many areas of life, yet food can feel like the one place things quietly unravel. You might start the day with good intentions, only to find that by evening you're eating in a way that doesn't match what you truly want. Afterwards comes frustration, guilt, or the familiar promise to "start again tomorrow." Struggles with food rarely come down to willpower. For many people — particularly those with ADHD, or those who've always felt wired a little differently — eating becomes entangled with dopamine, emotional regulation, and the exhaustion of masking.
01248 665952 View 01248 665952
Photo of Debbie Black - Solace CBT & Counselling, Counsellor, BACP
Solace CBT & Counselling
Counsellor, BACP
1 Endorsed
Falkirk FK1
As an experienced Cognitive Behavioural Therapist I can offer you a safe space to explore your difficulties in confidence; to identify how you would like things to be and work with you to find your own way forward.
I have an interest in how cultivating mindfulness and compassion can enable us to grow from a place of kindness and understanding. Also how we can learn to understand and regulate our nervous systems to find relief from chronic symptoms of distress. We will work in collaboration to grow self awareness with curiosity and compassion leading to lasting change.
As an experienced Cognitive Behavioural Therapist I can offer you a safe space to explore your difficulties in confidence; to identify how you would like things to be and work with you to find your own way forward.
I have an interest in how cultivating mindfulness and compassion can enable us to grow from a place of kindness and understanding. Also how we can learn to understand and regulate our nervous systems to find relief from chronic symptoms of distress. We will work in collaboration to grow self awareness with curiosity and compassion leading to lasting change.
01324 462083 View 01324 462083
Photo of Jacob Williams, Psychotherapist, MSc, MBABCP
Jacob Williams
Psychotherapist, MSc, MBABCP
1 Endorsed
Serves Area
As a CBT therapist, I have worked with clients across the lifespan with a wide range of issues including depression and low mood; anxiety; single event trauma; multiple traumas; phobias; panic attacks; obsessive-compulsive disorder; grief and bereavement; low self-esteem; relationship issues; work stress; life transitions; neurodiversity (eg.
My approach is based on authenticity, collaboration and empowerment, providing the conditions to make sense of problems, understand what’s getting in the way, and work towards avenues of growth. My practice is inclusive, with deep respect for your lived experience and autonomy. I work short-, medium-, and long-term, depending on your needs.
As a CBT therapist, I have worked with clients across the lifespan with a wide range of issues including depression and low mood; anxiety; single event trauma; multiple traumas; phobias; panic attacks; obsessive-compulsive disorder; grief and bereavement; low self-esteem; relationship issues; work stress; life transitions; neurodiversity (eg.
My approach is based on authenticity, collaboration and empowerment, providing the conditions to make sense of problems, understand what’s getting in the way, and work towards avenues of growth. My practice is inclusive, with deep respect for your lived experience and autonomy. I work short-, medium-, and long-term, depending on your needs.
0141 673 8947 View 0141 673 8947
Photo of Marcus O'Shea, Psychotherapist, MSc, MBACP
Marcus O'Shea
Psychotherapist, MSc, MBACP
I offer a warm, empathic, flexible approach to talk through your issues, along with evidence based tools that are tailored to your unique needs, so we can work with your mind for a happier, more fulfilling life, drawn from multiple schools including CBT, DBT, ACT, Mindfulness, and Somatics.
I work in a collaborative and flexible manner, with understanding my client's stories and experiences as my priority. I believe each client is unique, and seek to establish an empathic, accepting space where you can feel safe to share your feelings and experiences, talk through the issues you’re facing, and find the solutions and tools that’re right for you.
I offer a warm, empathic, flexible approach to talk through your issues, along with evidence based tools that are tailored to your unique needs, so we can work with your mind for a happier, more fulfilling life, drawn from multiple schools including CBT, DBT, ACT, Mindfulness, and Somatics.
I work in a collaborative and flexible manner, with understanding my client's stories and experiences as my priority. I believe each client is unique, and seek to establish an empathic, accepting space where you can feel safe to share your feelings and experiences, talk through the issues you’re facing, and find the solutions and tools that’re right for you.
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Photo of Sandeep Kaur, Psychotherapist, MBABCP
Sandeep Kaur
Psychotherapist, MBABCP
1 Endorsed
Online Only
I specialise in Cognitive Behavioural Therapy ( CBT).
Online Therapy Only; I am currently working with clients on an online basis only via email, instant messaging, voice only and/or video. My approach to therapy is a collaborative one. You are the expert on you’re life and through the relationship built together we draw on your strengths and attributes. I am passionate about providing a space where you can be open, comfortable and feel validated. My aim is to support you to live the life you love to live, through healing, having healthy relationships, coping strategies and processing difficult emotions.
I specialise in Cognitive Behavioural Therapy ( CBT).
Online Therapy Only; I am currently working with clients on an online basis only via email, instant messaging, voice only and/or video. My approach to therapy is a collaborative one. You are the expert on you’re life and through the relationship built together we draw on your strengths and attributes. I am passionate about providing a space where you can be open, comfortable and feel validated. My aim is to support you to live the life you love to live, through healing, having healthy relationships, coping strategies and processing difficult emotions.
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Photo of Emma Ryland - Emma Ryland Positive About Neurodiversity, Psychotherapist, MBACP
Emma Ryland Positive About Neurodiversity
Psychotherapist, MBACP
1 Endorsed
I draw on counselling, CBT, coaching, ACT & self-compassion techniques, and I’ll meet you just as you are, so we can work together in ways that suit you.
It’s a big step to come to therapy, especially if you’ve had a lifetime of feeling different and not understood or heard. Maybe you experience anxiety and it’s starting to impact your life? Perhaps you have poor self-esteem and would like to set better boundaries? Have you or someone you care about recently received an autism or ADHD diagnosis and you’re having complicated feelings, not sure what to do now? Are you keen to please others but really harsh on yourself? I regularly work with people who answer 'yes' to these types of question.
I draw on counselling, CBT, coaching, ACT & self-compassion techniques, and I’ll meet you just as you are, so we can work together in ways that suit you.
It’s a big step to come to therapy, especially if you’ve had a lifetime of feeling different and not understood or heard. Maybe you experience anxiety and it’s starting to impact your life? Perhaps you have poor self-esteem and would like to set better boundaries? Have you or someone you care about recently received an autism or ADHD diagnosis and you’re having complicated feelings, not sure what to do now? Are you keen to please others but really harsh on yourself? I regularly work with people who answer 'yes' to these types of question.
01764 915850 View 01764 915850
Photo of Ernest Wagner - Dr Ernest Wagner - Online - Authentic Psychology, Psychologist, HCPC - Clin. Psych.
Dr Ernest Wagner - Online - Authentic Psychology
Psychologist, HCPC - Clin. Psych.
1 Endorsed
Online Only
My approach is integrative, drawing on established models (including CBT, ACT, and psychodynamic approaches) while keeping the focus on what actually helps: developing awareness, shifting unhelpful patterns, and building a more coherent and sustainable way of living.
People usually come to therapy when something is no longer manageable—feeling overwhelmed, anxious, low, stuck in repeating patterns, or struggling to make sense of what’s going on in their lives. I am a HCPC-registered Clinical Psychologist with over 10 years’ experience across NHS and private settings. I offer evidence-based assessment and therapy, grounded in a clear understanding of how psychological difficulties develop and are maintained.
My approach is integrative, drawing on established models (including CBT, ACT, and psychodynamic approaches) while keeping the focus on what actually helps: developing awareness, shifting unhelpful patterns, and building a more coherent and sustainable way of living.
People usually come to therapy when something is no longer manageable—feeling overwhelmed, anxious, low, stuck in repeating patterns, or struggling to make sense of what’s going on in their lives. I am a HCPC-registered Clinical Psychologist with over 10 years’ experience across NHS and private settings. I offer evidence-based assessment and therapy, grounded in a clear understanding of how psychological difficulties develop and are maintained.
01224 007400 View 01224 007400
Photo of Rachel McKay, Psychotherapist
Rachel McKay
Psychotherapist
1 Endorsed
Hi there - I'm a CBT Therapist based in Edinburgh - offering accessible therapy options in-person in Edinburgh and remotely online.
While I specialise in Cognitive Behavioural Therapy ( CBT), I also draw on person-centred approaches to ensure therapy feels genuinely tailored to you. I believe everyone already has the inner resources needed to grow and heal - it just takes the right support to help them flourish.
Hi there - I'm a CBT Therapist based in Edinburgh - offering accessible therapy options in-person in Edinburgh and remotely online.
While I specialise in Cognitive Behavioural Therapy ( CBT), I also draw on person-centred approaches to ensure therapy feels genuinely tailored to you. I believe everyone already has the inner resources needed to grow and heal - it just takes the right support to help them flourish.
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Photo of Dr Fiona McConnell, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Fiona McConnell
Psychologist, PsychD, HCPC - Clin. Psych.
1 Endorsed
Online Only
I also integrate other therapies in my practice including Cognitive Behavioural Therapy ( CBT), Compassion Focused Therapy (CFT) and Flash Technique.
My name is Fiona. I am a HCPC registered, IFS trained Clinical Psychologist with 10+ years experience working with mental health. My main interests lie in working with relational and attachment trauma. I love working with people and I am interested in helping you discover what brought you to where you are now, the difficulties that feel stuck for you and then to work together to help you move forward in life.
I also integrate other therapies in my practice including Cognitive Behavioural Therapy ( CBT), Compassion Focused Therapy (CFT) and Flash Technique.
My name is Fiona. I am a HCPC registered, IFS trained Clinical Psychologist with 10+ years experience working with mental health. My main interests lie in working with relational and attachment trauma. I love working with people and I am interested in helping you discover what brought you to where you are now, the difficulties that feel stuck for you and then to work together to help you move forward in life.
0131 381 1382 View 0131 381 1382
Photo of Miles Dorfman - Miles Dorfman - Therapist and ADHD Specialist, Psychotherapist, MA, BACP
Miles Dorfman - Therapist and ADHD Specialist
Psychotherapist, MA, BACP
2 Endorsed
Online Only
I offer an adaptive blend of Person-Centred Psychotherapy, into which I bring elements of Cognitive Behavioural Therapy ( CBT), Attachment Theory/Styles and other sources.
Feeling stuck? Low? I work with individuals around ADHD, relationship concerns, depression, anxiety, self-development, social anxiety, and more. In my structured yet warm approach, I equip you with the tools to recognise and challenge your issues, instead of just putting a plaster on the symptoms. While working to uncover, challenge and dissolve unhelpful cognitions, we will also identify suboptimal aspects of your present life that are changeable, and work together to strategise forward.
I offer an adaptive blend of Person-Centred Psychotherapy, into which I bring elements of Cognitive Behavioural Therapy ( CBT), Attachment Theory/Styles and other sources.
Feeling stuck? Low? I work with individuals around ADHD, relationship concerns, depression, anxiety, self-development, social anxiety, and more. In my structured yet warm approach, I equip you with the tools to recognise and challenge your issues, instead of just putting a plaster on the symptoms. While working to uncover, challenge and dissolve unhelpful cognitions, we will also identify suboptimal aspects of your present life that are changeable, and work together to strategise forward.
020 3697 6940 View 020 3697 6940
Photo of Lorena Recio Aparicio, Psychologist, MSc, GMBPsS
Lorena Recio Aparicio
Psychologist, MSc, GMBPsS
My integrative approach combines CBT, mindfulness and The Decider Skills to help with anxiety, self-esteem, emotional regulation and relationship issues.
Many of my clients are adults who feel overwhelmed by anxiety, stuck in low self-esteem, or emotionally drained by relationship difficulties. Some are going through big life transitions or struggling to set healthy boundaries. They want to feel more balanced, confident, and able to cope. Often, they’re looking for a calm, supportive space where they can make sense of their thoughts and feelings – in a way that feels safe, respectful and non-judgmental.
My integrative approach combines CBT, mindfulness and The Decider Skills to help with anxiety, self-esteem, emotional regulation and relationship issues.
Many of my clients are adults who feel overwhelmed by anxiety, stuck in low self-esteem, or emotionally drained by relationship difficulties. Some are going through big life transitions or struggling to set healthy boundaries. They want to feel more balanced, confident, and able to cope. Often, they’re looking for a calm, supportive space where they can make sense of their thoughts and feelings – in a way that feels safe, respectful and non-judgmental.
0131 381 8043 View 0131 381 8043
Photo of Kelly Combe, Counsellor, DCounsPsych, MNCPS Acc.
Kelly Combe
Counsellor, DCounsPsych, MNCPS Acc.
Bilston EH25
I work with a person centered approach as well as including elements of CBT, mindfulness, Hypnotherapy, relaxation techniques and Aromatherapy treatments.
I believe that it's important for an individual to find the right counsellor, as one counsellors method may not suit all. I therefore offer my initial consultation at a reduced rate. The initial consultation is not only an opportunity for the counsellors to find out more about the client but also for the client to find out more about the counsellor, giving both the opportunity to discover if a suitable rapport can be built, creating an appropriate environment for counselling to take place.
I work with a person centered approach as well as including elements of CBT, mindfulness, Hypnotherapy, relaxation techniques and Aromatherapy treatments.
I believe that it's important for an individual to find the right counsellor, as one counsellors method may not suit all. I therefore offer my initial consultation at a reduced rate. The initial consultation is not only an opportunity for the counsellors to find out more about the client but also for the client to find out more about the counsellor, giving both the opportunity to discover if a suitable rapport can be built, creating an appropriate environment for counselling to take place.
01968 700122 View 01968 700122
Cognitive Behavioural (CBT) Counsellors
How does cognitive behavioural therapy work?
Cognitive behavioural therapy works by exploring how your thoughts affect your emotions and experiences. CBT helps you identify distortions in your thinking. For example, you may tend to jump to the worst case scenario catastrophising or think in extremes (all-or-nothing thinking). A therapist can teach you how to push back against those thoughts to ultimately change your feelings and behavior for the better. They can also provide coping skills to better deal with stressors and challenges.

When do I know to seek treatment with cognitive behavioural therapy?
It’s reasonable to consider cognitive behavioural therapy if you struggle to manage difficult emotions or behaviors to such an extent that you are not getting the most out of life on a day-to-day basis. If you want a shorter term, concrete, skills-based approach, CBT is a great option. (By contrast, other types of therapy may devote more time to exploring your past and its effects.) The decision to seek CBT also depends on the condition you’re treating; CBT is an effective treatment for anxiety, depression, trauma, and many other disorders.

How can I find a cognitive behavioural therapist for someone else?
To find a cognitive behavioural therapist for someone else, you may want to begin by discussing the person’s problem, researching cognitive behavioural therapy, and assessing whether the approach is the right fit. You could then reach out to a few cognitive behavioral therapists in this directory, explain the scenario, have a consultation with those available, and determine who could be a good match.

Why is CBT such a popular form of therapy?
CBT has become a popular form of therapy because it is effective and accessible. Robust research has demonstrated that CBT is an effective treatment for many mental health conditions. And CBT can be learned in relatively few sessions, which means that many people can engage in the process, afford it, and see results quickly. It involves learning concrete skills such as disputing unhelpful thoughts; these skills can also be taught and spread widely.