Cognitive Behavioral (CBT) Therapists in Worcester, MA

Photo of Tamise Francois - Perseverance Clinical Services, LLC , LMHC, Counselor
Perseverance Clinical Services, LLC
Counselor, LMHC
Verified Verified
1 Endorsed
Worcester, MA 01605
I work with clients from diverse backgrounds, my therapeutic approaches are Cognitive behavioral therapy (CBT), family therapy and faith based approaches.
" I am a dedicated and skilled Christian counselor with experience providing care for children, teenagers, and adults. I have experience treating individuals diagnosed with anxiety, trauma-related issues, depression, borderline personality, attention deficit disorder, oppositional defiant disorder, bipolar disorder, and adjustment disorders. I have experience providing individual and couples therapy. I recognize that my clients are able to make progress in treatment when they are open, ready, and able to commit to making changes in their lives. I am trained, experienced, and prepared to help my clients function better physically, emotionally, and spiritually."
I work with clients from diverse backgrounds, my therapeutic approaches are Cognitive behavioral therapy (CBT), family therapy and faith based approaches.
" I am a dedicated and skilled Christian counselor with experience providing care for children, teenagers, and adults. I have experience treating individuals diagnosed with anxiety, trauma-related issues, depression, borderline personality, attention deficit disorder, oppositional defiant disorder, bipolar disorder, and adjustment disorders. I have experience providing individual and couples therapy. I recognize that my clients are able to make progress in treatment when they are open, ready, and able to commit to making changes in their lives. I am trained, experienced, and prepared to help my clients function better physically, emotionally, and spiritually."
(508) 507-8461 View (508) 507-8461
Photo of Carly Brownell, CAGS, LMHC, Counselor
Carly Brownell
Counselor, CAGS, LMHC
Verified Verified
Worcester, MA 01605
I have been trained in Applied Behavioral Analysis, Trauma Focused CBT and ARC.
I have several after-school appointments available
I have been trained in Applied Behavioral Analysis, Trauma Focused CBT and ARC.
I have several after-school appointments available
(508) 474-7965 View (508) 474-7965
Photo of Rebekah Bernard, Counselor
Rebekah Bernard
Counselor
Verified Verified
Worcester, MA 01605
Rebekah utilizes multiple treatment approaches including person-centered therapy, motivational interviewing, cognitive behavioral therapy, dialectical behavior therapy, existential therapy, and mindfulness therapy.
Rebekah Bernard is a Licensed Mental Health Counselor (LMHC) in Massachusetts with over 10 years of experience in the mental health field. Her counseling style is warm and supportive, with a humanistic foundation. Rebekah has worked for clients with a wide range of needs and specializes in counseling grief/loss, existential concerns, stress/anxiety, communication challenges, anxiety/depression, and major life transitions. She has supported individuals living with terminal illness as well.
Rebekah utilizes multiple treatment approaches including person-centered therapy, motivational interviewing, cognitive behavioral therapy, dialectical behavior therapy, existential therapy, and mindfulness therapy.
Rebekah Bernard is a Licensed Mental Health Counselor (LMHC) in Massachusetts with over 10 years of experience in the mental health field. Her counseling style is warm and supportive, with a humanistic foundation. Rebekah has worked for clients with a wide range of needs and specializes in counseling grief/loss, existential concerns, stress/anxiety, communication challenges, anxiety/depression, and major life transitions. She has supported individuals living with terminal illness as well.
(774) 260-8624 View (774) 260-8624
Photo of Demi McLaren, LICSW, Clinical Social Work/Therapist
Demi McLaren
Clinical Social Work/Therapist, LICSW
Verified Verified
4 Endorsed
Worcester, MA 01609  (Online Only)
I primarily use cognitive-behavioral therapy and family systems therapy in my practice.
I specialize in working with LGBTQIA+ and marginalized folks through a strength-based, trauma-informed lens. I also have experience working with clients coping with anxiety and depression along with other identity shifts that come with life transitions.
I primarily use cognitive-behavioral therapy and family systems therapy in my practice.
I specialize in working with LGBTQIA+ and marginalized folks through a strength-based, trauma-informed lens. I also have experience working with clients coping with anxiety and depression along with other identity shifts that come with life transitions.
(774) 208-0589 View (774) 208-0589
Photo of John Richard Casey - J R Casey Counseling & Hypnosis, LICSW, CCH, Clinical Social Work/Therapist
J R Casey Counseling & Hypnosis
Clinical Social Work/Therapist, LICSW, CCH
Verified Verified
Worcester, MA 01603
Certificate from Boston University in cognitive behavioral therapy.
Know thyself, wrote the Greek scholar. My aim is to assist you toward effective and functional self-understanding so that you might pursue and achieve the life goals of which you, as a unique person, are most worthy. Harry Truman had on his desk, whatever job he held, these 10 words: "Know right from wrong. Do right. Do your best." I shall always use these words in your service.
Certificate from Boston University in cognitive behavioral therapy.
Know thyself, wrote the Greek scholar. My aim is to assist you toward effective and functional self-understanding so that you might pursue and achieve the life goals of which you, as a unique person, are most worthy. Harry Truman had on his desk, whatever job he held, these 10 words: "Know right from wrong. Do right. Do your best." I shall always use these words in your service.
(774) 221-6116 View (774) 221-6116
Photo of Lindsey Nogueira-Mayo, LCSW, LADC 1, DOT SAP, Drug & Alcohol Counselor
Lindsey Nogueira-Mayo
Drug & Alcohol Counselor, LCSW, LADC 1, DOT SAP
Verified Verified
Worcester, MA 01602  (Online Only)
I am person-centered while also utilizing cognitive behavioral therapy for relapse prevention and motivational interviewing.
Hello! I am currently accepting new clients for substance use counseling. I use a person-centered approach to counseling that puts emphasis on autonomy, strengths, and people's preferences while providing a non-judgemental, supportive space. I see substance use treatment as one that is holistic in nature, tying together lifestyle, personal beliefs, values, health, and motivations to help sustain recovery. I believe in taking an active, collaborative role as your counselor, helping you to reach your goals.
I am person-centered while also utilizing cognitive behavioral therapy for relapse prevention and motivational interviewing.
Hello! I am currently accepting new clients for substance use counseling. I use a person-centered approach to counseling that puts emphasis on autonomy, strengths, and people's preferences while providing a non-judgemental, supportive space. I see substance use treatment as one that is holistic in nature, tying together lifestyle, personal beliefs, values, health, and motivations to help sustain recovery. I believe in taking an active, collaborative role as your counselor, helping you to reach your goals.
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Photo of Paul Harris Sandman, EdD, LMHC, Counselor
Paul Harris Sandman
Counselor, EdD, LMHC
Verified Verified
Worcester, MA 01605
Positive based counseling, Evidence based, Brief Therapy, Medical Hypnosis (Ericksonian Hypnosis), Narrative therapy, Cognitive Behavioral Therapy (CBT), and Audiotape Therapy in which I offer any of 50 specialized CD's to help clients change their behaviors out of session, and use of my twelve psychology books.
My ideal clients are interested in improving their self awareness of their thoughts, feelings, and behaviors. I treat any of the following issues: depression, anxiety, anger, substance abuse, relationship issues, sexual behaviors, trauma, domestic violence, low self-esteem, eating disorders, attention deficit difficulties, autism, schizophrenia, stress management, Post-Traumatic Stress Disorder, child behavior and attitude problems, school behavior, low motivation, weight loss, quitting smoking, grief and loss of a loved one, divorce, parenting issues, co-dependency, pain management, social skills development, bi-polar disorder, abusive family situations, work problems, shame/inappropriate guilt, and negative thinking but treat many more issues.
Positive based counseling, Evidence based, Brief Therapy, Medical Hypnosis (Ericksonian Hypnosis), Narrative therapy, Cognitive Behavioral Therapy (CBT), and Audiotape Therapy in which I offer any of 50 specialized CD's to help clients change their behaviors out of session, and use of my twelve psychology books.
My ideal clients are interested in improving their self awareness of their thoughts, feelings, and behaviors. I treat any of the following issues: depression, anxiety, anger, substance abuse, relationship issues, sexual behaviors, trauma, domestic violence, low self-esteem, eating disorders, attention deficit difficulties, autism, schizophrenia, stress management, Post-Traumatic Stress Disorder, child behavior and attitude problems, school behavior, low motivation, weight loss, quitting smoking, grief and loss of a loved one, divorce, parenting issues, co-dependency, pain management, social skills development, bi-polar disorder, abusive family situations, work problems, shame/inappropriate guilt, and negative thinking but treat many more issues.
(774) 768-0617 View (774) 768-0617
Photo of Lisa M Dagnello, LMHC, LADC1, Counselor
Lisa M Dagnello
Counselor, LMHC, LADC1
Verified Verified
1 Endorsed
Worcester, MA 01604  (Online Only)
I have over 16 years of experience providing CBT, DBT, Solution Focused Therapy, trauma therapy and ACT.
I am accepting new clients age 18 and older. I am a licensed addiction counselor and a licensed mental health clinician. I work with individuals who suffer from anxiety, depression, trauma related disorders, eating disorders and many other mental health and substance use disorders. I believe in person-centered care and will work with a client to reach goals related to interpersonal relationships along with treating the disorder.
I have over 16 years of experience providing CBT, DBT, Solution Focused Therapy, trauma therapy and ACT.
I am accepting new clients age 18 and older. I am a licensed addiction counselor and a licensed mental health clinician. I work with individuals who suffer from anxiety, depression, trauma related disorders, eating disorders and many other mental health and substance use disorders. I believe in person-centered care and will work with a client to reach goals related to interpersonal relationships along with treating the disorder.
(508) 779-5694 View (508) 779-5694
Photo of Juan Eric Gomez, LMHC, Counselor
Juan Eric Gomez
Counselor, LMHC
Verified Verified
1 Endorsed
Worcester, MA 01605  (Online Only)
Above all, I prioritize building authentic connections with my clients based on empathy, trust, and mutual respect. I understand that the therapeutic journey can be challenging, and I am dedicated to walking alongside my clients, empowering them to tap into their inner resources, overcome obstacles, and cultivate meaningful change in their lives. My approach to therapy is grounded in a deep respect for diversity and cultural sensitivity By integrating CBT, Play Therapy, and Expressive Therapy techniques, I aim to empower youth and families to navigate life's challenges with resiliency and compassion and I am a proud LGBTQ+ ally.
Above all, I prioritize building authentic connections with my clients based on empathy, trust, and mutual respect. I understand that the therapeutic journey can be challenging, and I am dedicated to walking alongside my clients, empowering them to tap into their inner resources, overcome obstacles, and cultivate meaningful change in their lives. My approach to therapy is grounded in a deep respect for diversity and cultural sensitivity By integrating CBT, Play Therapy, and Expressive Therapy techniques, I aim to empower youth and families to navigate life's challenges with resiliency and compassion and I am a proud LGBTQ+ ally.
(508) 506-5590 View (508) 506-5590
Photo of Danny Elliott, LCSW, Clinical Social Work/Therapist
Danny Elliott
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Worcester, MA 01605  (Online Only)
Depending on needs and client preference, I am experienced in providing several modalities of treatment, including cognitive behavioral therapy, mindfulness, existential, person-centered, Gestalt, Art, mindfulness, guided meditation and behavioral therapy to name a few.
I provide individual therapy with adults who are ready for change. This may be dealing with issues like ruminating thoughts, anxiety attacks, disassociation, flashbacks, obsessions and compulsions, triggers and cognitive distortions Etc. I specialize in anxiety/panic, PTSD, CPTSD, depression, DID, schizophrenia, substance abuse, and LGBTQIA+-related issues as well as many other conditions.
Depending on needs and client preference, I am experienced in providing several modalities of treatment, including cognitive behavioral therapy, mindfulness, existential, person-centered, Gestalt, Art, mindfulness, guided meditation and behavioral therapy to name a few.
I provide individual therapy with adults who are ready for change. This may be dealing with issues like ruminating thoughts, anxiety attacks, disassociation, flashbacks, obsessions and compulsions, triggers and cognitive distortions Etc. I specialize in anxiety/panic, PTSD, CPTSD, depression, DID, schizophrenia, substance abuse, and LGBTQIA+-related issues as well as many other conditions.
(351) 208-2415 View (351) 208-2415
Photo of Danielle DaRocha - Empowered Pathways Counseling, LLC, LMHC, Counselor
Empowered Pathways Counseling, LLC
Counselor, LMHC
Verified Verified
1 Endorsed
Worcester, MA 01608  (Online Only)
As an LMHC I can provide advanced Training in TF-CBT, DBT, ARC, LGBTQ+, Family Therapy.
“I believe that therapy is a platform that allows people to understand themselves better. The therapeutic relationship provides an opportunity to overcome challenges by trialing coping skills and talking through issues to gain new insight. Engaging in activities of wellness that supports the whole individual promotes continuous healing that allows us to connect to ourselves and others on a deeper level.”
As an LMHC I can provide advanced Training in TF-CBT, DBT, ARC, LGBTQ+, Family Therapy.
“I believe that therapy is a platform that allows people to understand themselves better. The therapeutic relationship provides an opportunity to overcome challenges by trialing coping skills and talking through issues to gain new insight. Engaging in activities of wellness that supports the whole individual promotes continuous healing that allows us to connect to ourselves and others on a deeper level.”
(774) 315-1987 View (774) 315-1987
Photo of Robyn Quilliam, LMHC, Counselor
Robyn Quilliam
Counselor, LMHC
Verified Verified
Worcester, MA 01603
I utilize CBT and 12 Step.
To be human is to have joy and struggle. Without struggle, we know not joy. That being said, sometimes when people make every effort to do their best, they still have hard times in life for many reasons. Sometimes people seek out a professional counselor for help with mental health issues, substance abuse issues or other aspects of life that are difficult to manage alone. Hopefully, by engaging in counseling you will get help in developing and meeting your individual goals and finding solutions to many facets of life that have been difficult, e.g., anxiety, depression, substance abuse, life transitions, etc.
I utilize CBT and 12 Step.
To be human is to have joy and struggle. Without struggle, we know not joy. That being said, sometimes when people make every effort to do their best, they still have hard times in life for many reasons. Sometimes people seek out a professional counselor for help with mental health issues, substance abuse issues or other aspects of life that are difficult to manage alone. Hopefully, by engaging in counseling you will get help in developing and meeting your individual goals and finding solutions to many facets of life that have been difficult, e.g., anxiety, depression, substance abuse, life transitions, etc.
(774) 278-5979 View (774) 278-5979
Photo of Jeffrey White, LICSW, Clinical Social Work/Therapist
Jeffrey White
Clinical Social Work/Therapist, LICSW
Verified Verified
Worcester, MA 01605  (Online Only)
Jeffrey integrates the use of attachment theory, DBT, CBT, psychodynamic, relational, and mindfulness- based approaches to help his clients build their strengths and achieve their goals.
Jeffrey White is a Licensed Independent Clinical Social Worker with over thirty years of experience providing empathic listening and compassionate understanding to adults, couples, and families looking to increase their insight and understanding into how they function, and relate to themselves and others to improve their quality of life. Jeffrey utilizes a strength’s based, here and now approach, to address issues associated with depression, anxiety, PTSD, C-PTSD, relationship betrayal, stress management, self -esteem, co-dependency, life transition, anger management and grief/loss.
Jeffrey integrates the use of attachment theory, DBT, CBT, psychodynamic, relational, and mindfulness- based approaches to help his clients build their strengths and achieve their goals.
Jeffrey White is a Licensed Independent Clinical Social Worker with over thirty years of experience providing empathic listening and compassionate understanding to adults, couples, and families looking to increase their insight and understanding into how they function, and relate to themselves and others to improve their quality of life. Jeffrey utilizes a strength’s based, here and now approach, to address issues associated with depression, anxiety, PTSD, C-PTSD, relationship betrayal, stress management, self -esteem, co-dependency, life transition, anger management and grief/loss.
(508) 257-7304 View (508) 257-7304
Photo of Jessica M Holmes, PhD, LMFT, Marriage & Family Therapist
Jessica M Holmes
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Worcester, MA 01605
I utilize CBT skills and art therapy for individuals, and take an emotionally-focused approach for couples therapy.
Do you ever feel like the odds are against you? Or nothing ever goes right for you? Let's talk about how you can start living the life you want to live! Maybe it's that you have trouble finding the right partner for you. Or maybe you want to feel better about who you are. No matter the issue, together, we can make the changes necessary to improve your life. I love working with clients of all ages who are ready to make the change they've been putting off.
I utilize CBT skills and art therapy for individuals, and take an emotionally-focused approach for couples therapy.
Do you ever feel like the odds are against you? Or nothing ever goes right for you? Let's talk about how you can start living the life you want to live! Maybe it's that you have trouble finding the right partner for you. Or maybe you want to feel better about who you are. No matter the issue, together, we can make the changes necessary to improve your life. I love working with clients of all ages who are ready to make the change they've been putting off.
(508) 863-4892 View (508) 863-4892
Photo of Michael King, MA, LMHC, Counselor
Michael King
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Worcester, MA 01603  (Online Only)
I am a Licensed Mental Health Counselor (Massachusetts & Vermont) with extensive experience treating Substance Use, Mood Disorders, and Personality Disorders using evidence-based practices such as Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Motivational Interviewing. Combining these tried and tested therapies with genuine compassion, validation and understanding is how we will help build insight and resilience to find a path toward the living the life you want.
I am a Licensed Mental Health Counselor (Massachusetts & Vermont) with extensive experience treating Substance Use, Mood Disorders, and Personality Disorders using evidence-based practices such as Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Motivational Interviewing. Combining these tried and tested therapies with genuine compassion, validation and understanding is how we will help build insight and resilience to find a path toward the living the life you want.
(774) 344-3304 View (774) 344-3304
Photo of Michael Cirillo - Cornerstone Behavioral Health, Psychologist
Cornerstone Behavioral Health
Psychologist
Verified Verified
Worcester, MA 01605
Immediate availability for psychiatric medication management with our psychiatric nurse practitioner for individuals ages 16 and up. The mission of Cornerstone Behavioral Health is to provide comprehensive, state of the art behavioral health services by meeting all neuropsychological, assessment, psychiatric and cognitive behavioral therapy needs of our clientele (children, adolescents and adults) in our roles as diagnosticians, therapists, and consultants.
Immediate availability for psychiatric medication management with our psychiatric nurse practitioner for individuals ages 16 and up. The mission of Cornerstone Behavioral Health is to provide comprehensive, state of the art behavioral health services by meeting all neuropsychological, assessment, psychiatric and cognitive behavioral therapy needs of our clientele (children, adolescents and adults) in our roles as diagnosticians, therapists, and consultants.
(508) 644-8911 View (508) 644-8911
Photo of Katrina Baniukiewicz, MA, LMHC, Counselor
Katrina Baniukiewicz
Counselor, MA, LMHC
Verified Verified
Worcester, MA 01605  (Online Only)
I typically utilize a variety of therapy modalities including Cognitive Behavioral techniques, Motivational Interviewing and solution-focused methods.
I enjoy working with individuals with a sense of humor and a desire to understand themselves on a deeper level. I am a Licensed Mental Health Counselor who has been working with individuals seeking a more enjoyable, peaceful and stable way of life since 2014. I prioritize the value of human connection and client/practitioner collaboration to achieve realistic goals and sustainable outcomes while in treatment.
I typically utilize a variety of therapy modalities including Cognitive Behavioral techniques, Motivational Interviewing and solution-focused methods.
I enjoy working with individuals with a sense of humor and a desire to understand themselves on a deeper level. I am a Licensed Mental Health Counselor who has been working with individuals seeking a more enjoyable, peaceful and stable way of life since 2014. I prioritize the value of human connection and client/practitioner collaboration to achieve realistic goals and sustainable outcomes while in treatment.
(774) 220-7868 View (774) 220-7868
Photo of Stephanie Pratico, LMHC, LADC-I, Counselor
Stephanie Pratico
Counselor, LMHC, LADC-I
Verified Verified
Worcester, MA 01602  (Online Only)
My approach is eclectic and client-driven; I am solution-focused and lean towards a CBT style.
July 2024: Currently no waitlist!-I am able to schedule new clients who have daytime (9a-2p) availability. I have considerable experience with substance/addictive disorders and mood disorders-particularly depressive and anxiety disorders. I take a humanistic approach and will listen to your goals and help shape and provide direction to manage your current stresses. I believe a future-focused approach is crucial to become "unstuck." I will end sessions with an emphasis on making concrete positive behavioral changes. We will be developing a treatment plan together, goal setting for each week.
My approach is eclectic and client-driven; I am solution-focused and lean towards a CBT style.
July 2024: Currently no waitlist!-I am able to schedule new clients who have daytime (9a-2p) availability. I have considerable experience with substance/addictive disorders and mood disorders-particularly depressive and anxiety disorders. I take a humanistic approach and will listen to your goals and help shape and provide direction to manage your current stresses. I believe a future-focused approach is crucial to become "unstuck." I will end sessions with an emphasis on making concrete positive behavioral changes. We will be developing a treatment plan together, goal setting for each week.
(508) 501-6557 View (508) 501-6557
Photo of Jacqueline A Fick Cleere, LMHC, CCTP, Counselor
Jacqueline A Fick Cleere
Counselor, LMHC, CCTP
Verified Verified
Worcester, MA 01605
As we work together, I am able to draw upon various therapeutic approaches (incl ACT, DBT and CBT) and specialized trauma training.
Life, at times, seems confusing and difficult. We find ourselves plagued by the past, anxious about the future, or overwhelmed by the stresses of today. Sometimes we feel all of these at once. Seeking help can be a hard thing to do, but seeking help is a courageous first step in making life better. Having worked in the health care and corporate sectors, and having served in the military, I understand some of the challenges you may be facing.
As we work together, I am able to draw upon various therapeutic approaches (incl ACT, DBT and CBT) and specialized trauma training.
Life, at times, seems confusing and difficult. We find ourselves plagued by the past, anxious about the future, or overwhelmed by the stresses of today. Sometimes we feel all of these at once. Seeking help can be a hard thing to do, but seeking help is a courageous first step in making life better. Having worked in the health care and corporate sectors, and having served in the military, I understand some of the challenges you may be facing.
(339) 217-9968 View (339) 217-9968
Photo of Hillary Murphy, LMHC, MA, Counselor
Hillary Murphy
Counselor, LMHC, MA
Verified Verified
4 Endorsed
Worcester, MA 01603
My primary therapeutic approach is Cognitive Behavioral Therapy (CBT).
Currently only accepting clients with OCD and PTSD. My passion is to help others. I specialize in OCD and PTSD treatment and always provide a calm, supportive environment for my clients. I have experience working with people of all ages in both in-person and telehealth settings.
My primary therapeutic approach is Cognitive Behavioral Therapy (CBT).
Currently only accepting clients with OCD and PTSD. My passion is to help others. I specialize in OCD and PTSD treatment and always provide a calm, supportive environment for my clients. I have experience working with people of all ages in both in-person and telehealth settings.
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Cognitive Behavioral (CBT) Therapists

How does cognitive behavioral therapy work?

Cognitive behavioral 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 catastrophizing 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 behavioral therapy?

It’s reasonable to consider cognitive behavioral 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 behavioral therapist for someone else?

To find a cognitive behavioral therapist for someone else, you may want to begin by discussing the person’s problem, researching cognitive behavioral 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.