Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy works by making the link between thoughts, feelings, and behavior visible, then changing the parts that can actually be changed. It is the most researched psychotherapy in existence and the first-line recommendation for a long list of conditions.

The premise is simple and does not insult anyone's intelligence: what you think about a situation shapes how you feel about it and what you do next, and the behavior then feeds back into the thought. Depression tells you there is no point trying, so you do not try, so nothing improves, which proves the thought right.

What a CBT session actually involves

Structured and collaborative rather than open-ended. You and your therapist pick a specific problem, look at the thoughts attached to it, test whether they hold up against evidence, and design an experiment — something to try between sessions that would confirm or disconfirm the belief.

There is homework, and it is the part that works. CBT delivers its results between sessions, not during them.

What we use it for

• Depression — behavioral activation and work on the self-critical thinking that keeps it in place
• Anxiety — identifying catastrophic predictions and testing them against what actually happens
• PTSD — cognitive processing of the beliefs a trauma left behind
• Substance use — recognizing the chain from trigger to thought to craving to use, and intervening earlier in it
• OCD, where CBT is delivered specifically as exposure and response prevention

Why it suits group work

CBT translates well to groups because the skills are teachable and the examples generalize. Hearing someone else describe a thought pattern you assumed was yours alone tends to do more than being told about it.

Where this fits in our programs

Therapy at Golden Coast Rehab is delivered inside a program rather than as a standalone service. That means our specialty mental health partial hospitalization and intensive outpatient programs, provided under our County of San Diego contract, and our substance use intensive outpatient and outpatient programs under DHCS certification 370254AP.

Which modalities you work with is decided with your clinician based on what you are dealing with, not assigned by a template.

Coverage and cost

If you have Medi-Cal in San Diego County — any of the four managed care plans — treatment here can be covered at no cost to you. See how Medi-Cal works here.

Call (858) 925-8589, answered 24 hours a day. The San Diego County Access and Crisis Line is available around the clock at 1-888-724-7240.