How does CBT work? Treating stress, anxiety, insomnia and more

Published May 2026 | 5 min read
Expert contributors: Dr Ben Bravery, psychiatrist, THIS WAY UP; Kate O'Meara, Alcohol and Other Drug Community Engagement Worker, Royal Flying Doctor Service
Words by Lucy E Cousins

Practical and goal-driven, cognitive behavioural therapy (CBT) is one of the most widely used therapies – but how does CBT work and why is it so effective?

Cognitive behavioural therapy (CBT) is an evidence-based therapy that focuses on the link between our thoughts, behaviours and habits. It’s one of the most widely used treatments offered by mental health professionals, because it’s highly effective and easily accessible, says Dr Ben Bravery, a psychiatrist at THIS WAY UP.

Unlike some other forms of therapy, he says CBT isn’t necessarily interested in why you've got a particular disorder, but how you can change the thoughts and behaviours that might be maintaining it.

“To explain, the ‘C’ stands for cognitive, so that's your thoughts and beliefs,” says Dr Bravery. “The ‘B’ is behavioural – that's facing your fears or changing behaviours. Then therapy puts those together so you can better understand yourself and change your behaviour into something that's healthier and more sustainable.”

How does CBT work?

Despite what you might see on a TV drama, a therapist trained in CBT might not ask you about your childhood trauma or get you to look at strange images or interpret your dreams. That’s because CBT is a “doing” therapy, explains Dr Bravery.

“The main reason people try CBT is that it’s practical. They want to feel better about X, Y or Z, and so that goal becomes the focus of the therapy,” he says.

Other types of therapy can lead to what health professionals call ‘drift’, he adds. This is where someone starts off with a particular focus, but then during the sessions the goalposts shift. With CBT, the goal is to address your specific need with tangible steps each week.       

“The mistake some people make is they think reading the material or [attending] the session is the therapy,” says Dr Bravery. “It's not the therapy. The therapy is what they do next.”

What happens in a CBT session?

According to Dr Bravery, a typical in-person CBT session may look like this:

• Review last week’s action plan: check in on progress (e.g. sleep diary, breathing exercises).
• Focus on the session goal: use tools like thought monitoring – perhaps exploring a scenario that makes you anxious and then deconstruct it.
• Recap key learnings: summarise insights about your behaviour or responses noticed during the session.
• Set a new action plan: agree on next steps, like breathwork targets or exercise goals, to keep building coping skills.

Homework might include journalling and tracking mood, sleep or triggers.

Online CBT sessions are a great option, too, especially if you prefer the flexibility and comfort of accessing support from home or have limited access to in-person appointments. THIS WAY UP^* offers a range of online programs that are available free of charge when prescribed by a clinician. This includes programs for:

• depression
• generalised anxiety
• social anxiety
• pregnancy or postnatal anxiety and depression
• obsessive-compulsive disorder (OCD)
• mindfulness
• insomnia
• chronic pain
• stress
• youth issues (e.g. worry, sadness).

Your provider can register with THIS WAY UP and refer you to an appropriate online program under their supervision. Alternatively, you can access the program without a supervising clinician for $59 per course. Depending on your extras cover, we'll also cover the cost of eligible THIS WAY UP programs, up to your annual limit.

Dr Bravery says CBT works well in online programs like THIS WAY UP because it can guide you step by step, prompting the next activity once you’re ready. “It knows when to say ‘here's the next activity to do before you move on’, and this allows you to build your skills nicely.”

What conditions can CBT help with?

CBT can help treat a wide range of unhelpful thought patterns and behaviour.

CBT for anxiety

While experiencing some anxiety is normal, Dr Bravery says if someone's distressed by their anxiety and it's holding them back in some way, CBT can help them develop coping skills. THIS WAY UP offers specific CBT programs for many types of anxiety disorder, from social anxiety disorder to panic disorder and OCD.

CBT for depression

CBT offers practical actions to help break the cycle of negative thinking and withdrawal associated with depression (including antenatal and postnatal depression). “You go back to your thoughts, feelings and behaviours, and usually there'll be something about what you're feeling, what you're thinking and what you're doing that you can tweak,” Dr Bravery explains.

CBT for stress and burnout

Most of us experience stress and burnout when dealing with challenging situations. But it may be time to try CBT if you start thinking, “Am I doing the right things to treat my stress or is there a better way to cope?”, says Dr Bravery.

CBT for substance use

CBT can help with different types of substance use by identifying triggers and habits that might drive cravings.

CBT for mood regulation

Depending on your specific goals and “what's driving the ups and downs”, CBT can help stabilise mood by encouraging balanced thinking and making small, consistent changes, says Dr Bravery.

CBT for insomnia

Insomnia responds extremely well to CBT as sleep is closely linked to our thoughts and behaviour, says Dr Bravery. In the long term, he adds, it can be more effective than medication. 

CBT in regional areas

CBT has been helping rural and regional Australians through a weekly program run by the Royal Flying Doctor Service (RFDS) Alcohol and Other Drug (AOD) team. Based at the Wellbeing Place in Broken Hill, the program offers help with substance use, food disorders, shopping addiction, gambling and other behaviours.

“We work with the four-point SMART [Self Management and Recovery Training] program, which focuses on building and maintaining motivation, coping with urges, managing thoughts, feelings and behaviour, and living a balanced life,” explains Kate O'Meara, RFDS AOD Community Engagement Worker.

The program has been so successful the team is about to expand its group work offering to meet demand, adds Kate.

“Being able to deliver this program in person, in a group, is extremely helpful for Australians living in rural and remote areas,” she explains. “Group work offers other people's perspectives and helps with feelings of isolation.”

Working with others can also help with the stigma of mental health conditions, which still persists in some smaller towns, says Kate. The RFDS estimates about one in five (or 960,000) rural and remote Australians experience a mental illness each year.

Who is CBT not suitable for?

There are a few situations where CBT might not be helpful, says Dr Bravery. This includes when people:

• aren’t ready to change or delve into their thoughts, feelings and behaviours
• think they have to change for someone else – the drive has to come from within
• don’t want to try exposure therapy or attempt behavioural change.

If that sounds like you, Dr Bravery says it may be helpful to try a different therapeutic approach first, where you can have more control over your body, mood and emotion. Then, consider CBT at a later stage.

For advice, speak with your GP. Through our partnership with GP2U, eligible members can access a standard online GP consultation^ (up to 10 minutes) for a fee of $50 to help you get access to care when you need it. Also consider booking an annual telehealth HealthyMinds Check-in with a psychologist, which eligible members can access at no extra cost⁺.

How to get started

In Australia, you don’t need a referral to contact a psychologist or trained therapist to begin using CBT, but a mental health treatment plan from a GP will allow you to claim Medicare rebates for your visit.

Book a CBT session

Ready to get started with CBT? Speak to your GP to understand your options. You can also access a range of evidence-based online treatment programs through THIS WAY UP^*, a mental health service developed by psychiatrists and psychologists, to help you take control of your mental wellbeing.

If you’re struggling and need to speak to someone now, call Lifeline on 13 11 14.