CBT Techniques for Depression, Anxiety, and ADHD

CBT techniques for depression, anxiety, and ADHD provide a structured, time-limited psychotherapy course that aims to change patterns of thinking or behavior that are causing people’s problems, and thus change the way they feel. Therapy using CBT methods is a collaborative exploration of the surface patterns that cause immediate distress and the deeper layers of meaning, emotion, and history that shape a person’s life. My approach blends cognitive behavioral therapy techniques — practical tools for challenging unhelpful thinking and behavior — with newer strength based third-wave therapies emphasizing mindfulness, acceptance, and emotional flexibility. I also draw from psychodynamic and existential perspectives, honoring the role of early experiences, unconscious processes, identity, freedom, and the search for meaning.

Cognitive Behavioral Therapy Methods in Practice

Healing is not only about symptom reduction but also about fostering greater self-awareness, resilience, and an authentic connection to one’s values and purpose. I use cognitive behavioral therapy methods in combination with other approaches to provide a powerful, effective treatment course.

CBT Techniques Overview

Here’s a breakdown of key cognitive behavioral therapy techniques, with detailed explanations:

Cognitive Restructuring or Reframing CBT Techniques

Goal: Use CBT methods to identify and challenge negative thought patterns and replace them with more balanced ones.

• How it works:
  • Identify the negative automatic thoughts (e.g., “I always fail.”)
  • Examine the evidence for and against these thoughts.
  • Challenge distortions like catastrophizing, black-and-white thinking, or mind reading.
  • Replace with a more realistic or compassionate thought.
• Example:
  • Thought: “If I don’t do this perfectly, I’m a failure.”
  • New Thought: “Doing my best is enough, and mistakes help me learn.”

CBT Techniques and Behavioral Activation

Goal: Use CBT methods to increase engagement with positive and rewarding activities to combat depression and avoidance behaviors.

• How it works:
  • Track daily activities and mood.
  • Identify avoidance patterns.
  • Schedule specific positive activities (even small ones).
  • Gradually increase participation in these activities, even if motivation is low.
• Example: Scheduling a 10-minute walk even when feeling low, to break the inactivity cycle.

Exposure and Response Prevention Cognitive Behavioral Techniques

Goal: Use CBT methods to reduce fear and avoidance by gradually facing feared objects, activities, or situations.

• How these cognitive behavioral techniques work:
  • Develop a fear hierarchy: list fears from least to most scary.
  • Gradually expose yourself to these fears in a safe, controlled way.
  • Stay in the feared situation long enough to experience anxiety decrease.
  • Repeat exposures until the fear reduces (habituation).
• Example: Someone afraid of dogs might first look at pictures, then watch videos, then visit a dog park from a distance, and eventually pet a dog.

Activity Scheduling and Planning

Goal: Structure the day to improve mood and productivity.

• How it works:
  • Create a detailed schedule for the day or week.
  • Include pleasurable activities, mastery activities (building skills), and necessary tasks.
  • Helps counter procrastination, hopelessness, and lack of motivation.
• Example: Planning “clean kitchen for 10 minutes” at 5 PM and “call a friend” at 7 PM.

Solution-Focused CBT Therapy Techniques

Goal: Improve coping by teaching structured CBT methods to solve real-world problems.

• How it works:
  • Clearly define the problem.
  • Brainstorm possible solutions without judging them.
  • Evaluate pros and cons.
  • Choose the best option and create an action plan.
  • Review outcome and revise if needed.
• Example: Deciding how to approach a conflict with a coworker by generating options and choosing a respectful conversation.

Mindfulness-Based CBT Methods

Goal: Increase awareness of the present moment and reduce judgment of thoughts.

• How it works:
  • Practice observing thoughts, feelings, and body sensations without reacting.
  • Use breathing exercises, body scans, or meditation.
  • Learn to allow thoughts to come and go without clinging to them.
• Example: Notice anxiety rising before a presentation, acknowledge it without self-criticism, and refocus on breathing.

Distortion Identification

Goal: Use CBT methods to recognize specific types of faulty thinking that maintain emotional distress.

• Common cognitive distortions:
  • All-or-nothing thinking (“If I’m not perfect, I failed.”)
  • Overgeneralization (“I didn’t get this job; I’ll never succeed.”)
  • Mental filter (focusing only on the negatives).
  • Discounting the positive.
  • Jumping to conclusions (mind reading, fortune-telling).
• Technique:
  • Catch the distortion.
  • Label it.
  • Reframe the thought.

Socratic Questioning CBT Methods

Goal: Encourage critical thinking to challenge harmful beliefs using cognitive behavioral therapy methods.

• How it works:
  • I (or you) ask open-ended, guiding questions to explore the validity of beliefs.
  • Examples of Socratic questions:
    • “What evidence supports this thought and what evidence contradicts it?”
    • “What would I tell a friend in this situation?”
    • “Is there another way to look at this?”
• Example: If you believe “I’m worthless,” a series of questions might reveal many past successes that contradict that belief.

Cognitive Behavioral Techniques for Relapse Prevention

Goal: Use cognitive behavioral therapy techniques to prepare for future challenges and setbacks after therapy ends.

• How it works:
  • Identify early warning signs of relapse (e.g., increased isolation).
  • Develop a personal action plan (e.g., seeking support, using coping skills).
  • Normalize setbacks as part of growth.
• Example: A checklist of coping strategies ready to use when early signs of depression reappear.

Thought Records

Goal: Use CBT methods to track situations, thoughts, emotions, and alternative thoughts.

• How it works:
  • Fill out structured worksheets.
  • Typical columns:
    • Situation
    • Emotion (intensity 0–100%)
    • Automatic thought
    • Evidence for/against
    • Alternative thought
    • Outcome (emotions after rethinking)
• Example:
  • Situation: “Got critical feedback at work.”
  • Emotion: “Embarrassed (80%)”
  • Thought: “I’m incompetent.”
  • Evidence for: “I made some mistakes.”
  • Evidence against: “I usually do well; feedback is common.”
  • Alternative: “This is a learning opportunity.”
  • Outcome: “Less embarrassment (40%)”

Case example: CBT Techniques for Anxiety

Name: Emma
Age: 16
Presenting Problem: Emma struggles with intense social anxiety. She worries constantly about being judged at school, avoids raising her hand in class, and recently started skipping social events like parties and group projects. She reports feeling nauseous and shaky when around peers. Her grades have dropped due to participation fears.

Assessment:

• Automatic Thoughts: “Everyone will think I’m stupid.” “If I say something wrong, I’ll be humiliated.”
• Core Beliefs: “I am not good enough.” “I must be perfect to be liked.”
• Behavioral Responses: Avoids speaking in class, avoids social gatherings, pretends to be sick.

We decided that cognitive behavioral therapy methods would help address these symptoms. Therapy for presentation anxiety and social worries would be the focus.

CBT Techniques for Anxiety Applied:

1. Psychoeducation about CBT Techniques for Anxiety

• Explained what anxiety is (fight/flight response) and how avoidance actually strengthens anxiety.
• Normalized that everyone feels judged sometimes, but avoidance keeps fears alive.
• Introduced CBT methods as a way to change how she thinks and acts to feel better.

2. Cognitive Restructuring CBT Techniques for Anxiety

• Identified Negative Thoughts:
  • Example: Before a class discussion, Emma thinks: “If I say the wrong thing, people will laugh at me.”
• Challenge/Restructure:
  • Evidence for: “Sometimes people giggle, but not always at me.”
  • Evidence against: “I’ve answered questions right many times before.”
  • New Thought: “Even if I stumble, most people won’t notice — and mistakes are normal.”

3. Exposure CBT Therapy Techniques (gradual exposure to feared situations)

• Created a fear hierarchy:
  • 1/10: Saying “hi” to a classmate.
  • 4/10: Answering a question wrong in a small group.
  • 7/10: Speaking in front of the full class.
  • 10/10: Giving a formal speech.
• Planned gradual exposures:
  • Start with saying “hi” daily to two people.
  • Progress to asking one question in a small group.
  • Then move to volunteering a short answer in class.
• She stayed in the feared situation long enough to let the anxiety naturally decrease (rather than escaping).

4. Behavioral Experiments

• Set up experiments to test beliefs.
• Example: Emma believes if she answers wrong, classmates will laugh.
• Plan: She volunteers a simple answer, even if unsure.
• Outcome: Nobody laughs. Some nod supportively.
• Conclusion: Her belief was inaccurate; most people aren’t focused on her.

5. Thought Records (CBT Techniques for Anxiety Daily Homework)

Emma keeps a journal:

6. Relaxation and Coping Skills

• Taught breathing exercises (e.g., “4-7-8 breathing”: inhale 4 sec, hold 7 sec, exhale 8 sec).
• Introduced Progressive muscle relaxation: Tense and release muscles to lower physical anxiety symptoms.
• Mindfulness moments: She practiced focusing attention on the present (sounds, sensations) during anxious moments.

7. Problem-Solving Cognitive Behavioral Therapy Techniques

• Problem: Feeling lonely because she avoids parties.
• Steps:
  • Identified the problem.
  • Brainstormed options (e.g., attend a party for just 20 minutes, bring a supportive friend).
  • Chose a doable action.
  • Evaluated the experience afterward.

8. Relapse Prevention Plan

• Taught Emma to notice early signs of rising anxiety (increased avoidance thoughts).
• Developed a mini-action plan of cognitive behavioral therapy techniques:
  • Re-engage with exposures.
  • Revisit positive coping thoughts.
  • Use relaxation strategies early.

Results after several months of CBT Therapy Techniques:

Cognitive behavioral therapy for anxiety resulted in:

• Emma gradually participates more in class discussions.
• She attended a school dance for the first time without leaving early.
• She reports moderate anxiety but no longer avoids social settings.
• Her self-confidence and mood significantly improve.

Case example: CBT Techniques for Depression

Name: Lisa
Age: 34
Presenting Problem: Lisa reports persistent low mood, fatigue, hopelessness, and withdrawal from friends and hobbies over the past 6 months. She often thinks, “Nothing I do matters,” and “I’m a burden to everyone.” She has stopped exercising, spends most weekends in bed, and feels overwhelmed by small tasks.

CBT Assessment:

• Automatic Thoughts: “I’m useless.” “Things will never get better.”
• Core Beliefs: “I’m a failure.” “I’m unlovable.”
• Behavioral Responses: Isolation, inactivity, avoidance of work and personal responsibilities.

We chose a treatment course centered on cognitive behavioral therapy techniques for depression.

CBT Techniques for Depression Applied

1. Psychoeducation

• Taught Lisa about the cycle of depression:
  • Negative thoughts → Low mood → Inactivity → Reinforced negative thoughts.
• Introduced cognitive behavioral therapy techniques for depression as a way to interrupt this cycle by changing thoughts and behaviors.

2. Behavioral Activation CBT Techniques for Depression (First priority)

• Depression often leads to withdrawal and inactivity, which worsens the mood.
• Action Plan:
  • Identify activities Lisa used to enjoy or find meaningful (e.g., yoga, reading, coffee with friends).
  • Start very small: One pleasurable or mastery task per day, even if motivation is low.
  • Use activity scheduling with checkboxes to create a sense of accomplishment.
• Example:
  • Monday: 5-minute stretch
  • Tuesday: Call sister for 5 minutes
  • Wednesday: Walk to mailbox
• Outcome: Completing small tasks builds momentum, boosting mood through real experiences.

3. Cognitive Restructuring CBT Techniques for Depression

• Identify negative automatic thoughts (e.g., after sleeping late: “I’m so lazy; I’ll never get better.”)
• Challenge and Reframe:
  • Evidence for: “I overslept today.”
  • Evidence against: “I’ve been very tired; my body may need extra rest. I’ve completed other tasks this week.”
  • Alternative thought: “One day doesn’t define my progress.”
• Introduce a “Thought Diary”: Lisa records daily thoughts, feelings, evidence, and reframed thoughts.

4. Cognitive Distortion Identification

• Teach Lisa about common distortions she frequently uses, like:
  • All-or-nothing thinking (“Either I’m successful or a total failure.”)
  • Overgeneralization (“This mistake means I always fail.”)
  • Fortune telling (“Things will never get better.”)
• Technique:
  • Spot the distortion.
  • Label it.
  • Reframe the thought logically.

5. Problem-Solving Cognitive Behavioral Therapy Techniques for Depression

• Address overwhelming tasks (e.g., unpaid bills).
• Steps:
  • Clearly define the problem.
  • Break it into small, specific parts.
  • Brainstorm possible steps (e.g., open bills, make a list, call the utility company).
  • Choose one small first step.
• Example: Opening the stack of unopened mail without having to act immediately.

6. Activity Scheduling and Monitoring Mood

• Lisa logs daily activities and rates her mood (0–10).
• Goal: Notice connections between activities and feelings.
• Example: Mood 2/10 after lying in bed all day, but 5/10 after a short coffee outing.
• Insight: Even small actions influence mood positively.

7. Behavioral Experiments (Challenging Beliefs with CBT Techniques for Depression)

• Belief: “If I reach out to my friends, they will be annoyed.”
• Experiment: Send a simple text (“Thinking of you — hope you’re well”).
• Outcome: Friends respond warmly.
• Conclusion: Her belief is not accurate; she’s valued.

8. Relapse Prevention Plan Using Cognitive Behavioral Therapy Techniques for Depression

• Prepare for setbacks:
  • Identify early warning signs (e.g., stopping activities, increased negative thinking).
  • Create an action plan (restart activity scheduling, call therapist or supportive friend).
  • Normalize that setbacks are not failures, but chances to use skills.

Results after 3–4 months of CBT Methods:

CBT for depression resulted in:

• Lisa steadily re-engages in life: short daily walks, occasional dinners with friends, pursuing a small side project.
• Her thoughts are more balanced.
• She reports feeling hopeful about the future and experiencing fewer “hopeless” days.

Quick Summary of CBT Techniques Used:

Case example: CBT Techniques for ADHD

Name: Jordan
Age: 20
Presenting Problem: Jordan is a college sophomore struggling with focus, procrastination, missed deadlines, and emotional frustration. He often feels overwhelmed by large assignments, starts but rarely finishes projects, and calls himself “lazy” or “stupid” when he falls behind. He had psychological testing for  ADHD in high school, but he never received structured support.

CBT Assessment:

• Automatic Thoughts: “I’ll never be able to manage this workload.” “Everyone else is better at this than me.”
• Core Beliefs: “I’m incapable.” “I’m not good enough.”
• Behavioral Responses: Procrastination, avoidance of large assignments, late-night cramming, perfectionism leading to shutdown.

Cognitive behavioral techniques seemed like a perfect fit.

CBT Techniques for ADHD Applied:

1. Psychoeducation on CBT techniques for ADHD and Executive Function

• Taught Jordan about how ADHD impacts:
  • Task initiation
  • Working memory
  • Planning and organization
  • Emotional regulation
• Normalized that his struggles are brain-based and not because he’s “lazy” or “stupid.”
• Framed ADHD management as a skills training process, not a personal flaw.

2. Cognitive Restructuring CBT Techniques for ADHD

• Identify Negative Automatic Thoughts:
  • Example: “This project is too big. I can’t even start.”
• Challenge/Restructure:
  • Evidence for: “It feels overwhelming.”
  • Evidence against: “I have completed large projects before, one step at a time.”
  • New Thought: “I don’t have to finish it all today. I can start with a small piece.”
• Daily Reframing Practice: Jordan writes down 1 negative thought a day and reframes it.

3. Behavioral Activation and Task Structuring

• Break tasks into small, specific steps.
  • Instead of “Write research paper,” the task becomes:
    • Open Word document
    • Write paper title
    • Find and save 3 journal articles
• Use “micro-tasking”: 5–10 minute work bursts with a clear goal.
• Example:
  • Monday: Find sources (10 minutes).
  • Tuesday: Outline first two sections (15 minutes).
  • Wednesday: Write intro paragraph.

4. Implementation Intentions (“If-Then Planning”)

• ADHD brains benefit from pre-deciding actions:
  • Example: “If I sit down at my desk after lunch, then I will open my laptop and work for 10 minutes.”
• Helps reduce reliance on willpower and increase automatic behavior.

5. Externalization of Memory and Planning

• ADHD often impacts working memory. Using cognitive behavioral therapy methods, Jordan is taught to:
  • Use external reminders (whiteboards, sticky notes, phone alarms).
  • Set visible, immediate cues for actions (“When the phone alarm rings, time to switch subjects”).
  • Plan in visual blocks (color-coded calendars).

6. Time Management and “Time Anchoring”

• Time Blindness is common in ADHD: tasks seem endless or fleeting.
• Cognitive behavioral therapy methods:
  • Use timers (Pomodoro technique: 25 mins focus, 5 min break).
  • Visibly block out time for tasks in calendar (e.g., “Study psych 3–3:30 PM”).
  • Celebrate micro-completions (e.g., “I studied 2 chapters!”).

7. Emotional Regulation Cognitive Behavioral Therapy Methods

• ADHD often comes with intense frustration or shame.
• Jordan learns CBT techniques, including:
  • Self-soothing skills (e.g., grounding techniques when overwhelmed).
  • Coping statements (“It’s okay to feel frustrated — I can still take the next small step.”).
  • Naming feelings instead of reacting immediately (“I’m feeling stuck, not lazy.”).

8. Problem-Solving Cognitive Behavioral Therapy Methods

• Example Problem: “I never finish homework on weekends.”
• Steps:
  • Define problem clearly.
  • Brainstorm options (e.g., study in a coffee shop, work with a friend, set morning alarms).
  • Choose one to try.
  • Evaluate results and adjust.

9. Relapse Prevention and Self-Compassion Using CBT Techniques for ADHD

• Jordan creates a self-support plan for bad days:
  • Notice early signs (e.g., “I’m endlessly scrolling TikTok instead of starting homework”).
  • Use a “reset” routine (e.g., take a 5-minute walk, reset timer, reframe thought).
  • Emphasize progress, not perfection: missing one day doesn’t mean failure.

Results after 3–4 months of Cognitive Behavioral Therapy Methods:

CBT for ADHD resulted in:

• Jordan regularly uses a planner for deadlines.
• He gets therapeutic tutoring to get the academic help he needs, with an understanding of the challenges and benefits of ADHD
• He tackles assignments in smaller steps, reducing procrastination.
• CBT methods have made his inner dialogue more compassionate (“I’m working with my ADHD, not against it.”).
• GPA improves, and he feels more confident in managing college life, continuing to use cognitive behavioral techniques.

Quick Summary of Cognitive Behavioral Therapy Methods Used:

I amso use these methods in ADHD treatment for teens.

My Work With Cognitive Behavioral Therapy Methods

Using CBT methods, you’ll find structure and depth: concrete strategies to manage everyday challenges and space to explore the larger questions of who you are and how you want to live. Whether we are addressing anxious thoughts, navigating painful emotions, revisiting early relational patterns, or confronting existential uncertainty, my goal is to support you in building a life that feels both empowered and deeply true to you. Cognitive behavioral therapy methods are powerful and effective!

CBT techniques are not about becoming a “perfect” version of yourself — it’s about growing into a more compassionate, resilient, and self-accepting one. If you want to learn more about how cognitive behavioral therapy techniques for depression, anxiety, or ADHD might help you or a loved one, please contact me or schedule a consultation.

Dr. Alan Jacobson Founder and President

Dr. Jacobson is a licensed clinical psychologist providing individual, couples, and family therapy for over 20 years. He uses an integrative approach. choosing from a variety of proven and powerful therapeutic methods.

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