Cognitive Behavioural Therapy (CBT) is commonly considered to be one of the most effective and successful types of talking therapy. In fact, the United Kingdom’s NHS considers it the gold standard therapy – making it the first line of treatment for many different mental health conditions.

CBT can be used to treat a range of conditions – though it is best associated with Depression and Anxiety. Substance Use Disorders, Obsessive Compulsive Disorders and Eating Disorders are other conditions that have been treated.

But for all of the fanfare and support that CBT has, there have also been many criticisms levelled at it. In this article, we take a look at the various criticisms that CBT has.

CBT is very popular, but it does have limitations

What is Cognitive Behavioural Therapy?

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

1. Too simplistic

One of the biggest issues with CBT is the idea that it is too simplistic. The idea that something as simple as changing a regular thought process can result in total remission of symptoms is near-absurd.

It could also be argued that CBT doesn’t take into account all of the areas that contribute to mental illness outside of thoughts, feelings and actions. For example, genetics is believed to play a big role – but this isn’t taken into account by CBT.

2. CBT doesn’t take the past into account

Following on from the above, CBT doesn’t take the past into account – instead the focus is very much on the “here and now”. While for many people focusing on the present is great, this isn’t universal.

CBT fails to take into account the fact that a large number of people who have a mental health condition are affected by a past trauma. This trauma needs to be spoken through and analysed in depth, rather than ignored.

3. High drop-out rates

CBT has also been plagued by high drop-out rates. One study in particular which analysed drop-out rates for seven different types of talking therapy found that CBT had the highest drop-out rate of all seven [1].

But as a caveat, it is important to mention that given how many people are offered CBT, it is unsurprising that there are a large number of people that drop out. It is easier to drop out of the first therapy you are offered – if you know that you will be offered others. This is important to remember.

4. Is it actually effective?

We here almost non-stop good things about CBT. As mentioned, it is often seen as the therapy of choice for many mental health conditions. However, when it comes down to it – is CBT actually as effective as we are lead to believe?

One research study analysed 13 clinical trials of CBT, and compared the findings with those of other therapy types. The researchers found that there was nothing to suggest that CBT was more effective than other types of talking therapy [2].

There are many other studies that back up the findings of the above. It is worth talking about whether or not CBT actually is as effective as professionals consider it to be – given how widely used it is.

5. Chances of relapse

There are also concerns that even for those who do initially succeed with CBT, that relapse is very common. The concern is that when the patient loses the support of their therapist, that they will stop implementing the ideas that they originally followed.

Therapists aim to guard against this by emphasising to the patient the importance of maintaining what they have learned during the sessions. Moreover, they also urge them to employ the techniques they teach – such as deep breathing and though diaries.

But regardless of the above, many people do see their symptoms worsen over time, resulting in them needing to seek further mental health treatment. One study found that out of 439 patients that had received CBT, 53% of them relapsed within a year [3].


It is important to remember that many people have benefitted enormously from CBT. Moreover, many people in the future will see a huge upturn in their mental health due to CBT. There is no denying that it can be effective.

However, it is also important to challenge the idea that CBT should be used to treat so many people. There are many problems with it, and questions remain over its effectiveness. Fortunately for anyone who struggles with CBT, there are a range of other types of talking therapy that exist.

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[1] Cuijpers, P., van Straten, A., Andersson, G., & van Oppen, P. (2008). Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology. 76 (6): p909–922.

[2] Baardseth, T. P., Goldberg, S. B., Pace, B. T., Wislocki, P., Frost, N. D., Siddiqui, J. R., Lindemann, A. M., Kivlighan III, M., Laska, K. M., Del Re, A. C., Minami, T., & Wampold, B. E. (2013). Cognitive-behavioral therapy versus other therapies: Redux. Clinical Psychology Review. 33 (3): p395-405.

[3] Ali, S., Rhodes, L., Moreea, O., McMillan, D., Gilbody, S., Leach, C., Lucock, M., Lutz, W., & Delgadillo, J. (2017). How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study. Behaviour Research and Therapy. 94: p1-8.