Self-guided CBT techniques to improve your mental health

Everyone has moments when they feel overwhelmed or aren’t acting like the best version of themselves. You might snap at a co-worker because you’re stressed out. Or skip your self-care routine if you feel depressed. Or lie awake worrying when you should be sleeping. While stress, fear, sadness, and anger are unavoidable parts of life, you can change how you respond to these feelings.

Cognitive behavioral therapy (CBT) can help you process strong emotions in a healthier way. Your thoughts affect how you feel, and your emotions lead to your actions. If you often worry about the future, feel anxious or angry, or have trouble sleeping, CBT may help you cope and be more effective.

Traditional talk therapy often focuses on the past. CBT gives you tools to help solve problems in the present. Practicing CBT techniques can help you connect what you think to how you feel so you can decide what to do next, says Lorena Roth, licensed clinical social worker and senior director of National Mental Health, Wellness, and Addiction Care for Kaiser Permanente. 

The goal is to pause when you’re having a thought that may not be helpful so you can challenge it, Roth says. Notice how your thought makes you feel and then consciously choose how to respond instead of just reacting. Like mindfulness, CBT offers strategies to help you focus on the present. But it also helps you change the pattern of what you do next.

Worries and problems are normal. “How we frame those worries and what we do about them can help us feel more resilient and confident,” Roth says. Learning CBT techniques can help motivate you to make positive changes in how you interact with loved ones, respond to challenges at work, or care for your physical and mental health.

Some mental health clinicians use CBT techniques with their patients, but you can also use them on your own for everyday challenges. You don’t need to work with a professional or have a mental health diagnosis. CBT techniques can be easy to adopt — they just take practice. If you’re a parent, you can also support your child’s mental health with CBT.

Here are a few CBT techniques that Roth uses with her patients, as well as herself and her family.

Strengthen the mind-body connection

Our bodies react faster than our brains. Physical reactions like a stomachache, sweaty palms, increased heart rate, and shallow breathing can be the first signs you’re feeling anxious, stressed, or angry. Take a few moments to quietly concentrate on your body or breath so you can calm yourself. Then, you’ll be in a better state of mind to address what’s upsetting you.

Progressive muscle relaxation

Methods like progressive muscle relaxation can help reduce physical signs of stress. Focus on your body by tensing and relaxing each muscle group, one at a time.

1. Sit comfortably or lay down.
2. Starting with one foot, squeeze your toes tightly for a few seconds while inhaling deeply through your nose.
3. Release the tension as you exhale through your nose.
4. Repeat with your other foot.
5. Follow your muscle groups up your body and repeat — squeezing and releasing as you breathe.
   • Toes
   • Calves
   • Thighs
   • Glutes
   • Stomach
   • Back
   • Chest
   • Arms and hands
   • Shoulders
   • Neck
   • Face

This CBT technique helps you feel what’s going on in your body and be present in the moment, Roth says.

Box breathing

The Navy SEALs are known to practice box breathing to help calm the “fight or flight” response. This simple exercise can help you relieve stress and get out of your head and into your body, Roth says.

Repeat these steps for a few minutes, or until you feel calmer:

1. Breath in through your nose for a count of 4.
2. Hold your breath in for a count of 4.
3. Exhale through your nose for a count of 4.
4. Hold your breath for a count of 4.

Use progressive muscle relaxation or box breathing to help you clear negative thoughts that are impacting your feelings. Practice them a few times a day — like during your commute, with a meditation, or before bed. When your child is physically upset, sit with them and try to guide them through one of these exercises.

Reframe your perspective

Worrying about the future is a common source of fear and anxiety. But the reality of what happens is often less scary than what we imagine, Roth says.

When you’re feeling anxious or afraid about something, think of 3 different outcomes to help you change your perspective. Identify what’s bothering you, then imagine the:

• Worst-case scenario
• Best-case scenario
• Most likely scenario

Imagining possible scenarios can help you overcome your fears. For example, you may get social anxiety before a party. What could happen if you went? You might be afraid of being judged, but it’s likely that people will be focused more on themselves than on you. It’s also likely that you’ll have a good time with your friends. You might even make a new friend. Research shows that people usually enjoy talking to strangers more than they expected — even if they were afraid to start a conversation.¹

Play the script until the end

You can take reframing a step further and come up with a detailed plan of what you would do if the worst happened. This is known as “playing the script until the end.”

Say you’re afraid of running into someone you don’t want to see. You could imagine the confrontational things they might say and how you would respond. Picturing yourself handling the worst-case scenario can help you realize you’re capable of being resilient if something bad were to happen. This can help relieve your anxiety so you can focus on the present.

Qualify your negative thoughts

When you notice a negative thought or feeling, it can help to soften it by reminding yourself it’s temporary. This is called qualifying. People can get caught up in all-or-nothing thinking when they’re upset, Roth says. For example, if you feel frustrated because one thing went wrong, you may feel like everything is hard. Remind yourself, “I’m having a bad time right now.” This acknowledges how you feel in the moment — and that the feeling won’t last forever.

Another qualifier is to say “yet.” If you’re struggling with a work responsibility, you can qualify your thoughts with, “I’m not good at this task yet.” Did you stumble on your words during a presentation? It’s OK — you haven’t mastered presentations yet. You can take steps to improve your skills. Be open to learning, growing, and trying new things.

This technique can be especially helpful for parents. Young children are constantly learning new things and sometimes get discouraged if they don’t catch on quickly. A child on a soccer team may not have made a goal — yet. Teaching your child to qualify their thoughts can help them build confidence to keep trying.

Practice CBT techniques regularly

These CBT techniques seem simple, but they take practice, Roth says. Use them often and you’ll start to see changes in how you handle situations. 

The more familiar you become with the techniques, the more likely you are to use them when you’re anxious or upset. 

Build resilience with emotional wellness resources

Need extra support? Digital tools like mental wellness apps can help you manage stress, mood, relationships, productivity, and more.

The Headspace app offers mindfulness exercises to help you create healthy habits and navigate difficult situations. It even has a guided program of CBT techniques for anxiety and depression. Kaiser Permanente members can download Headspace at no extra cost.²