Cognitive Behavioural Therapy (CBT) and Its Variants for PLAB 2
- Ann Augustin
- May 28
- 3 min read
What is CBT?
Cognitive Behavioural Therapy (CBT) is a structured, goal-oriented talking therapy that helps patients identify and change:
Unhelpful thoughts
Maladaptive behaviours
Emotional responses
Core principle:
Thoughts → Feelings → Behaviours are interconnected.
CBT is usually:
Structured
Time-limited
Problem-focused
Collaborative
It is commonly used in NHS mental health services and is highly relevant for PLAB 2 and MSRA exams.
Common CBT Types and Their Uses
Standard CBT
Used for:
Depression
Generalized Anxiety Disorder (GAD)
Panic disorder
Social anxiety disorder
Health anxiety
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Chronic stress
Chronic pain
Insomnia
Common techniques:
Cognitive restructuring
Behavioural activation
Exposure therapy
Thought diaries
CBT-E (Enhanced CBT)
Used mainly for eating disorders:
Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Focuses on:
Restrictive eating
Binge-purge cycles
Body image issues
Weight and shape overvaluation
High-yield association:
Bulimia nervosa → CBT-E
TF-CBT (Trauma-Focused CBT)
Used for:
PTSD
Childhood trauma
Abuse-related psychological symptoms
Focuses on:
Trauma processing
Emotional regulation
Gradual exposure to traumatic memories
EMDR (Eye Movement Desensitization and Reprocessing)
EMDR is a trauma-focused psychotherapy commonly used for:
PTSD
Trauma-related disorders
During EMDR:
The patient recalls traumatic memories
While following side-to-side eye movements or other bilateral stimulation (e.g., tapping or sounds)
The aim is to:
Reduce distress associated with traumatic memories
Help the brain reprocess traumatic experiences
Is EMDR a Type of CBT?
Not exactly.
EMDR is considered a separate trauma-focused psychotherapy, but it overlaps with CBT principles and is often grouped alongside trauma-focused CBT in clinical practice.
TF-CBT vs EMDR
TF-CBT | EMDR |
Focuses more on thoughts and behaviours | Focuses more on trauma reprocessing |
Uses cognitive restructuring | Uses bilateral stimulation/eye movements |
Homework commonly given | Less homework-focused |
Traditional CBT structure | More experiential |
PTSD Treatments (High-Yield)
First-line psychological therapies for PTSD:
Trauma-focused CBT
EMDR
Common exam phrase:
“Offer trauma-focused CBT or EMDR.”
Medication is usually not considered first-line alone unless psychological therapy is unavailable or declined.
CBT-I (CBT for Insomnia)
Used for:
Chronic insomnia
Focuses on:
Sleep hygiene
Sleep restriction therapy
Stimulus control
Relaxation techniques
Preferred long-term treatment over sleeping tablets.
CBT-P (CBT for Psychosis)
Used for:
Schizophrenia
Persistent psychotic symptoms
Focuses on:
Challenging delusional beliefs
Coping with hallucinations
Reducing distress from psychosis
Usually combined with antipsychotic medication.
CBT-SP (CBT for Suicide Prevention)
Used for:
Suicidal ideation
Previous suicide attempts
Focuses on:
Safety planning
Trigger identification
Coping strategies
iCBT (Internet-Based CBT)
Delivered through:
Apps
Online modules
Guided digital therapy platforms
Used for:
Mild to moderate anxiety
Depression
Remote psychological therapy
Group CBT
Used for:
Anxiety disorders
Depression
Social anxiety
Addiction recovery
Benefits:
Peer support
Shared learning
Cost-effective therapy
MBCT (Mindfulness-Based Cognitive Therapy)
Combines:
CBT principles
Mindfulness techniques
Used mainly for:
Recurrent depression relapse prevention
Anxiety
Chronic stress
High-yield association:
Recurrent depression → MBCT
DBT (Dialectical Behaviour Therapy)
A CBT-derived therapy.
Used for:
Borderline personality disorder (Emotionally unstable personality disorder)
Emotional dysregulation
Self-harm behaviours
Focuses on:
Emotional regulation
Distress tolerance
Mindfulness
Interpersonal effectiveness
High-yield association:
Borderline personality disorder → DBT
ACT (Acceptance and Commitment Therapy)
A CBT-related therapy.
Used for:
Anxiety
Depression
Chronic pain
Stress-related disorders
Focuses on:
Acceptance of thoughts
Psychological flexibility
Values-based action
Important CBT Techniques
Exposure and Response Prevention (ERP)
Mainly used in OCD.
Example:
Patient touches a “contaminated” object
Prevented from performing compulsive handwashing
High-yield association:
OCD → CBT with ERP
Behavioural Activation
Mainly used in depression.
Goal:
Increase meaningful activities
Break the cycle of avoidance and low mood
Cognitive Restructuring
Helps patients:
Identify cognitive distortions
Challenge negative automatic thoughts
Examples of cognitive distortions:
Catastrophising
Black-and-white thinking
Overgeneralisation
High-Yield Exam Associations
Condition | Common Therapy |
OCD | CBT with ERP |
PTSD | TF-CBT or EMDR |
Bulimia nervosa | CBT-E |
Chronic insomnia | CBT-I |
Borderline personality disorder | DBT |
Psychosis | CBT-P |
Recurrent depression | MBCT |
Panic disorder | CBT |
Health anxiety | CBT |
NHS Referral Pathway
Many CBT services in the UK are accessed through:
NHS Talking Therapies (formerly IAPT)
Common accepted conditions:
Anxiety
Depression
OCD
PTSD
Panic disorder
Health anxiety
PLAB 2 / MSRA One-Liners
OCD → “CBT with ERP”
Bulimia nervosa → “CBT-E”
PTSD → “TF-CBT or EMDR”
Borderline personality disorder → “DBT”
Chronic insomnia → “CBT-I”
Recurrent depression → “MBCT”
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