Cognitive behavior therapy (CBT) programs typically include education, skills acquisition and relapse/maintenance training to help patients retain the information and skills they have learned.

There are various techniques or skills – tailored to each individual patient – that may be taught during CBT sessions, including:

• Cognitive therapy. Techniques to help patients recognize and alter negative emotional responses. Patients are asked to keep track of emotional reactions to events, such as driving in traffic. Common reactions may be anger and frustration, which can lead to increased stress. Patients also keep track of thoughts that occur during events, such as thinking, “I am worthless,” or “This always happens to me.” Patients identify patterns, assumptions and distortions in thought processes and try to reframe them with healthier, more positive ones, such as thinking, “I am deserving of good things in life.” The goal of this technique is to learn to respond, and not react, to stressful or difficult situations.
  
  
• Behavior therapy. Techniques to teach patients how to modify and gain control over their fears, anxieties and unwanted or unhealthy behaviors. Patients gradually learn to cope with difficult situations or stimuli (anything provoking the behavior), typically through controlled exposure to them. The goal of this technique is to give patients a sense of control over their life.
  
  A therapist may also use reinforcement to encourage a particular behavior. For instance, children with attention deficit hyperactivity disorder may receive a gold star every time they stay focused on tasks and accomplish certain daily chores such as school homework assignments. This technique can reinforce and increase the desired behavior by pairing it with a positive outcome. Reinforcement can also be used to gradually do away with unwanted behaviors by imposing negative consequences, also known as punishment and response.
  
  
• Modeling exercises. The therapist and patient engage in role-playing exercises in which the therapist acts out appropriate behaviors or responses to situations.
  
  
• Relaxation therapy. Techniques that teach patients how to relax and balance the physical and emotional effects of stress. These include breathing and relaxation exercises that reinforce the connection between mind and body and give the patient more control when reacting to difficult situations.
  
  
• Keeping a diary or journal. Patients record their daily thoughts, feelings and actions when specific situations arise. This can help them identify negative thought and/or behavior patterns that may be reversed with therapy.