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What is the CBT Triangle?

7 min.

The cognitive triangle is a critical component of CBT, and helps clients identify and change the thoughts, feelings, and behaviors that impact mental health.

By: Amanda Lundberg

Clinically Reviewed By: Don Gasparini Ph.D., M.A., CASAC

March 2, 2023


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Table of Contents

What is CBT?

According to the Centers for Disease Control and Prevention, 1 in 5 Americans will experience a mental health condition in any year, and 1 in 5 children will have a seriously debilitating mental health disorder.

CBT therapy is a direct and structured approach to supporting a variety of mental health conditions. Strong evidence shows that it helps a person develop better adaptive thoughts and behaviors.  

Your mental health is crucial to stabilizing behaviors, emotions, and thoughts. These three factors are the foundation of a cognitive triangle and form the basis of CBT.

CBT helps individuals understand how their emotions and feelings interact using behavioral therapy and cognitive processing. Many mental health challenges are characterized by recurring negative thoughts, which ultimately affect a person’s feelings and actions.

Cognitive therapy offers a mental health solution to improve a person’s thought life, develop positive emotions and feelings, and affect an individual’s outlook. Our clients work through four essential stages in CBT with a qualified therapist.


During the first stage, you and your skilled provider get to know each other and form an alliance. This helps you to feel optimistic about the results you’ll achieve working together. CBT has no fixed pattern or structure since it is customized to meet your needs.


During this second stage, your mental health provider begins to understand your thought patterns, what triggers them, and why you think the way you do. This provides a foundation for how your thought processes related to your mental health challenges.


During the third stage, you’ll discover new patterns to apply to your thinking. Frequently, the things you think influence your behavior, so establishing a different thinking pattern can help manage symptoms.


During the fourth stage, the goal of CBT is to make these changes permanent and to help you learn how to use the same principles in the future so you do not continue to struggle with the same behaviors and symptoms.

Between meetings with your healthcare provider, you may be asked to engage in activities that help you integrate new thought patterns and behaviors into your daily activities. These strategies address your automatic thoughts and cognitive processing for long-term results.

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What is the CBT triangle?

The cognitive triangle exists independently of cognitive behavioral therapy. Yet, it is a critical component that helps a cognitive behavioral therapist identify conditions that trigger a cascade of thoughts, emotions, and behaviors.

The cognitive triangle of CBT: thoughts, feelings, and behaviors are all connected.

The interrelationship between these can lead to several mental health challenges, including negative thinking thought patterns, obsessive-compulsive disorder, social anxiety, substance abuse disorder, panic disorder, or an eating disorder, to name a few.

Using the cognitive triangle is a strong tool for improving mental health disorders. This enhances your inner peace, allows you to think more clearly, improves relationships, and reduces anxiety.

Aaron T. Beck is widely recognized as a leading researcher in psychopathology, whose CBT system is commonly used fordepression. He believes that unrealistic situational interpretations have a negative impact on subsequent behaviors and can lead to chronic negative thinking patterns.

How the cognitive triangle relates to CBT

CBT was developed in the 1960s by Albert Ellis. Ellis’ approach was known as Rational Emotive Behavior Therapy (REBT), which provided a foundation for the development of CBT. Therapists have successfully used this technique to tackle depression, anxiety, substance abuse, anger, and eating disorders. The cognitive triangle is critical in CBT to help clients simplify the connections between thoughts, emotions, and behaviors.

A cognitive distortion or distorted thinking that affects your emotions and behaviors leads to mental health challenges such as anxiety and depression. CBT focuses on helping a person develop a healthy self-awareness to change negative emotions and therefore shift their feelings and behaviors.

Having negative thoughts is not uncommon. It is common for people to look for potential problems so they can prepare for the future. However, the tendency to be a negative thinker can have the opposite effect. Instead of preparation, you may feel anxious, depressed, and less happy.

An example of the relationship between thoughts, feelings, and actions or behaviors may include an individual who has recurring negative self-talk that they are bad at making friends. This makes them feel discouraged, which affects their behavior, and they stop trying to make friends.

Using the CBT triangle to treat mental illness

There are three basic principles your qualified CBT therapist uses. The first is an understanding that your childhood experiences inform your current core beliefs. In other words, your future is deeply rooted in how you see yourself, which is a product of your experiences as a child.

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The second is that people tend to believe the negative more quickly than they do the positive. This cognitive distortion is irrational, and CBT works to help improve the perception of reality. Finally, CBT addresses automatic negative thoughts that may occur out of habit. They are often brief, difficult to recognize, and trigger negative emotions. Some examples of cognitive distortions include:

  • All-or-nothing thinking, also called polarized thinking
  • Using “should” statements, such as believing you “should never make a mistake”
  • Catastrophizing or seeing the worst outcome in every situation
  • Holding yourself responsible for acts or events beyond your control
  • Jumping to conclusions
  • Labeling yourself or others based on limited evidence
  • Emotional reasoning – for example, “I feel like a lousy husband, so I must be a lousy husband.”

These cognitive distortions can become habitual, yet they are not rooted in fact. CBT helps identify the connections between thoughts, emotions, and resulting behaviors. These connections can predict your work behaviors, relationships, and social situations. Although CBT may appear simple on the surface, it is a powerful tool in the hands of a qualified therapist.

Using the cognitive triangle to combat anxiety and depression

Nearly every person experiences feelings of anxiety and depression. Many people have thoughts that are commonly on autopilot. These repeat with such frequency they have become a habit. For example, thoughts of self-criticism and self-doubt. These thoughts can happen quickly, without self-awareness, and can be extremely difficult to recognize.

  • “I’m not good enough to ______.”
  • “I always fail at _______, so there’s no use trying.”
  • “I’m not as good as ________.”
  • “I can’t learn or get better at ________.”
  • “I don’t look good enough.”
  • “I’m not thin/smart/tall/athletic enough.”

A mental health professional can use several CBT strategies to improve anxiety, depression, and other mental health challenges. Cognitive behavioral therapists use the cognitive triangle to demonstrate how a person’s thoughts can influence their feelings and behavior. This is especially powerful in people who are experiencing depression and anxiety disorders.

Have you noticed there are environmental triggers that can affect your mood? For example, listening to sad music for a long time can make you feel less motivated or increase your feelings of sadness. One way a skilled mental health professional helps clients to stay on top of their thoughts is to help them identify and write down negative thoughts during the day.

This allows people to recognize thought patterns and environmental triggers that initiate those thoughts. Identification is the first step to learning how to avoid these patterns. In some cases, it may feel easy to identify and name emotions, but it’s more challenging to recognize the connected underlying emotion, which may trigger feelings of anxiety.

For example, some parents get angry when their child gets hurt, but the emotion may be triggered by fear of losing their child. Cognitive behavioral therapists use the cognitive triangle as a technique to help organize a client’s approach to changing their thoughts and behaviors. This ultimately improves their mental health.

As young people navigate their education and early career years, mental health is essential to their quality of life. Mental health includes psychological, emotional, and social well-being. It affects all aspects of life and is necessary at every stage.

If you or someone you know may be living with a mental health challenge, our experienced counselors can help identify negative feelings and behaviors that could be early warning signs. Our skilled providers may use an established and recognized cognitive triangle with cognitive behavioral therapy (CBT) to help break negative thought patterns and improve mental health.

Charlie Health is here to help

There is tremendous potential in integrating the cognitive triangle with cognitive behavior therapy. The process is productive, but it is just one resource in an arsenal of strategies that skilled therapists use to help clients overcome mental health challenges.

Charlie Health was founded in 2020 and is the largest virtual mental health clinic for clients age 12 to 28 who struggle with mental health challenges. Our clients have unique advantages afforded by our customized Intensive Outpatient Programming (IOP), including facilitated groups, individual attention, and family support.

Every client is matched with a qualified mental health professional based on their individual needs. Charlie Health provides customized, evidence-based mental health care designed to support mental health healing.

Contact Charlie Health today to learn more.

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