Have you tried CBT but still feel like something is missing? This article looks honestly at when CBT helps—and when a deeper, more relational approach may be what you truly need.
What Is CBT, and Why Do Many People Find It Helpful?
Cognitive Behavioural Therapy (CBT) is one of the most common types of therapy offered today. If you have ever been referred for counselling through a GP, or searched for therapy online, you have likely come across it. CBT is often the starting point for people who are struggling with anxiety, panic, depression, or stress.
At its core, CBT is based on the idea that our thoughts, feelings, and behaviours are closely connected. It focuses on helping people notice unhelpful thought patterns and behaviours, and learn how to change them in order to feel better. CBT is usually short-term and structured, with specific goals and practical exercises.
Research has shown that CBT can be very effective, especially when people are dealing with clear and specific issues such as health anxiety, social fears, or exam stress. In these cases, it can offer people relief quite quickly. It gives strategies to cope with distressing thoughts, manage overwhelming emotions, and change certain behaviours that may be keeping them stuck (Axelsson & Hedman-Lagerlöf, 2019; Reiss et al., 2017).
Because of its structure and clear tools, CBT can feel reassuring. For many people, it provides a way to feel more in control when life feels chaotic.
What Are the Limitations of CBT?
Despite its popularity and evidence base, CBT is not without limitations—especially when it is used as a “one-size-fits-all” model.
Research suggests that while CBT is effective in the short term, its benefits may fade over time for many people, particularly those with complex or developmental trauma, longstanding emotional struggles, or deeply embedded patterns. A review by Korotana & Dobson (2016) highlights how CBT often fails to produce lasting change in individuals with adverse childhood experiences or relational trauma.
“CBT showed strong short-term results, but long-term relapse was frequent when early attachment wounds or trauma histories weren’t addressed.”
Korotana & Dobson, 2016
One of the reasons for this is that CBT tends to focus on symptom management rather than deep emotional processing. It teaches clients to change their thoughts—but doesn’t always explore where those thoughts come from, or what emotional pain lies beneath them. In fact, Karatzias & Hyland (2018) found that individuals with attachment-related difficulties were more likely to suppress emotions after CBT rather than express or process them.
Cultural limitations have also been noted. Heim, Karatzias & Maercker (2022) point out that CBT, rooted in Western ideas of rationality and individualism, often fails to address how emotional pain is shaped by social, cultural, and relational factors—something particularly important for clients from diverse backgrounds or those living with complex trauma.
In short, CBT can be efficient—but not always sufficient.
Why I Work Holistically: Depth, Relationship, and Real Change
In my work as a psychotherapist, I often meet people who’ve already tried CBT. Some found it helpful. Others left feeling like they’d been taught to “manage” their pain, but not to understand it. What they were really seeking wasn’t just tools—but connection, clarity, and care.
My approach is relational and integrative. I draw on psychodynamic theory, attachment models, trauma-informed practice, and mindfulness. I may sometimes use CBT tools—but always in the context of a deeper therapeutic process.
Here’s what makes this kind of therapy different:
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It goes beyond symptoms, exploring how early experiences shaped your nervous system, your relationships, and your sense of self
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It makes space for all parts of you, including the ones you’ve had to hide or silence
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It works with the body, not just the mind, recognising that trauma often lives in our physiology, not in our thoughts
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It values the therapeutic relationship itself, because healing often happens through being seen, felt, and held with compassion
Unlike short-term, manualised therapy, this work doesn’t offer a linear path. It’s not about fixing you. It’s about being with you. And in that space—through honesty, curiosity, and safety—something real begins to shift.
Emerging research continues to validate this. Studies on relational depth (Knox, 2015), right-brain attunement (Schore, 2019), and embodied therapy (Ogden & Fisher, 2015) all point to the importance of the therapeutic relationship, especially for people with complex histories.
In a world that often tells us to think our way out of pain, this kind of therapy invites us to feel, remember, and slowly re-connect—with ourselves, and with others.
References
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Axelsson, E., & Hedman-Lagerlöf, E. (2019). Effectiveness of internet-delivered cognitive behavioral therapy for health anxiety: A systematic review. Expert Review of Neurotherapeutics, 19(10), 887–898.
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Heim, E., Karatzias, T., & Maercker, A. (2022). Cultural concepts of distress and complex PTSD: Future directions for research and treatment. Clinical Psychology Review, 91, 102110.
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Karatzias, T., & Hyland, P. (2018). The role of negative cognitions, emotion regulation, and attachment style in complex PTSD: Implications for CBT. British Journal of Clinical Psychology, 57(2), 177–190.
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Knox, R. (2015). Relational Depth in Psychotherapy: Insights from Research. Palgrave Macmillan.
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Korotana, L. M., & Dobson, K. S. (2016). A review of primary care interventions for adult survivors of adverse childhood experiences. Clinical Psychology Review, 43, 34–47.
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Ogden, P., & Fisher, J. (2015). Sensorimotor Psychotherapy: Interventions for Trauma and Attachment. W. W. Norton & Company.
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Reiss, N., Warner, C. M., & Khalid-Khan, S. (2017). Cognitive behavioral therapy in children and adolescents: A meta-analysis of group versus individual treatment. Journal of Affective Disorders, 210, 66–72.
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Schore, A. N. (2019). Right Brain Psychotherapy. W. W. Norton & Company.